ObjectiveTo explore effect of Xianlian Jiedu prescription on the recurrence of colorectal cancer （CRC） and investigate the related mechanisms. MethodsA postoperative recurrence model was established in 25 Balb/c mice by injecting CT26 cells subcutaneously into the armpit， followed by surgical removal of 99% of the subcutaneous tumor. The mice were randomly divided into model group， low-dose Xianlian Jiedu prescription （XLJDP-L） group （6.45 g·kg^-1·d^-1）， medium-dose Xianlian Jiedu prescription （XLJDP-M） group （12.9 g·kg^-1·d^-1）， high-dose Xianlian Jiedu prescription （XLJDP-H） group （25.8 g·kg^-1·d^-1）， and 5-fluorouracil （5-FU） group （1×10^-3 g·kg^-1·d^-1）. The mice were euthanized after 14 days of continuous intervention， and recurrent tumor tissue was harvested. Hematoxylin and eosin （HE） staining was used to observe pathological and morphological changes in the recurrent tumor tissue. Immunohistochemistry （IHC） was employed to assess the expression of proliferating cell nuclear antigen （Ki67）， vascular endothelial growth factor （VEGF）， and platelet-endothelial cell adhesion molecule （CD31） in recurrent tumor tissue. The Western blot was used to detect the protein expression levels of angiopoietin-2 （ANG-2）， VEGF， phosphorylated-protein kinase B （p-Akt）， protein kinase B （Akt）， phosphorylated-phosphatidylinositol 3-kinase （p-PI3K）， and phosphatidylinositol 3-kinase （PI3K） in recurrent tumor tissue. ResultsBefore treatment， there were no statistical differences in tumor volume， tumor weight， and body mass among the XLJDP-L， XLJDP-M， and XLJDP-H groups and the 5-FU group compared to the model group， indicating model stability. After treatment， compared with those in the model group， the tumor volume and tumor weight in the XLJDP-L， XLJDP-M， and XLJDP-H groups and the 5-FU group were significantly reduced （P<0.01）， showing dose dependency. Meanwhile， there were no significant differences in body weight among the XLJDP-L， XLJDP-M， and XLJDP-H groups and the 5-FU group compared to the model group. HE staining showed that compared with that in the model group， tumor tissue in the XLJDP-L， XLJDP-M， and XLJDP-H groups and the 5-FU group had loosely arranged cells， increased intercellular spaces， small and shriveled nuclei， light staining， fewer mitotic figures and atypical nuclei， and increased necrotic areas. IHC showed that compared with those of the model group， the positive rates of Ki67， VEGF， and CD31 in the recurrent tumor tissue of the XLJDP-L， XLJDP-M， and XLJDP-H groups and the 5-FU group were significantly reduced （P<0.01） in a dose-dependent manner. Western blot results showed that compared with those of the model group， the protein expression levels of ANG-2 and VEGF in the recurrent tumor tissue of the XLJDP-L， XLJDP-M， and XLJDP-H groups and the 5-FU group were significantly downregulated （P<0.05， P<0.01）， and the p-Akt/Akt and p-PI3K/PI3K ratios were significantly decreased in a dose-dependent manner （P<0.05， P<0.01）. ConclusionXianlian Jiedu prescription significantly inhibits the recurrence of CRC in mice after subcutaneous tumor surgery. The mechanism may involve regulating the PI3K/Akt pathway and downregulating key angiogenic proteins such as ANG-2， VEGF， and CD31.

