By systematically sorting out the theoretical origin， manipulation key points， and clinical applications of sparrow-pecking needling， it is believed that sparrow-pecking needling method involves performing small-amplitude， high-frequency lifting and thrusting of the needle tip in the original position， with heavy thrusting and light lifting， starting slowly and then becoming rapid， thus forming a characteristic needling sensation that spreads to the surroundings in a wavelike manner. The sparrow-pecking needling plays a role in stimulating the conduction of channel qi and regulating the circulation of qi and blood. Additionally， this paper summarized the clinical applications of sparrow-pecking needling in five aspects， regulating mind， regulating channel sinews， regulating zang-fu organs， regulating ying-wei （nutrient and defense qi）， and regulating yang qi， so as to provide references for inheriting and expanding the theory and clinical application of sparrow-pecking needling.

Objective:To explore the relationship between the expression of tumor necrosis factor receptor-associated factor 5 (TRAF5) and interferon regulatory factor 5 (IRF5) in intestinal mucosa of patients with ulcerative colitis and gut microbiota and intestinal mucosal barrier function.Methods:A total of 126 patients with ulcerative colitis in Qingdao Municipal Hospital from April 2021 to April 2023 were collected, according to the condition, there were 76 patients in the active phase and 50 patients in the remission phase, another 50 patients with intestinal polyps were taken as controls, intestinal mucosal tissues were collected from patients in three groups. Immunohistochemical staining was applied to detect the expression of TRAF5 and IRF5, the relationship between the expression of TRAF5 and IRF5 in intestinal mucosa of patients with ulcerative colitis and clinical symptoms, gut microbiota, and intestinal barrier function indicators was analyzed. Spearman method was applied for correlation analysis.Results:The positive expression rates of TRAF5 and IRF5 in intestinal mucosa of patients with active phase and remission phase ulcerative colitis were higher than those of patients with intestinal polyps: 85.53% (65/76) and 80.00% (40/50) vs. 40.00% (20/50), 81.58% (62/76) and 76.00% (38/50) vs. 50.00% (25/50), and the difference was statistically significant ( P<0.05); the expression of TRAF5 and IRF5 in intestinal mucosa of patients with ulcerative colitis was related to diarrhea, abdominal pain, purulent stool, tumor necrosis factor-α (TNF-α), Interleukin-6 (IL-6), C-reactive protein (CRP), erythrocyte sedimentation rate, Baron endoscopic score, inflammatory bowel disease questionnaire score, Mayo index score and Geboes index ( P<0.05). Compared with patients with negative expression of TRAF5 and IRF5, patients with positive expression of TRAF5 and IRF5 had fewer bifidobacteria and lactobacilli, and more enterobacteria and enterococcus: (8.72 ± 0.43) cfu/g vs. (6.85 ± 0.47) cfu/g, (9.74 ± 0.31) cfu/g vs. (8.26 ± 0.27) cfu/g, (9.73 ± 0.46) cfu/g vs. (11.06 ± 0.48) cfu/g, (7.64 ± 0.31) cfu/g vs. (8.47 ± 0.34) cfu/g; (8.82 ± 0.44) cfu/g vs. (6.73 ± 0.47) cfu/g, (9.13 ± 0.30) cfu/g vs. (8.22 ± 0.27) cfu/g, (11.09 ± 0.48) cfu/g vs. (9.87 ± 0.46) cfu/g, (7.76 ± 0.32) cfu/g vs. (8.48 ± 0.34) cfu/g, and the difference was statistically significant ( P<0.05). The levels of diamine oxidase, lipopolysaccharide and D-lactic acid in patients with positive expression of TRAF5 and IRF5 were obviously higher than those in patients with negative expression of TRAF5 and IRF5: (12.18 ± 2.75) mg/L vs. (7.56 ± 2.49) mg/L, (76.14 ± 13.86) ng/L vs. (37.57 ± 12.51) ng/L, (18.15 ± 4.83) U/L vs. (9.87 ± 3.25) U/L; (12.39 ± 2.72) mg/L vs. (7.65 ± 2.66) mg/L, (77.21 ± 13.79) ng/L vs. (40.87 ± 13.04) ng/L, (18.36 ± 4.75) U/L vs. (10.67 ± 3.86)U/L, and the difference was statistically significant ( P<0.05). The expression of TRAF5 in the intestinal mucosa of patients with ulcerative colitis was negatively correlated with the numbers of bifidobacteria and lactobacilli ( r = - 0.645 and - 0.646; P<0.05), and positively correlated with the number of enterobacteria, number of enterococcus, diamine oxidase, lipopolysaccharide and D-lactic acid ( r = 0.629, 0.589, 0.509, 0.606 and 0.596; P<0.05). The expression of IRF5 was negatively correlated with the numbers of bifidobacteria and lactobacilli ( r = - 0.701 and - 0.690; P<0.05), and positively correlated with the number of enterobacteria, number of enterococcus, diamine oxidase, lipopolysaccharide and D-lactic acid ( r = 0.690, 0.624, 0.605, 0.595 and 0.568; P<0.05). Conclusions:The positive rates of TRAF5 and IRF5 in intestinal mucosa of patients with ulcerative colitis is high, which is closely related to the imbalance of gut microbiota and the damage of intestinal mucosal barrier function.

