To explore the feasibility and accuracy for evaluating mitral regurgitation (MR) severity with MR jet volume (MRvol) by means of general imaging three-dimensional quantification (GI3DQ). Methods: A total of 93 MR patients were divided into 2 groups: Central MR group, n=41 and Eccentric MR group, n=52. According to real-time three-dimensional echocardiography (RT3DE) examined planimetry of effective regurgitation orifice area (EROA), the patients were graded into mild MR, moderate MR and severe MR. MRvol was directly measured by GI3DQ. Results: In Central MR group, ROC analysis showed that as GI3DQ measured MRvol>16.2 ml, AUC=0.93, P<0.0001, the sensitivity and specificity for distinguishing mild MR and moderate MR were 96.0% and 70.0%respectively; as MRvol>44.5 ml, AUC=0.96, P<0.0001, the sensitivity and specificity for distinguishing moderate MR and severe MR were 97.6% and 91.7% respectively. In Eccentric MR group, as MRvol>14.2 ml, AUC=0.77, P=0.0243, the sensitivity and specificity for differentiating mild MR and moderate MR were 91.8% and 62.5% respectively; as MRvol>40.5 ml, AUC=0.83, P<0.0001, the sensitivity and specificity for differentiating moderate MR and severe MR were 82.3% and 77.9% respectively. Conclusion: Taking RT3DE examined EROA as reference, GI3DQ directly measured MRvol could more accurately assess MR severity especially in patients with central MR, it may distinguish moderate MR and severe MR with the higher sensitivity and specificity.

To investigate the effect of lipid accumulation index on islet βcell function in middle-aged and elderly people.A total of 10 109 subjects were enrolled in the community residents of Dalian City,aged≥40 years, from July to December 2011, according to enrollment and exclusion criteria.The relationship between lipid accumulation index(LAP)and homeostasis model assessment for βcell function(HOMA-β)was described by curve fitting model, and the effect of LAP on HOMA-βwas proved by correlation and linear regression analysis.The relationship between LAP and HOMA-βshowed an inverted U trend.With the increase of LAP,HOMA-βincreased gradually, following then entered the plateau, and then decreased slowly.According to the LAP quartile classification,each category was analyzed separately as a separate data.Spearman correlation results showed that HOMA-βwas positively correlated with LAP in Q1 group, not in Q2 and Q3 group, while in Q4 group, it was negatively correlated.Multivariate linear regression analysis showed that LAP could enter the equation in group Q1 and group Q4 after adjustment of age, sex, systolic blood pressure, diastolic blood pressure, low density lipoprotein-cholesterol,and high density lipoprotein-cholesterol(all P<0.05).With the increase of LAP,pancreatic β-cell secretion activity increases compensatorily,then decreases to decompensation and finally to the process of weakening secretion.

Objective To study the mini-invasive surgical treatment for cholelithiasis disease in the primary hospital. Methods Laparoseope,duodenoscope and choledochoscope were combined to treat 293 cases with cholelith-iasis which included 2 cases cholecystolithisasis, 131 cases were cholecystolithiasis with secondary choledocholith,28 cases with primary choledocholith,39 cases with calculus of intrahepatic duct,93 cases with calculus of intrahepatic or extrahepatic duct. Results The program had minor trauma, mild suffering, and less operative complications,compared with traditional open operations. Conclusion The combined treatment of laparoscopy, duodenoscopy, choledochoscope and surgery for the cholelithiasis in the primary hospital is feasible, safe and effective.

