Objective:This study aims to compare the difference in the expression levels of prostaglandin E2 (PGE2), vascular endotheli-al growth factor (VEGF), and the clinicopathological features among gastric carcinoma patients with and without hyperlipidemia and to assess whether hyperlipidemia promotes gastric carcinoma progression. Methods:We analyzed the PGE2 and VEGF serum levels and the VEGF expression in gastric carcinoma tissues in 102 gastric carcinoma patients. The PGE2 and VEGF serum levels were detected by enzyme-linked immunosorbent assay, and the VEGF expression in gastric carcinoma tissues was detected by SABC immunohistochemi-cal staining. Results:Among the 102 gastric carcinoma patients, 49 patients had hyperlipidemia, and 53 did not have the condition. The PGE2 and VEGF expressions in the serum and the VEGF expression in gastric carcinoma tissues were higher in hyperlipidemic pa-tients than in those without hyperlipidemia (P<0.05). The degrees of differentiation, depths of invasion, lymph node metastasis, and TNM staging in the two groups also showed statistical differences (P<0.05). Conclusion:Hyperlipidemia possibly contributes to the pro-gression of gastric carcinoma by upregulating the PGE2 and VEGF expressions.

Objective To evaluate the effectiveness of treatment for osteoarthritis of the first carpometacarpal joint.Methods From June 2019 to June 2022,15 patients with osteoarthritis of the first carpometacarpal joint underwent a combined procedure of trapezium excision,first carpometacarpal joint arthroplasty,ligament reconstruction,and tendon interposition.Surgical efficacy was assessed using X-rays,thumb joint range of motion,grip strength,pinch strength,and pain rating(VAS).Results 9 months postoperative follow-up revealed significant pain reduction,increased thumb range of motion,enhanced grip and pinch strength,with an overall surgical excellence rate of 86.7％.Conclusion Trapeziecotomy arthroplasty with ligament reconstruction and tendon tamponade demonstrates significant efficacy in treating osteoarthritis of the first carpometacarpal joint,effectively alleviating pain,improving thumb mobility,and enhancing hand strength.The method is simple and effective.

BACKGROUND: Posterior pedicle screw fixation of lower cervical spine has many advantages. However, because of the special anatomy of pedicle, the technical requirements of nailing placement are high and it is also a challenge to surgeons. The application of three-dimensional (3D) printing technology can help to complete screw placement, and has certain advantages. OBJECTIVE: To introduce the method of 3D printing personalized navigation template assisted posterior lower cervical pedicle screw fixation and evaluate its clinical application value. METHODS: Totally 20 patients with lower cervical spine pedicle screw internal fixation who were treated from June 2015 to December 2016 in Affiliated Hospital of Yan'an University were retrospectively analyzed. Before the surgery, the patient's lower cervical spine CT data was introduced into the relevant software and the 3D printing personalized navigation template assisted nailing pedicle screw was designed. The number of screws inserted was recorded. After the operation, CT scan was used to calculate the accuracy rate of screw placement. Preoperative and postoperative cervical spine Visual Analogue Scale score and spinal function score of Japanese Orthopedic Association were used to evaluate the clinical effect of cervical nerve. RESULTS AND CONCLUSION: (1) All patients were followed up for 3 months postoperatively. (2) 3D printing personalized navigation template assisted 132 pedicle screws. The precise insertion rate was 94.7%. Among them, 125 screws were at grade 0 (94.7%, 125/132), 3 screws grade 1 (2.3%, 3/132), 4 screws grade 2 (3.0%, 4/132), no screw grade 3. (3) At postoperative 1 and 3 months, the neck shoulder Visual Analogue Scale score and spinal function score of Japanese Orthopedic Association of the patients were significantly improved (P < 0.05), but there was no significant difference (P > 0.05), compared with those at preoperative. (4) In summary, 3D printing personalized navigation template assisted cervical pedicle screw placement had the high insertion rate and satisfactory clinical efficacy.

Objective: : Covered stenting is an optional strategy for traumatic carotid pseudoaneurysm, especially in malignant conditions of potential rupture, but the long-term outcomes are not clear. Our aim was to determine if covered stenting is an effective option for traumatic carotid pseudoaneurysm with promising long-term outcomes. Methods: : Self-expanding Viabahn and balloon-expandable Willis covered stents were separately implanted for extra- and intracranial traumatic carotid pseudoaneurysm. The covered stent was placed across the distal and proximal pseudoaneurysm leakage under roadmap guidance. Procedural success was defined as technical success (complete exclusion of the pseudoaneurysm and patency of the parent artery) without a primary end point (any stroke or death within 30 days after the procedure). Longterm outcomes were evaluated as ischemic stroke in the territory of the qualifying artery by clinical follow-up through outpatient or telephone consultation and as the exclusion of the pseudoaneurysm and patency of the parent artery by imaging follow-up through angiography. Results: : Five patients with traumatic carotid pseudoaneurysm who underwent covered stenting were enrolled. The procedural success rate was 100%. No ischemic stroke in the territory of the qualifying artery was recorded in any of the five patients during a mean clinical follow-up of 44±16 months. Complete exclusion of the pseudoaneurysm and patency of the parent artery were maintained in all five patients during a mean imaging follow-up of 39±16 months. Conclusion : Satisfactory procedural and long-term outcomes were obtained, suggesting that covered stenting is an effective option for traumatic carotid pseudoaneurysm.

