Objective:To explore a new surgical approach [anteromedial approach of the hip (AMA)] for Pipkin Ⅰ and Ⅱ femoral head fractures through an imaging and anatomical study.Methods:The hip imaging data were collected of the 38 patients who had undergone lower limb CT angiography for open tibiofibular fractures at Department of Orthopaedics, The Sixth People’s Hospital, School of Medicine, Shanghai Jiao Tong University from June 2023 to January 2024. There were 20 males aged (40.9±3.5) years and 18 females aged (41.5±3.3) years. The origins and shapes of the femoral artery and its main branches were observed. The distances between the femoral head and the femoral artery, the medial femoral circumflex artery, and the lateral femoral circumflex artery were measured. Four fresh adult cadavers were collected, including 2 males and 2 females. Their ages of death were 56, 65, 72 and 78 years old, respectively. An incision was made along the axis of the limb at the midpoint of the inguinal ligament at the 4 fresh cadavers. After the femoral head was exposed through the gap between the femoral artery and the femoral nerve, the range of the femoral head exposed was marked.Results:The femoral artery ran along the anteromedial side of the femoral head. The shortest distance between the medial femoral circumflex artery and the femoral head was (13.1±5.7) mm, and the shortest distance between the origin of the lateral femoral circumflex artery and the femoral head (21.6±8.6) mm. On the lateral view of CT angiography, the distance between the femoral artery and the femoral head was (20.6±4.9) mm at the level of the apex of greater trochanter. Gross observation on the cadavers found only small branches of vessels between the femoral artery and the femoral nerve. After the femoral artery and femoral nerve were respectively pulled medially and laterally, the anterior-inferior part of the femoral head was exposed directly by pulling the muscles to open the joint capsule. The exposure range of the femoral head was further expanded through internal and external rotation of the hip joint under traction. The anatomical gap between the femoral artery and the femoral nerve was named the AMA.Conclusion:AMA utilizes the potential gap between the femoral artery and the femoral nerve, providing a new surgical approach for exposure and fixation of Pipkin type Ⅰ and Ⅱ femoral head fractures.

Objective To investigate the current status and influencing factors of anticipatory grief of main caregivers of young and middle-aged patients with advanced liver cancer by cross-sectional survey.Methods A total of 330 caregivers of young and middle-aged patients with advanced liver cancer who were admitted to The Third Affiliated Hospital of Naval Medical University from January 2023 to May 2023 were enrolled as research objects by convenience sampling.A questionnaire survey on general information,anticipatory grief and simple coping style was conducted on these caregivers one day before discharge.Results The score of anticipatory grief of the caregivers was 94.10±22.33.Multiple linear stepwise regression analysis was performed with statistically significant data from the characteristics of the research objects as independent variables and anticipatory grief as the dependent variable,and the result showed that gender,monthly income,educational level,personality self-assessment and coping were main factors affecting anticipatory grief of main caregivers of young and middle-aged patients with advanced liver cancer(all P<0.05).The mean score for positive response was 2.23±0.14,which was negatively associated with anticipatory grief(P=0.041).The mean score for negative response was 1.31±0.24,which was positively associated with anticipatory grief(P<0.001).Conclusion The anticipatory grief of main caregivers of young and middle-aged patients with advanced liver cancer is at a high level.The anticipatory grief is negatively related to positive coping,and positively related to negative coping.The main factors affecting anticipatory grief of main caregivers of young and middle-aged patients with advanced liver cancer are gender,family economic status,educational level,and introverted personality.

