Objective To design a storage device for lymph node specimens of gynecological malignant tumors and to evaluate its application effect.Methods The specimen depository is composed of 3 parts,including storage frame,partition plate and marking plate.391 patients with gynecological malignant tumor surgeries requiring collection of retroperitoneal lymph nodes were selected in the operating room of a tertiary A hospital in Zhejiang Province from January to December 2022 in accordance with the operation schedule.They were randomly divided into an experimental group(n=196)and a control group(n=195).Patients in the experimental group used a newly developed storage device,while the control group was with traditional device.The incidence of additional verification specimens by doctors,the average time for disposing of lymph node specimens,and the job satisfaction survey of doctors and nurses were compared.Results Within a period of 12 months after utilizing this easily recognizable specimen storage device,the additional verification rate in the experimental group was 10.62％compared with the rate of 72.48％in the control group.The average time of disposing lymph node specimens was reduced from(8.3±0.9)to(5.2±0.3)minutes.Doctors and nurses in the experimental group reported a higher level of satisfaction for the specimen storage device(P＜0.05).Conclusion Utilizing the newly designed specimen storage device can help medical staff to alleviate their workload,enhance their work efficiency,raise their job satisfaction,and ensure the accuracy of pathological results.

ObjectiveTo systematically explore the underlying mechanisms of Huashi Baidu prescription （HBP） against myocardial injury through a multidimensional network analysis of "transcriptome-putative target-phenotype gene". MethodPutative targets of compounds in HBP were predicted using the Encyclopedia of Traditional Chinese Medicine （ETCM 2.0，http：//www.tcmip.cn/ETCM2/front/） and the Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine （TCMIP v2.0，http：//www.tcmip.cn/TCMIP/index.php/Home/Login/login.html）. Clinical predominant symptom phenotypes for HBP against coronavirus disease 2019 （COVID-19） were collected from CNKI and PubMed databases， while clinical side effects of doxorubicin were gathered from the CTD database. Phenotype-related genes were collected from the HPO database and SoFDA data platform （http：//www.tcmip.cn/Syndrome/front/#/）. An interaction network of "transcriptome-putative target-phenotype gene" was constructed. Key nodes were identified through topological feature calculations， and functional enrichment analysis was conducted to explain the underlying mechanism. Pharmacodynamic evaluation and mechanism verification were performed using a doxorubicin-induced myocardial injury mouse model. Sixty-five SPF-grade C57BL/6J male mice were randomly divided into a control group， a doxorubicin model group， and low-， medium-， and high-dose HBP groups （HBP-L/M/H）， with 13 mice per group. Histopathological severity was assessed using hematoxylin-eosin （HE） and Masson staining. Fibrosis markers were measured by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）， and protein expression was detected by Western blot. ResultA total of 1 044 putative targets for HBP were obtained from ETCM 2.0 and TCMIP v2.0. From the CTD， HPO， and SoFDA databases， 1 223 potential effect-related targets were identified. Cardiac transcriptome sequencing （RNA-seq） yielded 214 genes related to doxorubicin-induced myocardial injury and 58 genes associated with the effects of HBP， using criteria of P-value<0.05 and FC > 1.5/< 0.667. Analysis of the multidimensional molecular network revealed that the mechanisms of HBP on myocardial injury were mainly related to immune-inflammation imbalance， cellular metabolism， myocardial cell function and fibrosis， angiogenesis， contraction and platelet activation， DNA synthesis， metabolism and repair， as well as cell death and oxidative stress. HBP improved cardiovascular abnormalities such as reduced ejection fraction， myocardial fibrosis， myocarditis， hypertriglyceridemia， and arterial/venous thrombosis. Animal experiments demonstrated that HBP reduced the abnormal high expression of Nod-like receptor heat protein domain Protein 3 （NLRP3）， Caspase-1， apoptosis-associated speck-like protein （ASC）， and Gasdermin D （GSDMD） in myocardial tissue induced by doxorubicin （P<0.05）， and improved the elevated mRNA levels of fibrosis markers transforming growth factor-β₁ （TGF-β₁）， Smad3， and α-smooth muscle actin （α-SMA） （P<0.05）. ConclusionHBP can improve myocardial injury through multiple components， targets， and effects， with the inhibition of the NLRP3 inflammasome activation pathway being a key pharmacodynamic mechanism. This study is expected to provide new insights for the development of targeted therapeutic drugs.