Objective To investigate the expression level of calcitonin gene-related peptide-receptor component protein (CRCP) in hepatocellular carcinoma (HCC) tissue and adjacent tissue and its association with the clinicopathological features and prognosis of patients. Methods HCC and adjacent tissue samples were collected from 79 HCC patients who underwent surgical resection in Eastern Hepatobiliary Surgery Hospital, Navy Medical University, from June 2003 to September 2009. Tissue microarray was prepared, and immunohistochemistry was used for quantitative analysis. Related proteins were extracted and measured by Western blot, and the expression of CRCP was compared between HCC tissue and adjacent tissue. The chi-square test was used for comparison of categorical data between groups. The receiver operating characteristic (ROC) curve analysis was performed to obtain the area under the ROC curve (AUC), and goodness of fit was evaluated. Youden index was used to determine the optimal cut-off value. and the Kaplan-Meier survival analysis was used to analyze the association of CRCP expression with the recurrence and prognosis of HCC, and the log rank test was used for comparison between the two groups. Results Among the 79 HCC patients, there were 67 male patients and 12 female patients, with an age of 10-72 years, and 20 patients had portal vein tumor thrombus. As for pathological grade, 1 had grade 4 HCC, 61 had grade 3 HCC, and 17 had grade 2 HCC; as for BCLC stage, 5 had BCLC stage 0 HCC, 55 had BCLC stage A HCC, 11 had BCLC stage B HCC, and 8 had BCLC stage C HCC. Western blot showed that the expression level of CRCP in HCC tissue was lower than that in adjacent tissue in 4 patients, and immunohistochemistry showed that the expression level of CRCP in HCC tissue was significantly lower than that in adjacent tissue in 75.9% of the patients. Low CRCP expression was associated with CK19 positivity, incomplete tumor capsule, presence of portal vein tumor thrombus, and high pathological grade ( χ 2 =6.410, 4.829, 9.319, and 9.083, all P < 0.05). Compared with the low CRCP expression group, the high CRCP expression group had a significantly longer overall survival time and a significantly lower recurrence rate ( P < 0.001 and P =0.009). Conclusion Patients with low CRCP expression in HCC tissue tend to have a poorer prognosis than those with high CRCP expression, and CRCP may participate in the development, progression, and metastasis of HCC, suggesting that this molecule can be used as a potential biomarker to predict the prognosis of HCC patients.

Objective:To investigate the inhibitory effect of esomeprazole on proliferation and chemosensitizing effect of breast cancer cells.Methods:Human MBA-MD-231, MCF-7 breast cancer cell line and human Huh7 liver cancer cell line were cultured by conventional methods; cells were treated with different concentrations of esomeprazole, and CCK8 kit was used to detect the proliferation of different tumor cells after stimulation. Cells were treated with different concentrations of esomeprazole, and the effects of esomeprazole on cell cycle of different cells were analyzed by flow cytometry. Cells were treated with different concentrations of paclitaxel and epirubicin combined with esomeprazole, and CCK8 kit was used to detect the proliferation of different tumor cells after stimulation. Measurement data were expressed as mean ± standard deviation ( ± s), and analysis of variance was used for comparison among multiple groups. Results:CCK8 results showed that esomeprazole could inhibit the proliferation of MBA-MD-231 cells, MCF-7 cells and Huh7 cells in a dose-dependent manner. Flow cytometry results showed that cells in G 0/G 1 phase were significantly increased by esomeprazole treatment. Esomeprazole can enhance the inhibitory effect of paclitaxel and epirubicin on the proliferation of MBA-MD-231 cells and MCF-7 cells, and improve the chemosensitivity. Conclusion:Esomeprazole blocks breast cancer cell MBA-MD-231, MCF-7 and liver cancer cell Huh7 in G 0/G 1 phase, thereby inhibiting cell proliferation. Esomeprazole can enhance the inhibitory effect of chemotherapeutic drugs on the proliferation of MBA-MD-231 and MCF-7 cells.

