The paper introduces the system design of internet platform in novelty assessment and selective dissemination of informa-tion of medical science and technology project in Zhejiang province, including the exploitation of environment , processing of novelty as-sessment and selective dissemination of information as well as main function design. This system has noticeable advantages, such as com-prehensive functions, multiple participation, transparent service process, which could finish the relevant work on the internet, improve the quality of information service and enhance the efficiency.

Objective To explore the safety and feasibility of single-incision laparoscopic cholecystectomy without using titanium-clips. Methods Data of 1016 patients(group A) undergoing single-incision laparoscopic cholecystectomy without using titanium-clips were compared to that of 874 patients(group B)undergoing two-port laparoscopic cholecystectomy without using titanium-clips by t test and chi square test for operating time,operative hemorrhage,the length of postoperative hospital stay and postoperative pain.Results In group A,1001 cases were successfully operated on with single-incision laparoscopic cholecystectomy,with conversion to classic four-port laparoscopic cholecystectomy in 15 cases,while 874 cases in group B were operated on with two-port laparoscopic cholecystectomy.There were no bile leakage,biliary tract injury or death in both groups.There were no difference in operating time[(34.5 ±5.2) min vs (32.0±7.4)min,t=0.063,P=0.526],the length of postoperative hospital stay[(3.1±0.8)d vs(3.2±0.7)d,t=1.073,P=0.326]and operative hemorrhage[(56.5±17.8)ml vs (55.2±15.9)ml,t=0.812,P=0.425](P>0.05) between the two groups,but the postoperative pain was less severe in Group A than that in group B (P=0.000<0.05). Conclusions The single-incision laparoscopic cholecystectomy is feasible,safe,less traumatic and more cosmetic.

Objective In this article Response Surface Analysis(RSA)was applied to optimize the formulation of doxycycline hydrochloride sustained release tablet.Methods Single factor exploration was used to determine the three factors which have the greatest impact on the release rate.The three factors were the dosage of the HPMC in the total weight of the tablet,the concentration of PVP-K30,and the ratio of lactose to microcrystalline cellulose,respectively.The composite score of the release behaviour was taken as the response value.The dosage of the ingredients were determined by Box-Benhnke design principles and 3 factors and 3 levels.Results The optimized formulation and process are as follows:the dosage of the HPMC in the total weight of the tablet was 30%;the concentration of PVP-K30 was 10%,and the ratio of lactose to microcrystalline cellulose was 13.The release behavior in vitro is ideal.Conclusion The optimized preparation process of doxycycline hydrochloride sustained release tablet is stable,highly efficient and suitable for industrial production.

BACKGROUND:In recent years, chitosan-based thermosensitive hydrogel, as scaffold materials, have received more and more attentions in the field of tissue repair because of good biocompatibility, biodegradability and drug-sustained release.
OBJECTIVE:To explore the directed differentiation and growth of rat bone marrow mesenchymal stem cells on the quaternary chitosan thermosensitive hydrogel scaffold and to look for more ideal tissue engineering materials for the treatment of nervous system damage.
METHODS:The thermosensitive hygrogel scaffold was prepared using hydroxypropyltrimethyl ammonium chloride chitosan (HACC) andβ-glycerophosphate (β-GP). The spatial structure of scaffold was observed by scanning electronic microscope. Effect of leaching liquor from the HACC/β-GP scaffold on the viability of bone marrow mesenchymal stem cells was detected by (4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. The albumin from bovine serum was combined with the scaffold, and the slow-release effect of the scaffold was detected by ultraviolet absorption spectrometry. Bone marrow mesenchymal stem cells were incubated onto the compound scaffold at 3 passages. The adhesion, growth and differentiation of bone marrow mesenchymal stem cells on the compound scaffold were observed by the scanning electron microscope. Neuron-specific enolase was detected by immunofluorescence.
RESULTS AND CONCLUSION:The porosity and thermal sensitivity of HACC/β-GP scaffold and slow-release effect of glial cellline-derived neurotrophic factor were apparent. The results of MTT showed that the compound scaffold cannot take apparent negative effects to the proliferation of bone marrow mesenchymal stem cells. After inoculation, bone marrow mesenchymal stem cells permeated the porous structure of the scaffold and adhered to the scaffold. Under the role of glial cellline-derived neurotrophic factor, bone marrow mesenchymal stem cells showed neuron-like cellmorphology and cells co-cultured with the compound scaffold expressed the marker of neurons, neuron-specific enolase. Under the role of slow-release glial cellline-derived neurotrophic factor, bone marrow mesenchymal stem cells can grow wel in vitro and differentiate into neuron-like cells on the HACC/β-GP scaffold.

