Acute pancreatitis is a common acute abdominal disease in clinical practice,some of which can still recur after standardized treatment,known as recurrent acute pancreatitis(RAP).The etiology and mechanism of RAP are complicated,and there is still a lack of standardized evaluation,diagnosis and treatment.So,early identification of the cause and targeted intervention is important.In this review,we summarize the current progress in the research of RAP.

Objective:To compare the early clinical outcomes between domestic robot-assisted total knee arthroplasty (RA-TKA) and conventional manual total knee arthroplasty (CM-TKA) for patients with primary knee osteoarthritis.Methods:Embase, Pubmed, Web of Science, Zhi.com and Wanfang databases from January 2015 to April 2023 were searched for clinical controlled trials (RCTs) comparing the clinical outcomes between RA-TKA and CM-TKA. After literature screening, quality evaluation and data extraction according to the criteria required, Revman 5.3 software was applied to perform a Meta-analysis of the literature data. The operation time, intraoperative bleeding, hip-knee-ankle angle (HKA), HKA bias value, frontal femoral component (FFC), frontal tibia component (FTC), lateral femoral component (LFC), lateral tibia component (LTC), Knee Society Score (KSS), visual analogue scale (VAS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), knee mobility, Hospital for Specialty Surgery (HSS) knee score, length of hospital stay, and rate of complications were compared between the RA-TKA and CM-TKA patients.Results:Eight RCTs and 449 patients were included, with 221 patients in the RA-TKA group and 228 ones in the CM-TKA group. The Meta-analysis showed that the RA-TKA group had significantly longer operation time ( MD=18.41, 95% CI: 11.28 to 25.23, P<0.001), significantly better HKA ( MD=0.41, 95% CI: 0.06 to 0.76, P=0.020), significantly better HKA bias value ( MD=-0.92, 95% CI: -1.25 to -0.60, P<0.001), significantly better FTC ( MD=0.38, 95% CI: 0.08 to 0.67, P=0.010), significantly better LTC ( MD=1.71, 95% CI: 0.94 to 2.48, P<0.001), and significantly better knee mobility ( MD=-2.23, 95% CI: -4.18~-0.27, P=0.030) than the CM-TKA group. However, the differences were not statistically significant between the 2 groups in the intraoperative bleeding, FFC, LFC, KSS, VAS, WOMAC, HSS, length of hospital stay, or rate of complications ( P>0.05). Conclusion:Use of a domestic robot to assist conventional manual TKA can significantly improve the accuracy of prosthesis fixation and reconstruct the alignment of lower limb better, showing potential advantages in promoting functional recovery of the knee for the patients.

Objective To explore the dosimetric differences of radiotherapy plan for cervical cancer with 4 different fluence smoothing (FS) parameters using Monaco treatment planning system (Monaco TPS). Methods Fifteen patients with ⅠB2 stage cervical cancer in our hospital were enrolled in this study. And a 2 Volumetric Modulated Arc Therapy (VMAT) plan for each patient were completed by Monaco 5.11 TPS according to the X-Ray Voxel Monte Carlo (XVMC) method. For each plan was optimized by FS function, with the level of Off, Low, Medium and High. To compare the difference of plan optimization time, conformity index (CI), Homogeneity index (HI), D_mean, D_min, D_2% of PTV，dose to the organ at risk (OAR)，the number of Segments# and MU#，estimated total delivery time (ETDT), quantum Efficiency (QE) of the plans, the formation of Segments# with the same angle and verification of inserting 729 two-dimensional matrix into PTW octavius 4D module of different FS function levels, with the precondition of the Prescription isodose curve covering 95% of the target area. The data was analysed by multivariate factor analysis with the application of SPSS, and P < 0.05 was considered as statistically significant. And the Planned revenue score of different FS levels was also calculated. Results Except for the D_min of PTV (the lowest value is (32.09 ± 0.26) Gy for the Off group, and the highest value is (35.98 ± 0.42) Gy for the High group), V₄₀ of the rectum (the lowest value in the Medium group is 55.88% ± 2.02%, and the highest value in the High group was 61.90% ± 2.98%) and bladder (the lowest value was 45.01% ± 2.08% in the Medium group, and the highest value is 50.45% ± 1.98% in the High group), the V₂₀ (the lowest value High group was 49.05% ± 1.98%, the highest value Off group was 56.52% ± 1.75%) of femoral head (P < 0.05), there was no significant difference of the dose assessment results for PTV and OARs in 4 different FS function levels. In the High level, the ETDT, QE and MU# were showed better than other groups evidently, however, the number of Segments# showed no significant difference. The plan validation results was increased with the improvement of FS function level, and the level of High was considered to be the optimal. To compare the score of overall benefits of the plan, the level of Medium (−17.18 ± 0.05) got the highest score, and the Low group (−17.58 ± 0.05) and the High group (−17.42 ± 0.06) have similar scores, and Off group (−18.81 ± 0.08) has the lowest score. Conclusion Different FS levels of the Monaco 5.11 TPS can optimize the radiotherapy plan for cervical cancer, but the level of Medium is considered to be the most applicable.