Objectives:To analyze the effects of preoperative traction and surgical osteotomy correction in patients with severe scoliosis(SS)accompanied by syringomyelia(SM),and explore the safety and efficacy of one-stage posterior osteotomy surgery following preoperative traction in treating patients with SS accompanied with SM(SS-SM).Methods:A retrospective study was conducted on 40 cases of SS-SM patients who under-went one-stage posterior osteotomy surgery following preoperative traction in our department from January 2007 to October 2023.There were 19 males and 21 females,aged 11 to 41 years(18.28±6.66 years).All the patients had no history of neurosurgical operational treatment and underwent full-spine X-rays,CT,and MRI examinations before surgery to measure the major curve angle on coronal plane,kyphosis angle on sagittal plane,length of SM,to evaluate whether combined with Chiari malformation,and to calculate the size of SM(maximal syrinx/cord ratio,S/C)and deformity angular ratio(DAR).During traction and after operation,full-spine X-rays were re-examined in a timely manner to assess the correction conditions of deformity.According to whether SM was accompanied with Chiari Ⅰ malformation(CM Ⅰ),the patients were divided into the CM Ⅰ-related SM group(CS group)and the idiopathic SM group(IS group);According to the size of SM,the pa-tients were also divided into the big syrinx group(BS group,S/C＞0.6)and the little syrinx group(LS group,S/C ≤0.6).The contribution rates of preoperative traction and surgery to correction were statistically analyzed and compared between different groups(CS group vs IS group,BS group vs LS group).Results:The S/C ratio of SM in 40 patients was 0.59±0.18,with a length of 9.43±5.50 segments.Preoperative skull-femoral traction(SFT)was performed in 36 cases,and halo-gravity traction(HGT)in 4 cases.During traction,5 cases experi-enced temporary local numbness,2 cases had temporary local muscle weakness,and 5 cases developed trac-tion nail tract infections.Low-grade osteotomy was performed in 29 cases(72.5％),and high-grade osteotomy with spinal shortening and fusion was performed in 11 cases(27.5％),with an average of 13.48±1.34 fusion segments.Postoperative complications included local trunk numbness in 2 cases,pulmonary infection in 4 cases,and superficial wound infection in 3 cases,with no motor dysfunction observed.The coronal main curve angle,sagittal kyphosis angle,and total DAR(T-DAR)before operation were 104.80°±18.58°,66.57°±31.21° and 25.73°±8.30°/segment,respectively,which were 65.55°±19.00°,44.95°±23.32° and 16.73°±7.24°/segment,respectively after traction.After correction operation,the scoliosis and kyphosis angles were 37.78°±14.91° and 29.95°±14.14°,respectively,with a main curve flexibility of(20.79±11.02)％.The total correction rates for coronal scoliosis and sagittal kyphosis were(64.44±9.44)％and(51.74±18.40)％,respectively.The av-erage contribution rates of traction and surgery to the correction of coronal scoliosis and sagittal kyphosis were(59.90±17.67)％and(40.10±17.67)％,and(59.21±27.51)％and(40.79±27.51)％,respectively.There were no significant differences in the total correction rates of scoliosis and kyphosis,or the contribution rates of traction and surgery to the correction of scoliosis and kyphosis between the CS and IS groups,and between the BS and LS groups.Preoperative traction improved the DAR by more than 34％and achieved a correction contribution rate of over 50％.The proportion of males was higher in the CS group,while the proportion of females was higher in the IS group(P=0.027).There were no statistical differences between the CS and IS groups in terms of age,preoperative main curve Cobb angle and flexibility,spinal kyphosis angle,DAR value,S/C ratio and SM length,traction improvement effect,total postoperative correction rate,number of fusion seg-ments,osteotomy grade,blood loss,operational duration,or the contribution rates of traction and surgery to spinal correction(P＞0.05).The average S/C ratio in the BS group was significantly higher than that in the LS group(0.74 vs 0.45,P＜0.001),the number of fusion segments was lower in the BS group than in the LS group(13.00 vs 13.90,P=0.031),and the proportion of high-grade osteotomy was higher in the BS group than in the LS group(8/19 vs 3/21,P=0.049).There were no statistical differences between the BS and LS groups in terms of age,preoperative main curve Cobb angle and flexibility,spinal kyphosis angle,DAR value,SM length,traction improvement effect,total postoperative correction rate,blood loss,operational duration,or the contribution rates of traction and surgery to spinal correction(P＞0.05).Conclusions:Preoperative traction can improve spinal deformity to a certain extent,reducing the difficulty of intraoperative correction and risks of neurological injury.For SS-SM patients,regardless of whether they are accompanied with CM Ⅰ or the size of SM,preoperative traction can contribute more than half of the deformity correction rate for coronal scoliosis and sagittal kyphosis.One-stage posterior osteotomy correction surgery following preoperative traction is a safe and effective treatment strategy for SS-SM patients who have not undergone preventive neurosurgical interven-tion.