AIM: To quantitatively evaluate the clinical characteristics of haze after transepithelial photorefractive keratectomy(TPRK)for astigmatism using corneal densitometry.METHODS:In this retrospective clinical study, a total of 74 patients(106 eyes)with astigmatism ≥1.25 D who underwent TPRK in our hospital from October 2022 to December 2024 were continuously collected. All of the study subjects were divided into transparent group(65 eyes)and haze group(41 eyes)based on whether haze occurred after surgery. Pentacam examination was performed before and after surgery, and corneal densitometry was recorded at the time points of preoperation, 1 mo postoperation in the transparent group and the most severe haze degree in the haze group. The collected corneal densitometry included the average densitometry of the entire corneal layer in the central 2 mm, 2-6 mm, and 6-10 mm areas, as well as the average densitometry of the entire layer of the corneal section in the center 6 mm of the astigmatism axis(astigmatism expressed in negative cylindrical form)and orthogonal axis(the axis perpendicular to the astigmatism axis), and the average densitometry of the entire layer of the corneal section in the nasal and temporal 2-6 mm areas of the astigmatism axis in the haze group of patients with regular astigmatism. The change in corneal densitometry after surgery compared with that before surgery was calculated.RESULTS:There was no statistically significant difference in baseline data such as gender, age, and spherical equivalent between the transparent group and the haze group(all P>0.05). The change in corneal densitometry in the 2-6 mm area of the haze group was greater than that in the transparent group(Z=-2.226, P=0.026), while there was no significant difference in the change of corneal densitometry in the central 2 mm and 6-10 mm areas between the two groups(both P>0.05). There was no significant difference in the change of corneal densitometry between the transparent group and haze group along the orthogonal axis(all P>0.05), while the change of corneal densitometry in the haze group along the astigmatism axis was greater than that in the transparent group(Z=-2.371, P=0.018). The temporal corneal densitometry of patients with regular astigmatism in the haze group after surgery was higher than that of the nasal side, and the change in corneal densitometry was also greater than that of the nasal side(Z=-4.288, P<0.001; Z=-4.043, P<0.001).CONCLUSION:Unlike spherical correction for myopia and hyperopia, haze after TPRK for astigmatism was mainly manifested in the peripheral cutting area of the astigmatism axis, and patients with regular astigmatism had a higher probability or severity of haze on the temporal side of the astigmatism axis than on the nasal side.

Hearing loss is the most prevalent disabling disease. Cochlear implantation（CI） serves as the primary intervention for severe to profound hearing loss. This consensus systematically explores the value of genetic diagnosis in the pre-operative assessment and efficacy prognosis for CI. Drawing upon domestic and international research and clinical experience, it proposes an evidence-based medicine three-tiered prognostic classification system（Favorable, Marginal, Poor）. The consensus focuses on common hereditary non-syndromic hearing loss（such as that caused by mutations in genes like GJB2, SLC26A4, OTOF, LOXHD1） and syndromic hereditary hearing loss（such as Jervell & Lange-Nielsen syndrome and Waardenburg syndrome）, which are closely associated with congenital hearing loss, analyzing the impact of their pathological mechanisms on CI outcomes. The consensus provides recommendations based on multiple round of expert discussion and voting. It emphasizes that genetic diagnosis can optimize patient selection, predict prognosis, guide post-operative rehabilitation, offer stratified management strategies for patients with different genotypes, and advance the application of precision medicine in the field of CI.
Humans ; Cochlear Implantation ; Prognosis ; Hearing Loss/surgery* ; Consensus ; Connexin 26 ; Mutation ; Sulfate Transporters ; Connexins/genetics*

Objective Study on the reduction of false positive interference in the detection of human immunodeficiency virus(HIV)by chemiluminescence method with polyethylene glycol(PEG)precipitation.Methods A total of 109 outpatients and inpatients in Ningbo Medical Center,Lihuili Hospital from January to June 2022 were selected.The positive samples initially screened by chemiluminescence method were confirmed by Western blotting,and 20 true positive samples and 89 false positive samples were confirmed.According to whether treatment agent was added,the false-positive samples were divided into three groups:no PEG precipitation group(no special treatment,89 cases),PEG precipitation group(PEG precipitation treatment,89 cases)and control group(normal saline treatment,89 cases).The level of HIV antigen/antibody(Ag/Ab)in supernatant was measured after centrifugation,and the difference of HIV Ag/Ab level and recovery rate before and after different treatment methods were compared.Results After intervention,the HIV Ag/Ab concentration in PEG precipitation group and control group was significantly lower than that in non-PEG precipitation group(P<0.001).After intervention,there were 3 positive cases in PEG precipitation group and 56 positive cases in control group,and the positive rates were significantly lower than those in non-PEG precipitation group(P<0.001).The recovery rate of PEG precipitation group was 4.92(2.12,12.69)%,and that of control group was 65.28(18.04,91.28)%.The recovery rate of true positive samples was>50%regardless of PEG treatment or normal saline treatment.Conclusion PEG precipitation method can effectively reduce the false positive interference of chemiluminescent HIV fourth-generation reagent detection,and has no effect on true positive samples.