Objective To investigate the expression and clinical diagnosis significance of serum long non-coding RNA PANDAR(lncRNA PANDAR)and procollagen type I C-terminal propeptide(PICP)in diabetic nephropathy(DN).Methods A total of 310 patients with type 2 diabetes mellitus(T2DM)admitted to the Third Affiliated Hospital of Chengdu Medical College from January 2022 to December 2023 were selected as the case group,and further divided into DM group(n=190)and DN group(n=120)based on the presence or absence of concomitant kidney disease.60 healthy subjects were selected as the control group.The expression level of lncRNA PANDAR was determined by real time fluorescence quantitative PCR,and the serum PICP level was determined by enzyme-linked immunosorbent assay(ELISA).The expression of lncRNA PANDAR and serum PICP in each group was compared.Logistic regression was used to analyze the influencing factors of DN.ROC curve was used to evaluate the diagnostic value of serum lncRNA PANDAR,PICP and their combination in DN.Results The levels of serum lncRNA PANDAR(4.56±1.26),PICP(147.72±19.20 μg/L)in the case group were higher than those in the control group(2.27±0.61,117.24±12.72 μg/L),and the differences were statistically significant(t=13.758,11.799,all P<0.05).With the increase of chronic kidney disease(CKD)stage,the levels of serum lncRNA PANDAR and PICP gradually increased,and the differences were statistically significant(F=16.790,286.87,all P<0.05).The levels of serum lncRNA PANDA(5.27±1.26)and PICP(159.59±17.10 μg/L)in DN group were higher than those in DM group(4.11±1.03,140.22±16.56 μg/L),the differences were statistically significant(t=-8.847,-9.905,all P<0.05).Multivariate Logistic regression analysis showed that lncRNA PANDA and PICP were independent risk factors for DN in T2DM patients(Wald χ2=11.592,7.880,all P<0.05).The areas under curve(AUC)of serum lncRNA PANDA and PICP combined detection of DN in patients with T2 DM was higher than that of single index detection,and the differences were statistically significant(Z=-2.006,-3.069,all P<0.05).Conclusion The levels of serum lncRNA PANDAR and PICP in patients with DN are increased,and their combined detection can improve the diagnostic efficiency of DN.

Objective:To analyze the current status, hotspots, and trends of community integration (CI) at home and abroad, providing directions for subsequent research.Methods:The China National Knowledge Infrastructure and the Web of Science Core Collection data were used, and CiteSpace software was employed to analyze the publication, countries, disciplines, and keywords of CI.Results:A total of 932 Chinese and 2 319 English hits were included. The publication of CI had shown an increasing trend both domestically and internationally. Sociology and rehabilitation were the main disciplines in CI domestically and internationally, respectively. Domestically, CI research primarily focused on the community integration of migrant workers, floating populations, and accompanying family members. Internationally, the emphasis was on the integration of individuals with disabilities and other special groups. Future research directions in China were likely to focus on group work, the elderly, and relocated populations. Internationally, CI research would continue to concentrate on CI experiences and intervention methods for individuals with disabilities and special populations.Conclusion:CI is increasingly gaining attention both domestically and internationally. However, domestic research remains insufficient and needs to be expanded through more empirical studies in various vertical subfields. Future domestic scholars should continue to focus on CI of the elderly and engage in interdisciplinary research.

OBJECTIVE To provide help for further exploring the mechanism of action of traditional Chinese herb by constructing a complex network of traditional Chinese herb-gene-protein,optimizing the mining method of potential associated genes of traditional Chinese herb and improving the mining efficiency of traditional Chinese herb system biology information.METHODS A graph neural network model HERBGAT with an attention mechanism was proposed.A small amount of traditional Chinese herb-related gene data in the public data platform was used as input,and deep mining was performed in the traditional Chinese herb-gene-protein complex net-work to output potential traditional Chinese herb-related genes.The prediction results were analyzed by disease association analysis and KEGG signaling pathway analysis on the bioinformatics platform to clarify their mechanism of action,and the prediction results were verified by the literature retrieval platform.RESULTS The training results showed that the average prediction accuracy of the HERB-GAT model could reach 94%.Compared with the other two advanced complex network mining methods,HERBGAT showed better per-formance in the three indicators of ACC,AUC and AUPR.In the literature verification stage,the model prediction results were verified by TCM clinical literature and modern pharmacology literature,showing the good effect of HERBGAT in practical application.At the end of this paper,taking the HERBGAT model and the improved EMOGI model to explore the mechanism of action of Pinellia ternata in treating lung cancer as an example,199 potential associated genes of Pinellia ternata in treating lung cancer were found,and these potential associated genes were preliminarily analyzed and discussed with the help of bioinformatics methods.CONCLUSION The HERBGAT model can effectively mine potential traditional Chinese herb-associated genes,improve the mining efficiency of traditional Chinese herb-gene-protein complex networks,provide new ideas and references for the optimization of traditional Chinese herb system biology information mining methods,and provide data basis and experimental direction for exploring the mechanism of action of tradi-tional Chinese herb.

