Objective To explore the feasibility and clinical value of the trans-umbilical single-port laparoscopic operation with routine apparatus in treatment of hepatobiliary diseases. Methods From Mar 2010 to Sep 2012, 415 patients with hepatobiliary disease, splenic disease, abdominal cavity disease or combine hysteromyoma were performed by trans-umbilical single-port laparoscopic operation with routine apparatus. The clinical data of 415 cases were analyzed respectively.Result All patients except one patients who was added one port for hysterectomy, were performed successfully trans-umbilical single-port laparoscopic operation with routine apparatus without conversion to laparotomy or conventional laparoscopic surgery. Conclusions The trans-umbilical single-port laparoscopic operation with routine apparatus is safe and effective in treatment of hepatobiliary diseases. Limited by the anatomy position, the trans-umbilical single-port laparoscopic operation with routine apparatus can cure most hepatobiliary diseases. So the operator must have the experience both in single-port laparoscopic operation and traditional laparoscopic operation. With the improvement of rotatable equipment, the practical procedure is expected to be generalized in the future.

OBJECTIVE: To optimize the formula and preparation technology of gliclazide controlled-release tablets. METHODS: Gliclazide controlled-release tablets were prepared in different formulations and the release rates of the prepared tablets were determined to obtain the optimum formula and preparation technology. RESULTS: The optimized formula of gliclazide controlled-release tablets were determined as follow: with HPMC(K4M)=17g and HPMC(E50)=35g as matrix materials; Calcium hydrogen phosphate=91g as the bulking agent and magnesium stearate as lubricant. Gliclazide controlled-release tablets showed a similar release rate as the reference samples. CONCLUSION: The releasing rate of gliclazide controlled-release tablets prepared in the optimized formula is in line with the standards stated in China Pharmacopeia.

Objective:To develop a set of algorithms that could predict the precise size of acetabular cup preoperatively by the deep learning neural network technology.Methods:Retrospective analysis was performed on 30 patients with femoral head necrosis from April 2019 to April 2020, including 15 males and 15 females. At the age of (54.8±10.5) years (range 33-72 years). Thirteen hips on the left and seventeen hips on the right, who underwent primary unilateral THA. Based on the manually segmented hip joint CT database, a deep learning convolutional neural network was trained to realize automatic segmentation. A customized algorithm was created to fit the surface of the acetabulum. By the application of another deep learning convolutional neural network, the identification of anatomical points of the pelvis and correction of the pelvic position were realized. So that the placement of the acetabulum cup could be done. DOC (dice overlap coefficients) as well as the average error parameter were adopted to evaluate the accuracy of the above steps. The novel algorithm and Orthoview software were retrospectively used to template the acetabular cup separately. The results of both groups were compared with the actual size and the coincidence rate was calculated to evaluate the accuracy of the novel algorithm. To verify this algorithm, the conformance rate was calculated respectively.Results:Compared with other classical segmentation networks, the G-NET network can segment the pelvic with femoral head necrosis more accurately (DOC 92.51%± 6.70%). It also has better robustness. The average error of the point recognition network is 0.87 pixels. Among the 30 patients, the AI-based algorithm group had a complete coincidence rate of 96.7% and the Orthoview group had a complete coincidence rate of 73.3%. The difference was statistically significant ( χ2=6.405, P=0.011). Conclusion:The artificial intelligence-based algorithm can segment the CT image series and identify the feature points of the patient's hip accurately. Compared with the conventional 2D preoperative planning method, the AI-based algorithm is relatively more accurate. This artificial intelligence-based 3D preoperative software has promising prospect to makeaccurate surgical plan efficiently.