Objective To analyze the medication rules of compound patents for the prevention and treatment of viral pneumonia through data mining technology,and to provide new ideas for clinical diagnosis and treatment and new drug research and development.Methods Summarizing the patents of traditional Chinese medicine compounds for the prevention and treatment of viral pneumonia in Patent Announcement module of China National Intellectual Property Administration website,search time is from database establishment to December 31,2023,and the statistics on the frequency of use,medicinal properties,efficacy classification,association analysis,and cluster analysis were carried out with the help of data mining software such as Excel 2019,IBM SPSS Statistics 26.0,and IBM SPSS Modeler 18.0.Results Through screening,a total of 218 compound patents met the inclusion criteria,involving 424 kinds of Chinese materia medica,and the top 5 herbs with the highest frequency of use were Glycyrrhizae Radix et Rhizoma,Lonicerae Japonicae Flos,Forsythiae Fructus,Scutellariae Radix,and Platycodon Radix.The medicinal properties are bitter and cold,and mostly belong to the lung meridian.There were 4 medicinal groups of pair medicine,13 medicinal groups of triple medicine,and 1 medicinal group with four related medicine exhibiting strong correlation.A total of 6 high-frequency combinations of traditional Chinese medicine were obtained by cluster analysis.Conclusion The basic pathogenesis of viral pneumonia is that internal deficiency and evil enter,heat toxin is trapped in the ling,the phlegm and blood stasis is occurred inside,and affecting the lung's function of purging and eliminating.In clinical practice,the deficiency tonic drugs Astragali radix and Glycyrrhizae Radix et Rhizoma,are used to strengthen resistance,the heat-clearing drugs Lonicerae Japonicae Flos,Forsythiae Fructus,the phlegm antitussive and antiasthmatic drugs,Platycodon Radix,Armeniacae Semen Amarum,etc,are used to treat the symptoms,simultaneous treatment of the symptoms and root cause,prevention and treatment are organically combined.

Objective To explore the genetic polymorphism and mutation rate of 36 Y-STR loci in Sichuan Han population and provide basic data for their forensic applications.Methods Blood samples were collected from 307 unrelated male individuals and 367 father-son pairs in Sichuan Han population using FTA blood sampling cards.The Y41SE-v1.2 kit was used to type 36 Y-STR loci,and the population genetic parameters and mutation rates of each locus were calculated.The genetic relationship between Sichuan Han population and other ethnic populations was analyzed in combination with 19 other populations in China.Results A total of 79 mutations were observed in 36 Y-STR loci in 367 father-son pairs of Sichuan Han population,with an average mutation rate of 6.00×10-3.There were 74(93.67%)one-step mutations and 5(6.33%)multi-step mutations.A total of 383 alleles were found at 36 Y-STR loci in 307 Sichuan Han males.The number of alleles at each locus ranged from 5(0.016 29)to 56(0.182 41),GD ranged from 0.100 02(DYS645)to 0.959 99(DYS385),and 306 haplotypes were found.The HD,DC and HMP values were 0.999 973,99.67%and 0.003 284,respectively.The results of genetic distance(Fst)analysis showed that the Sichuan Han population had the closest genetic distance with the Chongqing Han population(0.000 9)and the furthest genetic distance with the Xinjiang Mongolian group(0.032 0).The MDS based on genetic distance was basically consistent with the results of cluster analysis.Conclusion The 36 Y-STR loci have high genetic polymorphism in the Sichuan Han population.The study data can provide data support for the construction of the Y-STR database in this region,and also provide basic genetic information for forensic investigation and population genetics research.

Two pediatric heart failure patients were treated with pulmonary artery banding(PAB)at Fuwai Hospital,from December 2021 to January 2022.In the first case,an 8-month-old patient presented with left ventricular non-compaction cardiomyopathy(LVNC),left ventricular systolic dysfunction,ventricular septal defect,and atrial septal defect.The second case was a 4-month-old patient with LVNC,left ventricular systolic dysfunction,and coarctation of the aorta.After PAB,the left ventricular function and shape of both patients were significantly improved,without serious surgery-related complications.In these individual cases of pediatric heart failure,pulmonary artery banding exhibited a more satisfactory efficacy and safety compared to pharmacological treatment,especially for those with unsatisfactory medication results.Future clinical data are needed to promote the rational and broader application of this therapeutic option for indicated patients.