Objective:To evaluate the safety and feasibility of robot assisted total gastrectomy plus hand-sewn esophagojejunostomy.Methods:The clinical data of 72 patients diagnosed with gastric cancer and undergoing total gastrectomy at the First Affiliated Hospital of Ningbo University from Nov 2021 to May 2024 were retrospectively analyzed. They were divided into two groups: robot-assisted total gastrectomy (RATG) group, consisting of 30 patients, and laparoscopic assisted total gastrectomy (LATG) group, consisting of 42 patients . In the RATG group, the digestive tract was reconstructed by manual suture under the robot scope and Roux-Y reconstruction was performed . In LATG group, digestive tract reconstruction was performed using an in vitro stapler and Roux-Y. The clinicopathological data, perioperative indexes, and postoperative follow-up data of both groups were observed and analyzed.Results:All 72 patients successfully completed the operation without conversion to open laparotomy. The total operation time in RATG group was longer than that in LATG group [(235.2±25.8) min vs. (200.7±40.6) min, t=4.099, P<0.05)].RATG was superior to LATG group in terms of digestive tract reconstruction time, postoperative fluid intake time and hospitalization days,the difference was statistically significant [(36.9±3.0) min vs.(39.4±4.5) min, (4.2±0.5) d vs. (5.2±0.6) d、(9.5±1.6) d vs. (10.8±2.4)d, t=-2.554,-7.135,-2.595, all P<0.05]; In terms of postoperative pathology, the number of lymph node dissection in RATG group was higher than that in LATG group [(29.8±6.2) vs. (26.3±7.5), t=2.197, P<0.05]. Conclusion:The application of delayed disconnection hand-sewn esophagojejunostomy in Da Vinci robot total gastrectomy is safe and feasible for cure-intent total gastrectomy in patients of gastric carcinoma.

Objective To study the clinical efficacy and safety of icotinib hydrochloride tablets combined with whole brain radiotherapy (WBRT) in non-small cell lung cancer (NSCLC) brain metastasis.Methods Fifty-three patients with NSCLC brain metastasis who were unable to tolerate chemotherapy or chemotherapy failed were selected in Baotou Central Hospital from October 2010 to April 2015.The patients were divided into the observation group (n =27) and the control group (n =26) using random number table method.Two patients were dropped out,one in the control group and one in the observation group.The patients in the control group were given WBRT (30 Gy/15 Fx).On this basis,the patients in the observation group were given icotinib hydrochloride tablets 125 mg,3 times a day.The patients were followed up for 18 months after the end of WBRT.The adverse reactions,clinical efficacy and the median survival times of the two groups were compared.Results The objective response rate of the observation group was 88.5％,which was higher than that of the control group (64.0％),and the difference was statistically significant (x2 =4.238,P =0.040).The incidence rates of skin rash and liver function damage in the observation group were 76.9％ and 15.4％,which were higher than those in the control group (0,x2=31.638,P ＜ 0.001;x2 =4.173,P =0.041).However,most of them were degree Ⅰ-Ⅱ,and they were tolerable.There were no significant differences in the incidence of myelosuppression and gastrointestinal reactions between the two groups (26.9％ vs.20.0％,x2 =0.339,P=0.560;34.6％ vs.28.0％,x2 =0.259,P=0.611).The median survival time in the observation group (9.0 months) was longer than that in the control group (7.0 months).The one year survival rate of the observation group was 33.3％,which was higher than that of the control group (23.1％),but the difference was not significant (x2 =0.676,P =0.411).Conclusion Icotinib hydrochloride tablets combined with WBRT in the treatment of brain metastasis with NSCLC can significantly improve the curative effects of brain metastasis,and it has a survival advantage,with tolerable adverse reactions.