The detection of coagulation factor Ⅷ activity plays an important role in the diagnosis, typing, efficacy monitoring and detection of inhibitor titer in hemophilia A, acquired hemophilia A and von Willebrand disease. However, due to the diversity of detecting systems, the difference of reagent composition, the existence of interfering substances and other influence factors, the detection of coagulation factor Ⅷ activity in the laboratories in China still needs to be improved.

There are few reports on the study of extraperitoneal robotic single-port laparoscopic radical prostatectomy in China. In this study, patients with localized prostate cancer were treated with extraperitoneal robotic single-port laparoscopic radical prostatectomy extraperitoneal robot-assisted single-port laparoscopic radical prostatectomy(EpRA-spRP)from April 2019 to June 2019.All patients performed EpRA-spRP successfully without adding additional auxiliary port. The operation time and blood loss were controllable, and hospitalization time was short. It is safe and feasible to perform EpRA-spRP for medium and low-risk prostate cancer. The short-term tumor control and functional recovery are satisfactory.However, the long-term effect needs further follow-up and observation.

Objective:To investigate the influence of infarct vessel diameter, blood flow before operation, blood flow status after operation, coronary artery disease, number of coronary artery lesions and other risk factors on the levels of inflammatory factors IL-1, IL-6, IL-10 in the coronary blood of patients with acute coronary syndrome (ACS), and to determine the relationship between inflammatory factors and ACS and its impact on clinical status.Methods:The peripheral blood and coronary blood of 54 patients with ACS underwent emergency interventional treatment were collected before the operation. The level of IL-1, IL-6, and IL-10 in the blood sample was detected by an automatic biochemical analyzer.Results:Postoperative adverse cardiac events were positively correlated with the patient's age, D-to-B time, and the number of coronary artery lesions (all P<0.05). The levels of IL-1, IL-6 and IL-10 in coronary blood of ACS patients were higher than those in peripheral blood (all P<0.05). The number of coronary artery disease branches (≥3), the onset time of myocardial infarction (>4 h), diabetes mellitus, ischemic post-treatment, preoperative blood flow level ( 2.5 mm, coronary artery disease number ≥ 3, severe right coronary artery disease, preoperative blood flow 22 frames, and cardiovascular events, the IL-10 levels are higher (all P<0.05). Conclusions:The levels of inflammatory factors IL-1, IL-6, and IL-10 in coronary blood of ACS patients are higher than those in peripheral blood, suggesting that acute coronary artery originates from local coronary inflammatory reaction, and the increase of inflammatory factors in peripheral blood belongs to "Erosion" effect. The level of inflammatory factors is significantly related to the diameter of the diseased blood vessel, preoperative blood flow, the number of coronary artery disease, the location of myocardial infarction, diabetes and smoking history.

Objective:To study the prognostic risk factors of Enterobacteriaceae bloodstream infection in patients with sepsis.Methods:The medical records of patients with sepsis caused by Enterobacteriaceae bloodstream infection in our hospital from June 2017 to May 2019 were screened. The gender, age, admission department, basic disease, infection site, etiology examination and treatment plan were recorded in detail. The survival and death groups were divided according to the patient's survival status. The ratio of C-reactive protein (CRP) to serum prealbumin (PA) was recorded within 24 h after admission. The acute physiological and chronic health scores (APACHEⅡ score) and Pitt bacteremia score (PBS score) were calculated within 24 h, and based on the results of blood culture drug sensitivity test to analyze whether the initial experience treatment was appropriate. Logistic regression analysis was used to analyze the risk factors affecting the prognosis of patients, and the receiver operating characteristic curve (ROC curve) was drawn to predict the occurrence of poor prognosis in patients with sepsis.Results:Logistic regression analysis showed that CRP ( OR=1.021, P<0.01), CRP/PA ( OR=34.638, P<0.01), extended-spectrum β-lactamase production ( OR=0.244, P<0.01), inappropriate empirical antibacterial treatment ( OR=0.156, P<0.01), APACHE Ⅱ score ( OR=1.436, P<0.01), and PBS score ( OR=8.622, P<0.01) were risk factors affecting patient's prognosis. Multivariate regression analysis showed that CRP/PA ( OR=25.420, P<0.05), inappropriate empirical treatment ( OR=0.077, P<0.05), APACHEⅡ score ( OR=1.476, P<0.01), PBS score ( OR=12.042, P<0.01) were independent risk factors for death in patients with sepsis ( P<0.05). The higher the CRP/PA level, PBS score and APACHEⅡ score, the worse the prognosis. When CRP/PA ≥0.89, PBS score ≥3.5, APACHEⅡ score ≥17.5, the patient's risk of death increased significantly. In addition, inappropriate empirical treatment was also a key factor in patients with poor prognosis. Conclusions:CRP/PA, PBS score, APACHE Ⅱ score, and inappropriate empiricaltreatment are independent risk factors affecting the prognosis of patients with enterobacter hemorrhagic infection with sepsis. The PBS score and APACHEⅡ score can better predict the poor prognosis and risk of death. Compared with APACHEⅡscore, the former is simpler and practical and can be widely used.