OBJECTIVE To provide help for further exploring the mechanism of action of traditional Chinese herb by constructing a complex network of traditional Chinese herb-gene-protein,optimizing the mining method of potential associated genes of traditional Chinese herb and improving the mining efficiency of traditional Chinese herb system biology information.METHODS A graph neural network model HERBGAT with an attention mechanism was proposed.A small amount of traditional Chinese herb-related gene data in the public data platform was used as input,and deep mining was performed in the traditional Chinese herb-gene-protein complex net-work to output potential traditional Chinese herb-related genes.The prediction results were analyzed by disease association analysis and KEGG signaling pathway analysis on the bioinformatics platform to clarify their mechanism of action,and the prediction results were verified by the literature retrieval platform.RESULTS The training results showed that the average prediction accuracy of the HERB-GAT model could reach 94%.Compared with the other two advanced complex network mining methods,HERBGAT showed better per-formance in the three indicators of ACC,AUC and AUPR.In the literature verification stage,the model prediction results were verified by TCM clinical literature and modern pharmacology literature,showing the good effect of HERBGAT in practical application.At the end of this paper,taking the HERBGAT model and the improved EMOGI model to explore the mechanism of action of Pinellia ternata in treating lung cancer as an example,199 potential associated genes of Pinellia ternata in treating lung cancer were found,and these potential associated genes were preliminarily analyzed and discussed with the help of bioinformatics methods.CONCLUSION The HERBGAT model can effectively mine potential traditional Chinese herb-associated genes,improve the mining efficiency of traditional Chinese herb-gene-protein complex networks,provide new ideas and references for the optimization of traditional Chinese herb system biology information mining methods,and provide data basis and experimental direction for exploring the mechanism of action of tradi-tional Chinese herb.

Objective To investigate the expression and clinical diagnosis significance of serum long non-coding RNA PANDAR(lncRNA PANDAR)and procollagen type I C-terminal propeptide(PICP)in diabetic nephropathy(DN).Methods A total of 310 patients with type 2 diabetes mellitus(T2DM)admitted to the Third Affiliated Hospital of Chengdu Medical College from January 2022 to December 2023 were selected as the case group,and further divided into DM group(n=190)and DN group(n=120)based on the presence or absence of concomitant kidney disease.60 healthy subjects were selected as the control group.The expression level of lncRNA PANDAR was determined by real time fluorescence quantitative PCR,and the serum PICP level was determined by enzyme-linked immunosorbent assay(ELISA).The expression of lncRNA PANDAR and serum PICP in each group was compared.Logistic regression was used to analyze the influencing factors of DN.ROC curve was used to evaluate the diagnostic value of serum lncRNA PANDAR,PICP and their combination in DN.Results The levels of serum lncRNA PANDAR(4.56±1.26),PICP(147.72±19.20 μg/L)in the case group were higher than those in the control group(2.27±0.61,117.24±12.72 μg/L),and the differences were statistically significant(t=13.758,11.799,all P<0.05).With the increase of chronic kidney disease(CKD)stage,the levels of serum lncRNA PANDAR and PICP gradually increased,and the differences were statistically significant(F=16.790,286.87,all P<0.05).The levels of serum lncRNA PANDA(5.27±1.26)and PICP(159.59±17.10 μg/L)in DN group were higher than those in DM group(4.11±1.03,140.22±16.56 μg/L),the differences were statistically significant(t=-8.847,-9.905,all P<0.05).Multivariate Logistic regression analysis showed that lncRNA PANDA and PICP were independent risk factors for DN in T2DM patients(Wald χ2=11.592,7.880,all P<0.05).The areas under curve(AUC)of serum lncRNA PANDA and PICP combined detection of DN in patients with T2 DM was higher than that of single index detection,and the differences were statistically significant(Z=-2.006,-3.069,all P<0.05).Conclusion The levels of serum lncRNA PANDAR and PICP in patients with DN are increased,and their combined detection can improve the diagnostic efficiency of DN.

Objective:To analyze the current status, hotspots, and trends of community integration (CI) at home and abroad, providing directions for subsequent research.Methods:The China National Knowledge Infrastructure and the Web of Science Core Collection data were used, and CiteSpace software was employed to analyze the publication, countries, disciplines, and keywords of CI.Results:A total of 932 Chinese and 2 319 English hits were included. The publication of CI had shown an increasing trend both domestically and internationally. Sociology and rehabilitation were the main disciplines in CI domestically and internationally, respectively. Domestically, CI research primarily focused on the community integration of migrant workers, floating populations, and accompanying family members. Internationally, the emphasis was on the integration of individuals with disabilities and other special groups. Future research directions in China were likely to focus on group work, the elderly, and relocated populations. Internationally, CI research would continue to concentrate on CI experiences and intervention methods for individuals with disabilities and special populations.Conclusion:CI is increasingly gaining attention both domestically and internationally. However, domestic research remains insufficient and needs to be expanded through more empirical studies in various vertical subfields. Future domestic scholars should continue to focus on CI of the elderly and engage in interdisciplinary research.