Objective To study of short-term rehabilitation index and its relationship with medium-term function in male rectal cancer after laparoscopic surgery. Methods A retrospective analysis was made of 60 cases with rectal cancer who received laparoscopic radical resection in our hospital. In the observation group,the pelvic autonomic nerves were retained in 30 cases,and 30 cases in the control group were not retained. The levels of se-rum prealbumin(PA),C reactive protein(CRP),white blood cell count(WBC)and blood cortisol(Cor)were compared between the 2 groups. The independent influence factors of erectile and ejaculatory disorder were fol-lowed up at 6 months after operation. Results Postoperative exhaust time,defecation time,postoperative extuba-tion time,ambulation time,postoperative hospitalization time in the observation group were significantly shorter than those in the control group(P < 0.05). The level of serum CRP,WBC and Cor in the observation group was significantly lower than those of the control group at 3 d after operation,and the level of PA was significantly high-er than that of the control group(P < 0.05).The independent influence factors of erectile dysfunction were the level of PA and CRP at 3d after operation(P < 0.05).The independent influence factors of ejaculatory dysfunction were PA level at 3D after operation(P < 0.05). Conclusion Pelvic nerve protection in laparoscopic surgery is helpful to promote the postoperative recovery. High PA at short term after operation may be one of the medium-term protec-tion mechanisms for sexual function.

Objective:To investigate the feasibility and safety of suprapubic bladder puncture and gland fixation in transurethral enucleation of the prostate.Methods:The clinical data of 15 patients with benign prostatic hyperplasia admitted to the First Affiliated Hospital of Guangxi Medical University from January 2020 to June 2020 were retrospectively analyzed. The age was (70.27±5.35) years old, preoperative serum prostate-specific antigen (PSA) level was (3.03±1.37) ng/ml, preoperative total prostate weight was 80.3(70.49, 96.78)g, preoperative postvoid residual urine volume(PVR)was 80 (55, 108)ml, and the maximum urine flow rate (Q max) was (6.13±2.25) ml/s. The international prostate symptom score(IPSS) was 25(22, 27), quality of life (QOL)score was 5(5, 6), international erectile function index-5 (IIEF-5) score was (15.38±5.10). All 15 patients underwent conventional transurethral plasma enucleation of prostate by using the three-lobe method, and the enucleated gland was pushed into the bladder completely. Then a laparoscopic pneumoperitoneum needle was used to perform suprappubic cystipuncture, and ureteral grasping forceps were inserted through the outer sheath. The forceps were used to fix the enencied gland. A rapid harvesting electric resection was performed in the broad space of the bladder, and the Ellick was rinsed to remove the tissue fragments. Surgical indicators and complications were recorded. The improvement of subjective score (IPSS, QOL, IIEF-5) and objective index (Q max, PVR) was compared between preoperative and postoperative. Results:All the 15 operations were completed successfully and there were no complications such as blood transfusion, capsule perforation, transurethral resection syndrome, bladder injury, bladder puncture site laceration and bleeding. The weight of resected prostate tissue was 44(40, 60)g, with blood loss (79.20±18.93)ml.The time of enucleation operation was (54.13±10.88)min, with harvest cutting time (14.67±2.50)min, evisceration efficiency (0.89±0.08)g/min, harvesting efficiency (3.26±0.36)g/min, bladder irrigation time (2.47±0.52) d. The time of indwelling catheter was (3.73±0.80)d.The postoperative hospital stay was (4.40±0.91) d. Temporary urinary incontinence occurred in 1 case after operation. All patients were followed up for 6 months after operation. The IPSS score was 3(2, 3), QOL score was 0(0, 1), IIEF-5 score was (20.12±2.30), Q maxwas (21.80±2.14) ml/s and PVR was 10(5, 15)ml, which were all significantly different compared with those before surgery ( P<0.05). The symptoms of the patients were significantly improved. Conclusions:Transurethral plasma enucleation of prostate combined with suprapubic bladder puncture and fixed gland is effective in the treatment of benign prostatic hyperplasia. The subjective symptoms and objective examination of patients have been significantly improved, and no adverse operation-related complications have occurred. It is a suitable method for enucleation of prostate in units which are not equipped with transurethral tissue planer.