Humans ; COVID-19/epidemiology* ; Pandemics ; SARS-CoV-2 ; Emergency Medical Services ; Emergency Treatment ; Emergency Service, Hospital

Objective:To analyze the long-term outcomes of different secondary surgeries in women with recurrent stress urinary incontinence (SUI) after Burch colposuspension.Methods:Between February 2004 to February 2010, five women with recurrent SUI after Burch colposuspension in Peking Union Medical College Hospital were retrospectively followed up, and the long-term outcomes of secondary surgeries were analyzed. Subjective cures of Burch colposuspension and secondary surgeries were assessed by patients′ self-reported incontinence symptoms and patient global impression of improvement questionnaire; objective cure, improvement or failure were determined by 1-hour pad test.Results:Three women underwent tension-free vaginal tape-retropubic (TVT) as the secondary surgery, one underwent tension-free vaginal tape-obturator (TVT-O), and one underwent single-incision tension-free vaginal tape-Secur (TVT-Secur). The follow-up period of five women was (14.6±2.4) years (range: 10.8 to 16.9 years). Three women undergoing TVT secondary surgery were subjectively cured; while the other two women undergoing TVT-O or TVT-Secur were not subjectively cured, but the woman undergoing TVT-O was objectively improved.Conclusions:It is feasible for women with recurrent SUI after Burch colposuspension to receive the secondary surgery. Our limited data suggests that TVT could be considered.

Application of new technical means and methods and in-depth exploration in medical service scenarios, for improving the efficiency and quality of diagnosis and treatment, improving the operation and management level and patient′s medical experience are the goals aimed by smart hospitals. Guangdong Second Provincial General Hospital, based on the technical framework of hospital intelligent twins, was exploring to build an all-scenario smart hospital. The hospital built an intelligent operations center, all-scenario smart wards and a smart security and fire protection integrated management center. These practices promoted the service synergy, provided efficient internet of everything experience, and promoted the integrated linkage management of security and fire protection. The hospital effective resolved such deficiencies as insufficient data connectivity, fragmented application scenarios, limited coverage and poor mobility, hence providing reference for the construction and application of whole-scenario smart hospitals.

Adaptation, Psychological ; Adolescent ; COVID-19 ; Child ; China ; Cross-Sectional Studies ; Female ; Humans ; Male ; SARS-CoV-2

