This paper summarizes the clinical experience in the syndrome differentiation and treatment of rosacea using the method of venting heat and resolving stagnation. It is considered that the key pathogenesis of rosacea is the accumulation of heat with stagnation. Accordingly， the method of venting heat and resolving stagnation is proposed， which vents and disperses constraint heat by applying approaches such as dredging defensive qi， clearing qi， venting ying （营） level， and cooling blood， while eliminating stagnation and masses through regulating qi， resolving dampness， dispelling phlegm and removing stasis. In clinical practice， a core prescription for venting heat and resolving stagnation is formulated， with flexible modifications made according to the clinical characteristics of different rosacea subtypes， including erythematotelangiectatic， papulopustular， phymatous， and ocular types， thereby providing therapeutic insights for the treatment of rosacea with traditional Chinese medicine.

Objective:To observe any effect of oscillating positive expiratory pressure training on the airway clearing ability of postoperative esophageal cancer patients after neoadjuvant chemotherapy.Methods:Forty postoperative esophageal cancer patients undergoing neoadjuvant chemotherapy were enrolled and randomized into a control group and an experimental group, each of 20. Both groups received conventional postoperative rehabilitation starting on the first postoperative day, while the experimental group additionally underwent oscillating positive expiratory pressure training (3 sets/day, 30 breaths/set) for five consecutive days. Peak cough flow was measured using a peak flow meter before and 1, 3 and 5 days after the operation. Forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), and peak expiratory flow (PEF) were also measured on the 5th day after the operation using spirometry. Any postoperative pulmonary complications were recorded.Results:On the 1st day after the operation, peak cough flow had decreased significantly in both groups compared to preoperative levels. However, it had increased significantly on days 3 and 5 in both groups, with the average increase in the experimental group significantly greater than in the control group. On day 5 the average FEV1, forced vital capacity and PEF in both groups were significantly lower than the preoperative values, while the experimental group demonstrated significantly higher average FEV1s (2.22±0.51L) and PEFs (5.09±1.26L/s) compared to the control group.Conclusions:Early postoperative oscillating positive expiratory pressure training can improve the peak cough flow and airway clearing ability of esophageal cancer patients after neoadjuvant chemotherapy, promoting the recovery of their lung function.

Objective:To observe any effect of oscillating positive expiratory pressure training on the airway clearing ability of postoperative esophageal cancer patients after neoadjuvant chemotherapy.Methods:Forty postoperative esophageal cancer patients undergoing neoadjuvant chemotherapy were enrolled and randomized into a control group and an experimental group, each of 20. Both groups received conventional postoperative rehabilitation starting on the first postoperative day, while the experimental group additionally underwent oscillating positive expiratory pressure training (3 sets/day, 30 breaths/set) for five consecutive days. Peak cough flow was measured using a peak flow meter before and 1, 3 and 5 days after the operation. Forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), and peak expiratory flow (PEF) were also measured on the 5th day after the operation using spirometry. Any postoperative pulmonary complications were recorded.Results:On the 1st day after the operation, peak cough flow had decreased significantly in both groups compared to preoperative levels. However, it had increased significantly on days 3 and 5 in both groups, with the average increase in the experimental group significantly greater than in the control group. On day 5 the average FEV1, forced vital capacity and PEF in both groups were significantly lower than the preoperative values, while the experimental group demonstrated significantly higher average FEV1s (2.22±0.51L) and PEFs (5.09±1.26L/s) compared to the control group.Conclusions:Early postoperative oscillating positive expiratory pressure training can improve the peak cough flow and airway clearing ability of esophageal cancer patients after neoadjuvant chemotherapy, promoting the recovery of their lung function.