Objective:To observe the clinical and multimodal imaging features of eyes with acute macular neuroretinopathy (AMN) associated with the coronavirus disease 2019 (COVID-19).Methods:A retrospective study. From December 20, 2022 to January 17, 2023, a total of 29 patients (58 eyes) with COVID-19-associated AMN admitted to Department of Ophthalmology of Eye and ENT Hospital, Shanghai Medical College were included in the study. All the affected eyes underwent the best corrected visual acuity, color fundus photography, infrared fundus photography (IR), short-wavelength autofluorescence (SW-AF), near-infrared autofluorescence (NIL-AF), optical coherence tomography (OCT), and OCT angiography (OCTA). All patients were administered microcirculation-improving oral medication with 12 cases receiving adjunctive low-dose corticosteroid therapy. Follow-ups were conducted 1 to 3 months after the initial diagnosis, with a total of 19 cases (38 eyes) completing the one-month follow-up.Results:Out of the 29 cases, there were 9 males (18 eyes) and 20 females (40 eyes), all of whom experienced bilateral eye involvement. The age of the patients ranged from 12 to 47 years, with an average age of (29.9±9.5) years. The time from the onset of fever to the appearance of ocular symptoms was (2.52±2.01) days. Among the 58 affected eyes, there were 5 cases with retinal cotton wool spots, 2 cases with optic disc edema, and 1 case with parafoveal branch retinal vein occlusion. All affected eyes exhibited deep reddish-brown macular dark spots. IR revealed wedge-shaped, wedge-like, or "petaloid-like" dark areas involving the fovea and parafovea. SW-AF examination showed no obvious abnormality in 39 eyes. Weak autofluorescence dark area were consistent with IR in 19 eyes. NIR-AF examination showed spot-like or flaky self-fluorescent dark areas. OCT examination showed strong reflex lesions spreading vertically upward from the retinal pigment epithelium (RPE) layer in the macular area in the acute stage, showing typical "bean seedling" sign. OCTA revealed reduced blood flow density in the deep capillary plexus (DCP) of 50 eyes. Enface OCT displayed lesion areas that corresponded to the dark areas seen in IR. One month after the initial diagnosis, the condition improved in 18 eyes (47.4%, 18/38). Among the 5 eyes with cotton wool spots, regression of these spots was accompanied by loss of nerve fiber layer in 4 eyes. In cases with optic disc edema, the edema subsided. The "bean sprout" sign disappeared in all affected eyes, and the lesions became localized. The ellipsoid zone and/or interdigitation zone in the lesion areas were discontinuous.Conclusions:COVID-19-related AMN is characterized by distinctive features. IR fundus reveals wedge-shaped, wedge-like, or petaloid dark areas involving the fovea and parafovea. OCT displays strongly reflective lesions with vertical spread above the RPE. OCTA shows reduced blood flow density in the DCP of the retina.