Objective To propose a method for classifying small bowel capsule endoscopy images by combining the Swin Transformer network with an improved Adapt-RandAugment data augmentation approach,aiming to enhance the accuracy and efficiency of small bowel lesion classification and recognition.Methods An Adapt-RandAugment data augmentation approach was formulated based on the RandAugment data enhancement sub-strategy and the principles of no feature loss and no distortion when enhancing small bowel capsule endoscopy images.In the publicly available Kvasir-Capsule dataset of small bowel capsule endoscopic images,the Adapt-RandAugment data augmentation approach was trained based on the Swin Transformer network,and the convolutional neural networks ResNet152 and DenseNet161 were used as the benchmarks to validate the combined Swin Transformer network and Adapt-RandAugment data augmentation approach for small bowel capsule endoscopy image classification.Results The proposed algorithm gained advantages over ResNet152 and DenseNet161 networks in the indicators,which had the macro average precision(MAC-PRE),macro average recall(MAC-REC),macro average F1 score(MAC-Fi-S)being 0.383 2,0.314 8 and 0.290 5 respectively,the micro average precision(MIC-PRE),micro average recall(MIC-REC)and micro average F1 score(MIC-Fi-S)all being 0.755 3,and the Matthews correlation coe-fficient(MCC)being 0.452 3.Conclusion The proposed small bowel capsule endoscopy image classification method based on Swin Transformer network and Adapt-RandAugment data augmentation approach behaves well in classified recognition efficiency and accuracy.[Chinese Medical Equipment Journal,2024,45(6):9-16]

Objective To investigate the association between single nucleotide polymorphisms ( SNPs) of FOXO1 gene and type 2 diabetic nephropathy(T2DN). Methods A total of 654 Chinese Han patients with type 2 diabetes mellitus (T2DM;394 without and 260 with T2DN) were enrolled. Six FOXO1 gene tags SNPs were selected using the Hapmap database. The genotypes of six SNPs in FOXO1 were determined by PCR-RFLP, and the clinical characteristics of the subjects were also evaluated. The interaction of SNPs with these clinical factors was analyzed by multiple factor reduction(MDR) method. Results After adjusting for age, gender, DM course, body mass index ( BMI ) , HbA1C , total cholesterol ( TC ) , triglycerides ( TG ) , high-density lipoprotein-cholesterol ( HDL-C ) , low-density lipoprotein-cholesterol ( LDL-C ) , hypertension history, DM family history, smoking, and drinking, FOXO1 rs17446614 variant genotype was significantly associated with an increased risk of T2DN, while rs17446593 variant genotype was associated with a decreased T2DN risk. In the stratified analysis of risk factors, the correlation between rs17446614 and T2DN was unrelated with patient' s gender, hypertension history, and blood TC level. Simultaneously, rs17446614 variant genotype significantly increased the risk of T2DN in people older than 60 years,BMI less than 24 kg/m2 , LDL-C less than or equal to 3. 5 mmol/L , or DM family history. rs2721068 variant genotype significantly decreased the risk of T2DN in people less than 60 years old or without DM family history. rs2951787 variant genotype significantly increased the risk of T2DN in people with DM duration longer than 10 years or with DM family history. A variant genotype rs17592236 significantly increased the risk of T2DN in male or TC higher than 5 mmol/L. A variant genotype rs17446593 significantly decreased the risk of T2DN in male or those DM duration longer than 10 years, or BMI≥24 kg/m2 . The interactions among rs17446614, DM duration, TC, and hypertension history were also observed. Conclusion The genetic variants rs17446614, rs2721068, rs2951787, rs17592236, and rs17446593 in FoxO1 may contribute to the risk of T2DN in T2DM patients.

To provide a scientific evidence for the initial primary processing method, an ultra-high performance liquid chromatography combined with a triple quadrupole electrospray tandem mass spectrometry (UPLC-MS/MS) was used to analyze the contents variation of catechins, flavonoids, flavonoid glycosides, biflavones, terpene lactones and phenolic acids during the process of drying in the sun, in the shade, and baked with 35, 45, 60, 80 degrees C, respectively. The results show that drying in the 80 degrees C is conducive to the accumulation of catechins, flavonoid glycosides, terpene lactones, better than the effects of other procedures. Therefore, the fast drying at 80 degrees C is beneficial for the retention of various types of active ingredient of Ginkgo biloba, and this method could be applied as a preferably dry processing.
Chromatography, High Pressure Liquid ; Ginkgo biloba ; chemistry ; Plant Leaves ; chemistry ; Tandem Mass Spectrometry ; Technology, Pharmaceutical