Objective:To explore a new surgical approach [anteromedial approach of the hip (AMA)] for Pipkin Ⅰ and Ⅱ femoral head fractures through an imaging and anatomical study.Methods:The hip imaging data were collected of the 38 patients who had undergone lower limb CT angiography for open tibiofibular fractures at Department of Orthopaedics, The Sixth People’s Hospital, School of Medicine, Shanghai Jiao Tong University from June 2023 to January 2024. There were 20 males aged (40.9±3.5) years and 18 females aged (41.5±3.3) years. The origins and shapes of the femoral artery and its main branches were observed. The distances between the femoral head and the femoral artery, the medial femoral circumflex artery, and the lateral femoral circumflex artery were measured. Four fresh adult cadavers were collected, including 2 males and 2 females. Their ages of death were 56, 65, 72 and 78 years old, respectively. An incision was made along the axis of the limb at the midpoint of the inguinal ligament at the 4 fresh cadavers. After the femoral head was exposed through the gap between the femoral artery and the femoral nerve, the range of the femoral head exposed was marked.Results:The femoral artery ran along the anteromedial side of the femoral head. The shortest distance between the medial femoral circumflex artery and the femoral head was (13.1±5.7) mm, and the shortest distance between the origin of the lateral femoral circumflex artery and the femoral head (21.6±8.6) mm. On the lateral view of CT angiography, the distance between the femoral artery and the femoral head was (20.6±4.9) mm at the level of the apex of greater trochanter. Gross observation on the cadavers found only small branches of vessels between the femoral artery and the femoral nerve. After the femoral artery and femoral nerve were respectively pulled medially and laterally, the anterior-inferior part of the femoral head was exposed directly by pulling the muscles to open the joint capsule. The exposure range of the femoral head was further expanded through internal and external rotation of the hip joint under traction. The anatomical gap between the femoral artery and the femoral nerve was named the AMA.Conclusion:AMA utilizes the potential gap between the femoral artery and the femoral nerve, providing a new surgical approach for exposure and fixation of Pipkin type Ⅰ and Ⅱ femoral head fractures.

Objective:To evaluate the long-term outcomes and prognostic factors of locally advanced gastric cancer with serosa-invasion.Methods:This study is a retrospective cohort study. The clinical and pathological data of 495 patients with locally advanced gastric cancer with serosa-invasion who underwent laparoscopic radical gastrectomy in Department of General Surgery, the First Hospital Affiliated to Army Medical University from October 2012 to October 2018 was analyzed retrospectively. There were 356 males and 139 females with an age ( M(IQR)) of 59 (16) years (range: 18 to 75 years). Observation indicators included postoperative results and long-term prognosis. The survival curve was drawn by the Kaplan-Meier method. Univariate and multivariate prognostic analysis was performed using the Cox proportional hazards model. Results:Among the 495 patients, a total of 57 patients (11.5%) were lost to follow-up, with a follow-up time of 89 (40) months (range: 23 to 134 months). The 5-year disease-free survival rate (DFS) and the 5-year overall survival rate (OS) were 56.0% and 58.2%, respectively. The 5-year DFS for patients with stage ⅡB, ⅢA, ⅢB, ⅢC were 71.2%, 60.5%, 51.6%, 33.3%, respectively. The 5-year OS for patients with stage ⅡB, ⅢA, ⅢB, ⅢC were 71.2%, 62.2%, 54.1%, 39.3%, respectively. Multivariate analysis showed that age >65 years (DFS: HR=1.402, 95% CI: 1.022 to 1.922, P=0.036; OS: HR=1.461, 95% CI: 1.057 to 2.019, P=0.022), lymph node dissection number less than 25 (DFS: HR=1.348, 95% CI: 1.019 to 1.779, P=0.036; OS: HR=1.376, 95% CI: 1.035 to 1.825, P=0.028), pathological stage Ⅲ (DFS: HR=2.131, 95% CI: 1.444 to 3.144, P<0.01; OS: HR=2.079, 95% CI: 1.406 to 3.074, P<0.01), and no postoperative chemotherapy (DFS: HR=3.127, 95% CI: 2.377 to 4.113, P<0.01; OS: HR=3.768, 95% CI: 2.828 to 5.020, P<0.01) were independent prognostic factors for the decrease in DFS and OS rates. Conclusions:Laparoscopic radical gastrectomy for locally advanced gastric cancer with serosa-invasion could achieve satisfactory long-term oncological outcomes. More lymph node dissection and standardized postoperative adjuvant chemotherapy are expected to further improve the prognosis of patients with locally advanced gastric cancer with serous invasion after laparoscopic radical surgery.