Objective: To explore the impact of maternal anxiety during pregnancy on social emotional development of toddlers aged 1-3 year old, so as to provide references for scientific early parenting and early intervention for toddlers with social emotional difficulties. Methods: From September 2022 to March 2023, a total of 815 toddlers aged 1-3 who underwent physical examinations and their mothers at Nantong Maternal and Child Health Hospital were enrolled. The Chinese Infant Toddler Social and Emotional Assessment (CITSEA) was used to evaluate the social emotional ability among toddlers. Maternal anxiety evaluated using the Self rating Anxiety Scale (SAS) during prenatal visit was collected. Results: The average scores on the externalizing, internalizing, dysregulation and competence domains of the CITSEA were (49.40±9.48,47.42±9.60,48.67± 10.15 , 50.07± 10.20), respectively. Among boys, the score of externalizing domain (50.89±9.45) was higher than that of girls (48.76± 9.50 ), while the score of competence domain (49.22±10.30) was lower than that of girls (51.17±9.84), and the differences were statistically significant( t =2.10, -3.03, P <0.05). The detection rates of abnormalities in the externalizing, internalizing, dysregulation, and competence domains were 7.36%, 7.12%, 7.61%, and 7.24%, respectively. Among them, boys (8.43%,6.32%, 7.96 %,7.49%) and girls (6.19%, 7.99 %,7.22%,6.96%) showed no statistical differences ( χ 2=1.50, 0.85, 0.16, 0.09, P >0.05). There were significant differences in externalizing domain scores（47.77±9.52，49.56±8.95，52.51±9.77） and competence domain scores（51.70±10.38，49.65±10.05，46.68±10.03） among toddlers of different maternal anxiety（normal, mild, moderate to severe） （ F =7.05,7.10, P <0.01）. There were significant differences in the abnormal detection rate of externalizing domain （4.81%，7.54%，11.17%） and competence domain（4.81%，6.96%，11.73%）（ χ 2=6.60，7.98， P ＜0.05）. Conclusion Maternal anxiety during pregnancy has a negative impact on the social emotional development among toddlers. In order to improve social emotional development of toddlers, multidimensional social support and education during pregnancy should be carried out.