Objective:To explore the mechanism of promotion effect of juglone combined with cisplatin on the apoptosis of human cervical cancer HeLa cells,and to clarify the effects of its associated signal transduction pathways.Methods:The HeLa cells at logarithmic growth phase were divided into control group,juglone group, cisplatin group and juglone combined with cisplatin group (combined treatment group).The inhibitory rates of proliferation of HeLa cells were detected by MTT assay.The apoptosis was detected by Hoechst 33258 staining. The expressions of Bcl-2, Bax and caspase-3, AKt, and pAKt were detected by Western blotting method. Results:The MTT results showed that the HeLa cell proliferation at 24,48 72 h in each drug group was inhibited;compared with control group,the profileration of HeLa cells in juglone group and cisplatin group was significantly inhibited,especially in combined group. Compared with single drug group,the inhibitory effect in combined treatment group was more significantly.After treatment for 12 h,the typical morphological changes of apoptosis were found in juglone group and cisplatin group by Hoechst 33258 staining,especially in combined treatment group. The Western blotting results showed that the expression levels of Bcl-2 and pAKt in HeLa cells in juglone group and cisplatin group 12 h after treatment were decreased obviously,whereas the expression levels of Bax,Caspase-3,and AKt were increased significantly, especially in combined treatment group compared with control group. Conclusion:Juglone combined with cisplatin could inhibit the PI3K/AKt pathway,thereby promoting the apoptpsis of HeLa cells.

OBJECTIVE To explore the pro-apoptotic mechanism of juglone in SiHa cells and to in?vestigate its associated signal transduction pathways. METHODS SiHa cells were treated with juglone 20μmol·L-1 for 24,48 and 72 h. Cellular morphology was detected by inverted microscopy.The cell viability was detected by methyl thiazolyl tetrazolium (MTT) assay. After 24 h treatment with juglone 20μmol·L-1,the cell apoptosis was detected by flow cytometry while the expressions of apopto?sis-related protein BCL-2,BAX and cleave-caspase-3,PI3K/AKt pathway-related protein PTEN,AKT and pAKT were detected by Western blotting. RESULTS After treatment with juglone for 24, 48 and 72 h,the growth of SiHa cells was significantly inhibited. Compared with cell control group,cells in juglone treated gruop were sparse,slipped off the wall,became round and the cell proliferation inhibitory rate was 43.3%,63.0%and 73.1%(P<0.05,P<0.01),respectively. Twenty-four hours post treatment, the early apoptosis rate of juglone treated gruop cells was increased by(6.47±1.79)%(P<0.01)compared with cell control group. Western blotting results showed that the expression of BCL-2 decreased by 53.0%while the expression of BAX and caspase-3 increased by 85.5%and 183.3%,respectively. The expression of PTEN was increased by 75.0% but the pAKt was decreased by 45.8%(P<0.01). CONCLUSION Juglone can upregulate the expression of PTEN, thus inhibiting PI3K/AKt pathway and promoting apoptosis of SiHa cells.

Objective To evaluate the effect and safety of intravenous (IV) thrombolysis, intra-arterial (IA) thrombolysis and mechanical adjuvant intra- arterial thrombolysis (IA + MA) in treating cardiogenic cerebral embolism. Methods A total of 66 patients with cardiogenic cerebral embolism were randomly divided into IV group (n = 25), IA group (n = 18), IA + MA group (n = 23). The artery recanalization rate, NIHSS score, GCS score, BI excellent rate, symptomatic intracranial hemorrhage rate and mortality after different thrombolytic therapies were determined. The results were compared between each other among the three groups. Results In all three groups both the post-treatment NIHSS score and GCS score were significantly improved when compared with pre-treatment ones (P < 0.05). In IA + MA group the artery recanalization rate was 78.3%(18/23) and the BI excellent rate was 40%(10/25), which were significantly higher than those in IV group (P < 0.05). The symptomatic intracranial hemorrhage rate in IA group was 5.6%(1/18), which was strikingly lower than that in IV group (32%, 8/25). Analysis of the causes showed that the artery recanalization rate in patients with valvular heart disease or cardiac myxoma was rather lower, but the intracranial hemorrhage rate and mortality in these patients were much higher. Conclusion Thrombolytic therapy can improve neurological deficit in cardiogenic cerebral embolism, and the therapeutic effect of mechanical adjuvant intra- arterial thrombolysis is definitely better.