Objective:To study the impact of repeat hepatectomy for patients with post-hepatectomy recurrent hepatocellular carcinoma (HCC).Methods:The data of patients who developed post-hepatecotmy recurrent HCC and underwent repeat hepatectomy at the General Surgery Department of Beijing Tongren Hospital from May 2013 to May 2016 (the Recurrence Group), were retrospectively compared with the data from patients who underwent initial hepatectomy for HCC during the same study period (the Primary Group). The general data, perioperative data, postoperative complications and survival of the two groups were compared.Results:The primary group included 179 patients, consisting of 133 males and 46 females, aged (57.3±11.7) years, with a range from 14.0 to 84.0 years. The recurrence group included 36 patients, consisting of 30 males and 6 females, aged (55.9±11.4) years, with a range from 40.0 to 77.0 years. There were no statistically significant differences between the two groups in gender, age, hepatitis virus infection status, preoperative alpha fetoprotein, Child-Pugh score and indocyanine green retention rate at 15 min ( P>0.05). However, there were statistically significant differences ( P<0.05) between the two groups in operative time [(244.2±84.3)min vs. (283.4±66.8)min], intraoperative blood loss[(428.5±151.6)ml vs. (756.2±187.4)ml], anatomic or nonanatomic hepatectomy, single tumor or multiple tumors, and maximum tumor diameter[(5.81±2.24)cm vs. (3.69±1.55)cm]. There were no statistically significant differences between the two groups in incidences of tumor capsular invasion, tumor thrombus and degrees of tumor differentiation ( P>0.05). There were no statistically significant differences in surgical complication rates ( P>0.05), and in 1-year and 3-year overall and disease free survival rates between the two groups ( P>0.05). Conclusions:Repeat hepatectomy for recurrent HCC after hepatectomy was safe and effective. Its long-term survival outcomes were similar to first hepatectomy for HCC.

Objective:To assess the safety and feasibility of single-port robotic radical cystectomy.Methods:During May 2019 and August 2019, nine patients (8 males, 1 female) received single-port robotic radical cystectomy by the same surgeon. The average age was 65.6(56-78)years. After a 4.5-5.5 cm trans-umbilical incision was made, Lagiport was inserted. Da Vinci Si system 1 #, 2 # arms and 30° lens were applied. Radical cystectomy and bilateral pelvic lymphadenectomy were performed without additional ports. Urinary diversion was completed outside the body. Uterus and vaginal anterior walls were also resected for female patient. Results:All 9 surgeries were successfully conducted without additional ports or conversion to laparoscopic and open surgery. The average operation time was 437.8(280-600)min. Urinary diversion methods included 2 orthotopic ileal neobladder, 5 ideal conduit and 2 cutaneous ureterostomy. Average estimated blood loss was 227.8(100-450)ml, without blood transfusion. Average intestinal recovery time was 3.1(2-4)days, drainage duration was 8.3(3-16) days, and postoperative hospital stays was 7.7(6-13) days. Pathological TNM stage: T 2aN 0M 0 6 cases, T 2bN 0M 0 1 case, T 3aN 3M 0 1 case, T isN 0M 0 1 case. All surgical margins were negative. One bowel obstruction was cured with fasting and indwelling gastric tube. During 9-12 months’ follow-up, no tumor recurrence and metastasis were observed. There was no hydronephrosis or ureterostenosis. All surgical incision healed well. Conclusions:For experienced surgeons, single-port robotic radical cystectomy is safe and feasible with small incision and fast recovery. Short-term clinical result is satisfied.