The aim of this study was to identify novel prognostic mRNA and microRNA (miRNA) biomarkers for hepatocellular carcinoma (HCC) using methods in systems biology. Differentially expressed mRNAs, miRNAs, and long non-coding RNAs (lncRNAs) were compared between HCC tumor tissues and normal liver tissues in The Cancer Genome Atlas (TCGA) database. Subsequently, a prognosis-associated mRNA co-expression network, an mRNA–miRNA reg-ulatory network, and an mRNA–miRNA–lncRNA regulatory network were constructed to identify prognostic biomarkers for HCC through Cox survival analysis. Seven prognosis-associated mRNA co-expression modules were obtained by analyzing these differentially expressed mRNAs. An expression module including 120 mRNAs was significantly corre-lated with HCC patient survival. Combined with patient survival data, several mRNAs and miRNAs, including CHST4, SLC22A8, STC2, hsa-miR-326, and hsa-miR-21 were identified from the network to predict HCC patient prognosis. Clinical significance was investigated using tissue microarray analysis of samples from 258 patients with HCC. Functional annotation of hsa-miR-326 and hsa-miR-21-5p indicated specific associations with several cancer-related pathways. The present study provides a bioinformatics method for biomarker screening, leading to the identification of an integrated mRNA–miRNA–lncRNA regulatory network and their co-expression patterns in relation to predicting HCC patient survival.

Objective To observe the effect of dapagliflozin on cardiac function in patients with heart failure after emergency percutaneous transluminal coronary intervention in acute ST segment ele-vation myocardial infarction.Methods A total of 100 patients with acute myocardial infarction un-derwent emergency PCI were randomly divided into study group(52 cases)and control group(48 ca-ses).The study group was given dapagliflozin on the basis of standardized treatment of myocardial in-farction,and the control group was given conventional treatment of myocardial infarction.Cardiac ul-trasound related indexes[left ventricular ejection fraction(LVEF),left ventricular end-diastolic di-ameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic vol-ume(LVEDV)],plasma N-terminal brain natriuretic peptide(NT-proBNP)level,6-minute walking test(6MWT)results.The incidence of adverse reactions and major cardiovascular adverse events(MACE)were compared between the two groups during follow-up.Results After 6 months of treat-ment,LVESD,LVEDD and LVEDV in the two groups were significantly lower than before treatment,and LVEF was significantly higher than before treatment(P＜0.05);the LVESD,LVEDD and LVEDV of the study group were significantly lower than those of the control group,and LVEF was sig-nificantly higher than that of the control group(P＜0.05).The NT-proBNP in the two groups was significantly lower than before treatment,and was significantly lower in the study group than that in the control group(P＜0.05).The 6MWT distance of the study group was significantly longer than that of the control group(P＜0.05).There was no significant difference in the incidence of adverse reactions and MACE between the two groups(P＞0.05).Conclusion Dapagliflozin can improve cardiac function in patients with heart failure after emergency PCI of acute ST segment elevation my-ocardial infarction.

Objective To observe the effect of dapagliflozin on cardiac function in patients with heart failure after emergency percutaneous transluminal coronary intervention in acute ST segment ele-vation myocardial infarction.Methods A total of 100 patients with acute myocardial infarction un-derwent emergency PCI were randomly divided into study group(52 cases)and control group(48 ca-ses).The study group was given dapagliflozin on the basis of standardized treatment of myocardial in-farction,and the control group was given conventional treatment of myocardial infarction.Cardiac ul-trasound related indexes[left ventricular ejection fraction(LVEF),left ventricular end-diastolic di-ameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic vol-ume(LVEDV)],plasma N-terminal brain natriuretic peptide(NT-proBNP)level,6-minute walking test(6MWT)results.The incidence of adverse reactions and major cardiovascular adverse events(MACE)were compared between the two groups during follow-up.Results After 6 months of treat-ment,LVESD,LVEDD and LVEDV in the two groups were significantly lower than before treatment,and LVEF was significantly higher than before treatment(P＜0.05);the LVESD,LVEDD and LVEDV of the study group were significantly lower than those of the control group,and LVEF was sig-nificantly higher than that of the control group(P＜0.05).The NT-proBNP in the two groups was significantly lower than before treatment,and was significantly lower in the study group than that in the control group(P＜0.05).The 6MWT distance of the study group was significantly longer than that of the control group(P＜0.05).There was no significant difference in the incidence of adverse reactions and MACE between the two groups(P＞0.05).Conclusion Dapagliflozin can improve cardiac function in patients with heart failure after emergency PCI of acute ST segment elevation my-ocardial infarction.