Objective:To explore the distribution of pelvic lymph node (PLN) metastasis and the correlative dangerous factors in early cervical cancer patients.Methods:The medical records of 508 patients who underwent extensive hysterectomy and lymphadenectomy for International Federation of Gynecology and Obstetrics (FIGO) stage Ⅰb-Ⅱb cervical cancer in Guizhou Provincial People`s Hospital were reviewed retrospectively.Results:There were 278 patients with stage Ⅰb cervical cancer, 204 patients with stage Ⅱa cervical cancer and 26 patients with stage Ⅱb cervical cancer; the positive rate of lymph node metastasis was 16.7%(85/508), and obturator lymph node metastasis was the most common (56.6%); there were 19 patients with bilateral lymph node metastasis, accounting for 22.35%(19/85); lymph node metastasis occurred 104 times (two times for bilateral simultaneous transfer), and jumping lymph node metastasis accounted for 37.5%(39/104); common iliac lymph node metastasis accounted for 18.3%(19/104). The metastasis rate of patients with stage Ⅱa and Ⅱb (including parametrial, lymph node, ovarian and oviduct metastasis) was higher than that of patients with stage Ⅰb, and the odd ratio ( OR) was 2.30 and 2.48 respectively ( P<0.05); the metastasis rate of patients with moderately differentiated tumors was significantly higher than that of patients with well differentiated and poorly differentiated tumors ( P<0.05). There was no significant difference in the positive rate of pelvic lymph node metastasis among patients with different ages and histological types ( P>0.05); the positive rate of pelvic lymph node metastasis in patients with stage Ⅱa and Ⅱb was higher than that in patients with stage Ⅰb with statistically significant difference ( P<0.05); the positive rate of pelvic lymph node metastasis in patients with moderately differentiated tumors was higher than that in patients with well differentiated and poorly differentiated tumors, with statistically significant difference ( P<0.05). Conclusions:Obturator lymph node metastasis is the most common in cervical cancer. The risk of lymph node metastasis is increased in patients with stage Ⅱa or moderately differentiated tumors. Jumping metastasis is also a common way of metastasis, which suggests that standard and complete lymph node resection is an important measure to ensure the curative effect.

Objective: To explore the effects of noscapine (Nos) on the expression of cadherin 17 (CDH17) in colon cancer SW480 cells and the mechanism of Nos on cell migration. Methods: SW480 cells were divided into the control group, empty vector (si-EV) group, CDH17 interference (si-CDH17) group, Nos treatment group, and CDH17 interference+Nos treatment (si-CDH17+Nos) group. Small interfering RNA (siRNA) was used to knockdown CDH17, and the selected concentration of Nos was (55.30±2.21) µg/ml (IC50). The mRNA expression of CDH17 was detected by qPCR; the apoptosis and migration abilities of SW480 cells were observed by Hoechst33258 staining and Transwell assay; the contents of VEGF, MMP2 and MMP9 in SW480 cells were measured by ELISA, and the protein expressions of CDH17, Wnt3a and β-catenin were determined by WB. Results: Compared with the control group, mRNA and protein expressions of CDH17 obviously decreased, cell apoptosis and migration significantly reduced, while the contents of VEGF, MMP2 and MMP9 as well as the protein expressions of Wnt3a and β-catenin significantly decreased in Nos treatment group, siCDH17 group and si-CDH17+Nos treatment group (all P<0.01).The effect of si-CDH17+Nos treatment was more significant than that of si-CDH17 (P<0.01). Conclusion: Nos induces apoptosis and inhibits the migration of human colon cancer SW480 cells, which may be related to the down-regulation of CDH17 expression and inhibition of the Wnt3a/β-catenin signaling pathway.

Objective: The aim of this study was to explore the clinicopathologic characteristics and prognostic factors of Paget′s disease. Methods: 137 patients with Paget′s disease of the breast who were diagnosed in Cancer Hospital Chinese Academy of Medical Sciences between January 2007 and May 2016 were identified and included in the study, including 134 females and 3 males. Results: The average age at onset of the disease was 51.8 years(range, 27-78 years). Among the 137 patients, 7 cases were Paget′s disease without any other underlying malignancy, who were alive during the follow-up period. The other 130 patients were diagnosed with Paget′s disease and underlying ductal carcinoma in situ (DCIS) or (and) with an invasive carcinoma. The positive expression rates of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) were 29.2%(40/137), 38.0%(52/137)and 78.1%(107/137), respectively. The two-year and five-year overall survival were 99.0%, 96.0%, and disease-free survival of two-year and five-year were 97.6%, 92.8%, respectively for all 137 patients. On survival analysis, longer course of disease, HER-2 positivity, tumor stage(T1-T4), and axillary lymph node metastasis were significantly associated with overall survival. Conclusions Paget′s disease of the breast is a slowly progressive malignancy with good prognosis. A longer course of disease, HER-2 positivity, tumor stage, axillary lymph node metastasis and distant metastasis were significantly associated with poor prognosis.