Objective To evaluate the performance of the Sendai Guidelines,Fukuoka Guidelines and Pancreatic Cystic Lesions Management Guidelines (Chinese guidelines) in predicting malignant mucinous pancreatic cystic neoplasms (PCN).Methods A retrospective analysis of 196 patients,who received surgery and were pathologically identified as PCN or intraductal papillary mucinous neoplasms (IPMN),underwent surgical resection in Ruijin Hospital affiliated with Shanghai Jiao Tong University from January 2003 to April 2017 was performed.The differences on clinical and pathological parameters between malignant mucinous and benign mucinous PCN were compared.The accuracy,sensitivity,specificity,positive predictive value (PPV)and negative predictive value (NPV) of the indications for surgery in the Sendai,Fukuoka and Chinese Guidelines in predicting malignant mucinous PCN were calculated.Results Of 196 patients,39 patients (19.9％) were confirmed as malignant tumors and 157 patients (80.1％) were confirmed as benign tumors by pathology.There were significant differences on age,symptoms (abdominal pain,jaundice or pancreatitis),tumor solid composition,pancreatic duct diameter,tumor site,tumor diameter ＞3 cm,and serum CA199 level between malignant and benign patients (all P ＜0.05).But there were no significant differences on gender distribution,tumor diameter,mural nodules and the proportion of mucinous cystic neoplasm (MCN)and intra-ductal papillary mucinous neoplasm (IPMN).165 patients (84.2％) met the Sendai Guidelines,153 patients (78.1％) met the Chinese guideline,and only 61 patients (31.1％) met the Fukuoka Guidelines.All 39 patients with malignant tumors met the indications in Sendai Guidelines and Chinese guidelines,and only 35 patients had the indication for surgery in the Fukuoka Guidelines.The accuracy,sensitivity,specificity,PPV and NPV of the Fukuoka Guidelines for predicting the malignancy were 84.7％,89.7％,83.4％,57.4％ and 97.0％,compared to 35.7％,100％,19.8％,23.6％ and 100％ for the Sendai and 41.8％,100％,27.4％,25.5％ and 100％ for the Chinese guidelines,respectively.Conclusions The performance of the Chinese guideline is slightly better than the Sendai Guidelines,while both of them can lead to a larger number of patients undergoing unnecessary surgical resection.Though the rate of missed diagnosis could reach 10.3％,the Fukuoka Guidelines gets the highest accuracy.

Objective To understand the changes of hepatitis B infection rates,before and after the hepatitis B vaccine Was included into EPI.and to evaluate the effect of immunization which would lead to the development of a more appropriate hepatitis B control strategy.Methods Seroepidemiologic method,with multi-section random sampling method were chosen.14 sites from 8 counties were involved.2-4 ml of the vein blood was drawn from all the individuals engaged in the study including 3806 samples.HBsAg,anti-HBs.anti-Hbe of the samples were tested with ELISA.Results Standardized positive rates of HBsAg and HBsAb were found as 7.05%and 29.77%respectively with the overall infection rate of HBV as 40.30%.The hepatitis B vaccine coverage of the children under 15 years was 70.73%and the positive rates for both HBsAg and anti-HBS were 2.62%and 56.68%.respectively.The coverage of hepatitis B vaccine among children under 3 years was 83.44%and the positive rates of both HBsAg and anti-HBs were 1.47%and 67.69%respectively.hepatitis B vaccine coverage of children under 3 years was 85.77%.with positive rates of HBsAg and anti-HBs as 1.78%and 75.44%respectively.Conclusion Results from our study revealed that since the introduction of hepatitis B vaccination,the prevalence rates of HBsAg and HBV infeetion had an obvious decline,especially in children aged under 15 years of old,suggesting that some changes had occurred in the epidemic characteristics ofhepatitis B in Sichuan.

By investigating the interaction between components from Flos Genkwa (FG) and Radix et Rhizoma Glycyrrhizae (RRG) and the dissolution profile of toxic components in co-decoction, the characteristics and possible mechanism of incompatibility were revealed. Ultra-high performance liquid chromatography quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF/MS) and ultra-high performance liquid chromatography triple-quadrupole mass spectrometry (UPLC-TQ/MS) were used to analyze multi-components in different herb extractions prepared by different ratios of FG/FG processed by vinegar (FGV) and RRG, which reflect the interaction and characteristics of multiple components in incompatibility combinations. The results showed that the components dissolution was influenced by compatibility ratio with certain regularity. Whether FG processed by vinegar or not, with the increase of RRG in co-decoction, the dissolution of diterpenes, especially for yuanhuacine, yuanhuadine and yuanhuajine, the toxic ingredients of FG, increased significantly. From these results, the material basis and one possible mechanism of incompatibility between FG and RRG is the increasing dissolution of diterpenes, toxic components of FG in co-decoction process, which caused by interaction between multi-components in these two herbs.
Acetic Acid ; chemistry ; Chromatography, High Pressure Liquid ; Daphne ; chemistry ; Diterpenes ; analysis ; Drug Incompatibility ; Flowers ; chemistry ; Glycyrrhiza uralensis ; chemistry ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Rhizome ; chemistry ; Spectrometry, Mass, Electrospray Ionization ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; Tandem Mass Spectrometry ; Terpenes ; analysis