Objective: To analyze molecular feature of rabies virus (RABV) epidemic strains in Sichuan province during 2011 to 2017, and explore differences at nucleotide, amino acid and protein modification between these street strains and vaccine strains. Methods: Nucleoprotein(N) and glycoprotein(G) genes were amplified by RT-PCR using specific primers for 23 antigen-positive canine brain specimens collected from 2011 to 2017. The evolutionary relationship and immune antigenicity of N and G genes was analyzed. Bioinformatics software was used to analyze and organize data. Results: We obtained the N and G genes sequences of 23 RABV strains by sequencing. Genetic evolution relationship analysis showed that all the 23 RABV strains belonged to rabies virus species and could be divided into three branches, which had apparent geographically specific characteristics but some Sichuan strains co-circulated with the epidemic strains in the eastern and northern regions of China.The N genes of Sichuan strains had nucleotide and amino acid homology of 97.4% to 100% and 99.6%-100%. The nucleotide and amino acid homology between Sichuan strains and reference strains were 72.1%-99.8% and 81.6%-100%, respectively. There were some differences in antigenic sites, cell epitopes and signal peptide sequences between vaccine strain and Sichuan strains but no significant change was found in antigenicity, organizational preference and virulence. Conclusions The 23 strains of RABV of Sichuan belonged to rabies virus species and had no obvious differences. There were few differences between Sichuan strain and vaccine strain in amino acid sequences of G, but the virulence did not change.

At present, total hip arthroplasty (THA) is the primary treatment for hip diseases such as femoral head necrosis and developmental dysplasia of the hip. It has good effects in reducing pain and improving joint function. The appearance of modular hip prosthesis facilitates adjustment of limb length and femoral offset. However, the wear between the interface of hip prosthesis can lead to inflammatory pseudotumor, osteolysis and other adverse reactions. To explore the risk factors of wear between hip prosthesis interface is helpful to improve the design and manufacturing concept of the product, improve the product performance, help surgeons optimize the operation technology and reduce the impact of human factors on the wear of the prosthesis. Many literatures have reported the mechanism of wear between the head-acetabula interface of prosthesis. The mechanism of wear between the interfaces has been described relatively clearly. In addition to the head-acetabula interface, the wear between the head-neck interface is another major cause of unexplained pain around the joint and prosthesis loosening after hip replacement. Many factors affect head-neck wear. The design of prosthesis (such as prosthesis material and prosthesis taper), surgical technology (such as impact strength and prosthesis mismatch) and patient factors (such as age, gender and activity) have important impact on head-neck wear. Adverse reactions caused by head-neck wear have also been widely concerned. However, there is no considerable solution for wear prevention. Thus, we should optimize the design of prosthesis, improve the surgical technology, and guide the rehabilitation of patients to prevent wear. In order to improve the attention of joint surgeons, the present paper reviews the literatures and analyzes the risk factors of head-neck interface wear and the clinical manifestations caused by head-neck wear.