OBJECTIVES: In light of the rise in the global aging population, this study investigated the potential of the oxidative balance score (OBS) as an indicator of phenotypic age acceleration (PhenoAgeAccel) to better understand and potentially slow down aging. METHODS: Utilizing data from the National Health and Nutrition Examination Survey collected between 2001 and 2010, including 13,142 United States adults (48.7% female and 51.2% male) aged 20 and above, OBS and PhenoAgeAccel were calculated. Weighted generalized linear regression models were employed to explore the associations between OBS and PhenoAgeAccel, including a sex-specific analysis. RESULTS: The OBS demonstrated significant variability across various demographic and health-related factors. There was a clear negative correlation observed between the higher OBS quartiles and PhenoAgeAccel, which presented sex-specific results: the negative association between OBS and PhenoAgeAccel was more pronounced in male than in female. An analysis using restricted cubic splines revealed no significant non-linear relationships. Interaction effects were noted solely in the context of sex and hyperlipidemia. CONCLUSIONS A higher OBS was significantly associated with a slower aging process, as measured by lower PhenoAgeAccel. These findings underscore the importance of OBS as a biomarker in the study of aging and point to sex and hyperlipidemia as variables that may affect this association. Additional research is required to confirm these results and to investigate the biological underpinnings of this relationship.

Objective To investigate the clinical efficacy of transurethral plasma electrotomy with rod electrode and end-to-end urethral anastomosis in the treatment of short urethral stricture.Methods 125 male patients with short urethral stricture(＜2 cm)who were admitted to our hospital from January 2014 to December 2020 were retrospectively analyzed.According to different surgical methods,they were divided into transurethral plasma resection with rod electrode(minimally invasive group)and urethral end-to-end anastomosis(open group).According to the length of urethral stricture,the minimally invasive group was divided into minimally invasive group 1(stricture length≤1 cm),minimally invasive group 2(stricture length1-2 cm),open group 1(stricture length ≤1 cm)and open group 2(stricture length 1-2 cm).The four groups were compared with each other,and the surgical success rates were compared between the four groups.Results The success rate of the minimally invasive group 1 and the open group 1 was 88.57％and 93.10％,respectively.There was no significant difference between the two groups(P＞0.05).The surgical success rate of the minimally invasive group 2 and the open group 2 was 67.86％and 90.91％,respectively.The surgical success rate of the minimally invasive group 2 was significantly lower than that of the open group 2.The difference was statistically significant(P＜0.05).The surgical success rate of minimally invasive group 1 and minimally invasive group 2 was 88.57％and 67.86％,respectively,the difference was statistically significant(P＜0.05).The success rate of operation in the open group 1 and the open group 2 was 93.10％and 90.91％,respectively,and there was no significant difference between the two groups(P＞0.05).Conclusion Transurethral plasma resection with rod electrode is preferred for urethral stricture with length≤1 cm,because the success rate of this surgery is the same as that of open surgery,and the surgical trauma is small and the recovery is fast.For 1-2 cm urethral stricture,minimally invasive surgery has less trauma and faster recovery,but open surgery has a higher success rate.The choice of surgical method needs to weigh the advantages and disadvantages and take comprehensive consideration.

Objective:To analyze the influencing factors for efficacy of microvascular decompression (MVD) in primary trigeminal neuralgia (PTN).Methods:A retrospective study was performed. Clinical data of 178 patients with PTN underwent MVD at Department of Neurosurgery, Affiliated Hospital Affiliated to Nantong University from January 2018 to April 2022 were collected. Efficacy was evaluated according to Brisman's criteria. Differences of MVD efficacy in patients with different clinical characteristics or different neurovascular characteristics were compared. Multivariate Logistic regression was used to analyze the independent influencing factors for MVD efficacy.Results:All patients were followed up for about 2 years; at the last follow-up, 164 patients (92.13%) had good postoperative efficacy (130 were cured, 28 were obvious improved, and 6 were improved); 14 patients (7.87%) had poor postoperative efficacy (10 were ineffective and 4 were relapsed). No significant difference in surgical efficacy was noted among patients with different gender, age, left/right lateral pain, disease courses or pain degrees ( P>0.05). Patients with different contact degrees between the trigeminal nerve and blood vessels, different distances between the trigeminal nerve and blood vessels, and different curvature degrees of the posterior trigeminal nerve had significantly different surgical efficacy ( P<0.05). Multivariate Logistic regression indicated that contact degrees between the trigeminal nerve and blood vessels ( OR=0.233, 95% CI: 0.080-0.675, P=0.007), distances between the trigeminal nerve and blood vessels ( OR=6.991, 95% CI: 3.261-14.984, P=0.000), and curvature degrees of the posterior trigeminal nerve ( OR=0.351, 95% CI: 0.158-0.776, P<0.001) were independent influencing factors for postoperative outcomes. Conclusion:The postoperative efficacy is good in patients with slight contact between the trigeminal nerve and blood vessels, with distance between the trigeminal nerve and blood vessels greater than 1×time median width of the trigeminal nerve (WTN), or with hypotenuse height of the arced trigeminal nerve less than 1/2 WTN.