Objective To study the dosimetry effect of D_w and D_m middle and lower esophageal cancer in Monaco treatment planning system (TPS). Methods 30 patients with T₃N₀M₀StageⅡa middle and lower esophageal cancer were selected for experiment. For each patient, optimize the plan using dose to water (D_w) and dose to medium (D_m) dose calculation mode, then rescale prescription dose to 95% volume of PTV. Compare the difference in the two mode, conformity index (CI), Homogeneity index (HI), Mean dose (D_mean), Minimum dose (D_min), Maximum dose (D₂), Dose to Organ at risk (OAR), MU, Optimization time, photon usage, and QA results of MatriXX and Arc Check. Use SPSS for multivariate analysis. Results In the dose evaluation of the middle and lower esophageal cancer cases under different dose calculation methods, the spinal cord, trachea, V₂₀ of the whole lung, and D₂ of the liver have significant dosimetric differences, the dose value, the sequential dose results were compared as (37.92 ± 1.11)/(35.85 ± 1.08), (59.91 ± 1.43)/(60.25 ± 0.98), (22.52 ± 1.75)/(21.38 ± 2.01), (42.89 ± 0.52)/(41.73 ± 0.58). In the comparison of dose cloud distribution, the difference is mainly located in the cavity and the inner wall of the lung in the target area, the dose in the target cavity in the D_w group is higher than that in the D_m group. The dose in the inner and outer walls of the lung cavity in the D_w group are slightly adducted than that in the D_m group, especially in the central area.Dose QA of MartiXX (3%-3 mm) and Arc Check (2%-2 mm) with different dose calculation methods of 60 plans of 30 cases have all passed clinical requirements. D_m Group is better than D_w group. Conclusion It is recommended to use D_m dose calculation method for Monaco 5.11 TPS in the condition of treatment planning for middle and lower esophageal cancer.

BackgroundNon-suicidal self-injury （NSSI） behavior is highly prevalent in middle school students， which poses a significant risk to the physical and mental health of middle school students， so finding ways to improve the NSSI behavior among middle school students is of great significance for promoting their healthy growth. ObjectiveTo investigate the relationship between psychological quality and NSSI behavior among middle school students in western Anhui， and to examine the pathway of coping style in the above relationship. MethodsFrom November to December 2020， 22 872 middle school students in western Anhui were selected using stratified cluster random sampling method， and were subjected to complete the assessment of Adolescent Non-suicidal Self-injury Assessment Questionnaire （ANSAQ）， Adolescent's Psychological Suzhi Scale-Simplified Version （APSS-SV） and Coping Style Scale for Middle School Students （CSSMSS）. Spearman correlation analysis was adopted to examine the correlation among scores of scales and the frequency of NSSI behavior in middle school students. Amos 23.0 was utilized to test the pathway of coping style in the relationship between psychological quality and NSSI behavior. ResultsA total of 21 718 （94.95%） middle school students completed the effective questionnaire survey. NSSI behavior was detected in 7 798 middle school students （35.91%）. ANSAQ total score and CSSMSS positive coping style score of middle school students were negatively correlated with the frequency of NSSI behavior （r=-0.219， -0.179， P<0.01）. CSSMSS negative coping style score was positively correlated with the frequency of NSSI behavior （r=0.093， P<0.01）. The direct effect value of psychological quality on the frequency of NSSI behavior was -0.136， and the indirect effect value of coping style on the relationship between psychological quality and the frequency of NSSI behavior was -0.084. Among them， the effect value of positive coping style was -0.122， accounting for 55.45% of the total effect， while the effect value of negative coping style was 0.038， accounting for 17.27% of the total effect. ConclusionCoping style may mediate the relationship between psychological quality and NSSI behavior in middle school students， and the positive coping style and negative coping style play separate roles in the pathway of psychological quality on NSSI behavior.［Funded by 2020 Natural Science Research Project of Anhui Provincial Education Department （number， KJ2020B006）］

Twenty-one protostane-type triterpenoids with diverse structures, including nine new compounds (-), were isolated from the of Linn. Structurally, alisolides A‒F (-), composed of an oxole group coupled to a five-membered ring, represent unusual C-17 spirost protostane-type triterpenoids. Alisolide H () is a novel triterpenoid with an unreported endoperoxide bridge. Alisolide I () represents the first example of 23,24-acetal triterpenoid. Their structures were elucidated based on spectroscopic analysis, wherein the absolute configurations of ‒, were further confirmed by the Mo(OAc)-induced ECD method. Furthermore, all isolates were evaluated for their inhibitory effects on LPS-induced NO production in Caco-2 cells, and all the compounds showed remarkable inhibitory activities, with IC values in the range of 0.76-38.20 μmol/L.