OBJECTIVE To investigate the correlation between serum levels of asprosin and adropin in elderly patients with obstructive sleep apnea syndrome(OSAS)and the disease severity.METHODS From August 2021 to August 2023,131 elderly OSAS patients admitted to Ezhou Central Hospital were collected as observation subjects(OSAS group),according to the sleep apnea hypopnea index(AHI),there were 40 cases in the mild group,52 cases in the moderate group,and 39 cases in the severe group,meantime,124 healthy individuals who came to health clinic of our hospital for physical examination were collected as the control group.Enzyme-linked immunosorbent assay(ELISA)was applied to determine the levels of asprosin and apropin in the serum of OSAS patients;Pearson method was applied to analyze the correlation between serum asprosin,apropin levels and AHI,ODI,and LSaO2.ROC curve was used to analyze the diagnostic value of serum asprosin and adropin levels in OSAS and the severity of OSAS patients.RESULTS Compared with the control group,the asprosin level in the OSAS group was obviously increased,while the adropin level was obviously reduced(P<0.05).There was no statistically obvious difference in gender,age,coronary heart disease,hypertension,TC,TG,HDL-C,LDL-C among the mild,moderate,and severe groups(P>0.05);compared with the mild group,the levels of BMI,AHI,ODI,and asprosin in the moderate and severe groups were obviously increased,while the levels of LSaO2 and apropin were obviously reduced(P<0.05);compared with the moderate group,the levels of BMI,AHI,ODI,and asprosin in the severe group were obviously increased,while the levels of LSaO2 and apropin were obviously reduced(P<0.05).The serum asprosin level in OSAS patients was positively correlated with AHI and ODI,and negatively correlated with LSaO2(P<0.05);the level of apropin was negatively correlated with AHI and ODI,and positively correlated with LSaO2(P<0.05).The AUC of serum asprosin,apropin levels,and their combination in diagnosing moderate and severe OSAS was 0.832,0.882,and 0.942,respectively,the combined diagnostic value of the two was superior to that of single diagnosis(Z=3.435,2.560,P=0.001,0.011).Serum asprosin,adropin levels and AUC of combined diagnosis of OSAS were 0.818,0.804 and 0.893,respectively.The value of combined diagnosis was better than that of single diagnosis(Z=3.886,4.126,P=0.000,0.000).CONCLUSION The serum level of asprosin is increased and the level of adropin is decreased in patients with OSAS,which is closely related to the severity of the disease,and may be used in the clinical diagnosis of OSAS and the evaluation of the severity of OSAS.

Objective:To develop a preoperative CT image segmentation algorithm based on artificial intelligence deep learning technology for total hip arthroplasty (THA) revision surgery, and to verify and preliminarily apply it.Methods:A total of 706 revision cases with clear CT data from April 2019 to October 2022 in Chinese PLA General Hospital were retrospectively analyzed, including 520 males, aged 58.45±18.13 years, and 186 females, aged 52.23±16.23 years. All of them were unilateral, and there were 402 hips on the left and 304 hips on the right. The transformer_unet convolutional neural network was constructed and trained using Tensorflow 1.15 to achieve intelligent segmentation of the revision THA CT images. Based on the developed three-dimensional planning system of total hip arthroplasty, an intelligent planning system for revision hip arthroplasty was preliminarily constructed. Dice overlap coefficient (DOC), average surface distance (ASD) and Hausdorff distance (HD) parameters were used to evaluate the segmentation accuracy of transformer_unet, full convolution network (FCN), 2D U-shaped Net and Deeplab v3 +, and segmentation time was used to evaluate the segmentation efficiency of these networks.Results:Compared with the FCN, 2D U-Net, and Deeplab v3+ learning curves, the transformer_unet network could achieve better training effect with less training amount.The DOC of transformer_unet was 95%±4%, the HD was 3.35±1.03 mm, and the ASD was 1.38±0.02 mm; FCN was 94%±4%, 4.83±1.90 mm, 1.42±0.03 mm; 2D U-Net was 93%±5%, 5.27±2.20 mm, and 1.46±0.02 mm, respectively. Deeplab v3+ was 92%±4%, 6.12±1.84 mm, 1.52±0.03 mm, respectively. The transformer_unet coefficients were better than those of the other three convolutional neural networks, and the differences were statistically significant (all P<0.05). The segmentation time of transformer_unet was 0.031±0.001 s, FCN was 0.038±0.002 s, 2D U-Net was 0.042±0.001 s, Deeplab v3+ was 0.048±0.002 s. The segmentation time of transformer_unet was less than that of the other three convolutional neural networks, and the difference was statistically significant ( P<0.05). Based on the results of previous studies, an artificial intelligence assisted preoperative planning system for THA revision surgery was initially constructed. Conclusion:Compared with FCN, 2D U-Net and Deeplab v3+, the transformer_unet convolutional neural network can complete the segmentation of the revision THA CT image more accurately and efficiently, which is expected to provide technical support for preoperative planning and surgical robots.