Objective To explore the efficacy of an 11-item modified frailty index(mFI-11)combined with surgical Apgar score(SAS)for predicting postoperative complications in elderly patients with colorectal cancer undergoing laparoscopic radical resection.Methods We enrolled a total of 481 elderly patients(aged≥65 years)undergoing laparoscopic radical resection of colorectal cancer.We performed a frailty assessment preoperatively using mFI-11 and calculated the SAS based on the lowest mean arterial pressure and heart rate as well as blood loss during surgery.Finally,we compared the clinical data,mFI-11,and SAS of patients with and without post-operative complications,and then analyzed their relationship with the postoperative complications and predictive values.Results The mFI-11,SAS,and operation time independently correlated with postoperative complication occurrence(P<0.05).The AUC of post-operative complications obtained using the mFI-11,SAS,and operation time were 0.805,0.800,and 0.610,respectively.The AUC of the postoperative complications derived from mFI-11 combined with SAS was 0.902.Conclusion In elderly patients undergoing laparo-scopic radical resection of colorectal cancer,the mFI-11,SAS,and operation time significantly correlated with postoperative complication occurrence.The combination of mFI-11 and SAS displayed a higher predictive power for postoperative complications compared to the use of a single indicator,which it could provide a reliable basis for early clinical identification of complications and reduce their occurrence.

Objective:To investigate whether end-tidal carbon dioxide (etCO 2) is associated with acute kidney injury (AKI) after liver transplantation. Methods:Clinical data of 83 patients undergoing classic allogeneic liver transplantation were retrospectively collected. Patients were divided into AKI group and non AKI group based on changes in serum creatinine levels within 48 hours after surgery, and differences in baseline data, intraoperative etCO 2 decrease rate [ΔetCO 2(%)], and postoperative creatinine values were analyzed between the groups. Results:The incidence of AKI within 48 hours after liver transplantation in 83 patients was 56.6%(47/83). The proportion of male patients in the AKI group was higher ( P=0.003), and the ΔetCO 2(%) in the anhepatic phase of AKI group patients was higher than that of non AKI patients [(0.26±0.08)% vs (0.22±0.07)%, P=0.024]. There was no statistically significant difference in ΔetCO 2(%) between the two groups during pre liver, inferior vena cava (IVC) occlusion, and new liver phase (all P>0.05). On the 7th day after surgery, the creatinine value in the AKI group was significantly higher than that in the non AKI group [68.7(55.4, 92.6)]μmol/L vs 52.7(44.1, 69.3)μmol/L, P<0.001], at a 3-month follow-up, creatinine levels in 43 patients (91.5%) in the AKI group returned to normal. Conclusions:The decrease in ΔetCO 2(%) during the anhepatic phase of liver transplantation reflects to some extent the severe fluctuations in circulation during the operation, which may be related to the occurrence of AKI within 48 hours after surgery.

Objective:To explore the efficacy, safety, and feasibility of single port laparoscopic liver resection via umbilical cord, and summarize its surgical experience.Method:A retrospective analysis was conducted on 39 patients who underwent liver resection surgery at the Department of Hepatobiliary and Pancreatic Surgery, the Affiliated Hospital of Qingdao University from February 2022 to September 2023. There were 19 patients in the transumbilical single-port laparoscopic group, including 5 males and 14 females, aged (49.6±2.5) years. There were 20 patients in the multi-port laparoscopic group, including 7 males and 13 females, aged (49.9±3.1) years. The intraoperative blood loss, operation time, intestinal recovery time, postoperative hospital stay and postoperative complications were compared between the single-port group and multi-port group.Results:All 39 patients successfully completed the surgery without any additional foramen or conversion to open surgery. The operation time of the single hole group (166.3±59.0) min was longer than that of the multi-port group (123.2±48.0) min, and the difference was statistically significant ( t=2.50, P=0.020). There were no statistically significant differences in intraoperative blood loss, intestinal recovery time, postoperative hospital stay, and postoperative complications between these two groups (all P>0.05). All patients had no postoperative complications such as bleeding, infection, or bile leakage. Follow up for 3~21 months showed no recurrence of primary diseases such as hepatic hemangioma, hepatic adenoma, and intrahepatic bile duct stones. The aesthetic effect of the umbilical incision in the single orifice group was significant, and patient satisfaction was 100%. Conclusion:Umbilical single-port laparoscopic liver resection surgery is safe and feasible, with significant minimally invasive and aesthetic effects.