Objective:To investigate the current status of prevention and treatment of esophagogastric variceal bleeding (EVB) in cirrhotic portal hypertension patients in Ningxia region.Methods:The retrospective and descriptive study was conducted. The clinical data of 820 cirrhotic portal hypertension patients who were admitted to 21 medical centers in Niangxia region from January 2018 to December 2020 were collected, including 85 cases in Ningxia Hui Autonomous Region People′s Hospital, 73 cases in the Fifth People′s Hospital of Ningxia Hui Autonomous Region, 59 cases in the Wuzhong People′s Hospital, 52 cases in the Qingtongxia People′s Hospital, 50 cases in the Guyuan People′s Hospital, 47 cases in the Yuanzhou District People′s Hospital of Guyuan City, 47 cases in the Yinchuan Second People′s Hospital, 40 cases in the General Hospital of Ningxia Medical University, 40 cases in the Tongxin People′s Hospital, 35 cases in the Yinchuan First People′s Hospital, 34 cases in the Third People′s Hospital of Ningxia Hui Autonomous Region, 32 cases in the Zhongwei People′s Hospital, 30 cases in the Lingwu People′s Hospital, 30 cases in the Wuzhong New District Hospital, 30 cases in the Yanchi People′s Hospital, 29 cases in the Ningxia Hui Autonomous Region Academy of Traditional Chinese Medicine, 28 cases in the Shizuishan Second People′s Hospital, 25 cases in the Shizuishan First People′s Hospital, 21 cases in the Haiyuan People′s Hospital, 20 cases in the Pengyang People′s Hospital, 13 cases in the Longde People′s Hospital. There were 538 males and 282 females, aged (56±13)years. Observation indicators: (1) clinical charac-teristics of cirrhotic portal hypertension patients; (2) overall prevention and treatment of EVB in cirrhotic portal hypertension patients; (3) prevention and treatment of EVB in cirrhotic portal hypertension patients from different grade hospitals. Measurement data with normal distribution were represented as Mean± SD. Count data were described as absolute numbers, and comparison between groups was analyzed using the chi-square test. Results:(1) Clinical characteristics of cirrhotic portal hypertension patients: of 820 cirrhotic portal hypertension patients, 271 cases were in compensated stage and 549 cases were in decompensated stage. Of the 271 cases in compensated stage, there were 183 maels and 88 females, aged (53±12)years. There were 185 Han people, 85 Hui people and 1 case of other ethic group. The etiological data of liver cirrhosis showed 211 cases of viral hepatitis B, 4 cases of alcoholic liver disease, 8 cases of viral hepatitis C, and 48 cases of other etiology. There were 235 cases of Child-Pugh grade A and 36 cases lack of data. Of the 549 cases in decompensated stage, there were 355 males and 194 females, aged (57±14) years. There were 373 Han people, 174 Hui people and 2 cases of other ethic group. The etiological data of liver cirrhosis showed 392 cases of viral hepatitis B, 33 cases of alcoholic liver disease, 10 cases of viral hepatitis C, and 114 cases of other etiology. There were 80 cases of Child-Pugh grade A, 289 cases of grade B, 170 cases of grade C and 10 cases lack of data. (2) Overall prevention and treatment of EVB in cirrhotic portal hypertension patients: of 271 patients in compensated stage, 38 cases received non-selective β-blocker (NSBB) therapy, 16 cases received endoscopic treatment, 6 cases received interventional therapy. Of 549 patients in decompensated stage, 68 cases received NSBB therapy, 46 cases received endoscopic treatment, 28 cases received interventional therapy. (3) Prevention and treatment of EVB in cirrhotic portal hypertension patients from different grade hospitals: of 271 patients in compensated stage, 181 cases came from tertiary hospitals, of which 28 cases received NSBB therapy, 15 cases received endoscopic treatment, 6 cases received interventional therapy. Ninety cases came from secondary hospitals, of which 10 cases received NSBB therapy, 1 cases received endoscopic treatment. There was no significant difference in NSBB for prevention of EVB between tertiary and secondary hospitals ( χ2=0.947, P>0.05), while there was a significant difference in endoscopic treatment for prevention of EVB between tertiary and secondary hospitals ( χ2=5.572, P<0.05). Of 549 patients in decompensated stage, 309 cases came from tertiary hospitals, of which 22 cases received NSBB therapy, 29 cases received endoscopic treatment, 22 cases received interventional therapy. Two hundreds and fourty cases came from secondary hospitals, of which 46 cases received NSBB therapy, 17 cases received endoscopic treatment, 6 cases received interven-tional therapy. There were significant differences in NSBB and interventional therapy for prevention of EVB between tertiary and secondary hospitals ( χ2=18.065, 5.956, P<0.05). Conclusions:The proportion of receiving EUB prevention in cirrhotic portal hypertension in Ningxia is relatively low. For patients with compensated liver cirrhosis, the proportion of NSBB therapy and endoscopic treatment in the secondary hospitals was lower than that in tertiary hospitals. For patients with decompensated liver cirrhosis, the proportion of interventional treatment in secondary hospitals is lower than that of tertiary hospitals, but the proportion of NSBB in secondary hospitals taking is higher than that of tertiary hospitals.

【Objective】 To investigate the efficacy of the adjustable "paper clip" techniques in the suture of dorsal vein complex (DVC) and retention of urethral function in robot-assisted laparoscopic radical prostatectomy (RALRP). 【Methods】 A total of 30 cases of prostate cancer treated with RALRP were enrolled, all of which used the adjustable "paper clip" techniques. During operation, the DVC was sewed with barbed suture, and then a reverse suture was made through two sides of the prostatic ligaments. A Hem-o-lock was used to fasten the suture, which would be flexible to control the degree of tightness for the ligature. Perioperative and follow-up data of urinary continence and symptoms were collected and analyzed. 【Results】 All operations were successful. The estimated blood loss was (123.3±80.7) mL, 53.6% patients recovered continence in 1 month, and the continence rate increased to 92.9% and 96.3% at month 3 and 6. 92.9 of patients had no risk of incontinence 3 months after surgery. 【Conclusion】 The adjustable "paper clip" techniques have advantages in reducing blood loss, maintaining clear surgical field, preserving urethral function, and improving urinary continence.