With reference to the teaching reform of standardized training cases based on organ systems, a teaching case writing team has been established, integrating the teaching experts in basic medicine, clinical medicine, humanities medicine, and other fields. Through collective lesson preparation and discussion, non-fictional comprehensive scenario writing techniques have been used based on organ systems and oriented by competency development, and the teaching cases for postgraduate students were written on the basis of real cases, which lays a solid foundation for the hierarchical and progressive cultivation and improvement of the quality of competency cultivation for postgraduate students through case teaching based on organ systems.

Objective:To investigate the protective effect and possible mechanism of sulforaphane (SFN) on acute liver injury in mice induced by diquat (DQ) poisoning.Methods:Forty-eight male C57BL/6 mice were divided into Control group, DQ model group (DQ group), SFN intervention group (DQ+SFN group), and SFN control group (SFN group) using a random number table method, with 12 mice in each group. Acute liver injury mice model was established by one-time intraperitoneal injection of 1 mL of 40 mg/kg DQ solution at once. SFN group was injected with 1 mL of ddH 2O. After 4 hours of molding, 0.5 mL of 5 mg/kg SFN solution was injected into the peritoneal cavity of the DQ+SFN group and SFN group, once daily for 7 consecutive days. DQ group and Control group were injected with an equal amount of ddH 2O. Then, the mice were euthanized to collect liver tissue and blood samples, and the levels of plasma biomarkers alanine aminotransferase (ALT) and aspartate aminotransferase (AST), as well as oxidative stress indicators such as superoxide dismutase (SOD), glutathione (GSH), and malondialdehyde (MDA) in liver tissue were measured. The changes of liver structure were observed under transmission electron microscopy. The apoptosis and reactive oxygen species (ROS) level in liver tissue were observed under fluorescence microscope. Western blotting was used to detect the protein expressions of nuclear factor E2-related factor 2 (Nrf2), hemeoxygenase-1 (HO-1), Kelch-like ECH-associated protein 1 (Keap1), and cleaved caspase-9 in liver tissue. Results:Compared with the Control group, the liver mitochondria in the DQ group showed severe swelling, partial dissolution of the matrix, and cristae rupture and loss; the levels of plasma AST and ALT significantly increased, the MDA content in the liver increased, the activities of SOD and GSH decreased, the level of ROS significantly increased, the number of apoptotic cells in the liver significantly increased, the protein expressions of Nrf2 and HO-1 significantly decreased, and the protein expressions of Keap1 and cleaved caspase-9 significantly increased. Compared with the DQ group, the mitochondrial damage in the DQ+SFN group was reduced, the levels of plasma AST and ALT were significantly reduced [ALT (U/L): 58.22±4.39 vs. 79.94±3.32, AST (U/L): 177.64±8.40 vs. 219.62±11.60, both P < 0.01], the liver MDA content decreased, and the activities of SOD and GSH increased [MDA (μmol/g: 5.63±0.18 vs. 5.96±0.29, SOD (kU/g): 102.05±4.01 vs. 84.34±5.34, GSH (mmol/g): 16.32±1.40 vs. 13.12±1.84, all P < 0.05], the production of ROS in liver tissue was significantly reduced [ROS (fluorescence intensity): 115.90±10.89 vs. 190.70±10.16, P < 0.05], and apoptotic cells were significantly reduced (cell apoptosis index: 4.39±1.00 vs. 10.71±0.56, P < 0.01), the protein expressions of Nrf2 and HO-1 were significantly increased, while the protein expressions of Keap1 and cleaved caspase-9 were significantly decreased (Nrf2/β-actin: 1.15±0.04 vs. 0.93±0.05, HO-1/β-actin: 1.75±0.12 vs. 0.78±0.04, Keap1/β-actin: 1.00±0.14 vs. 1.28±0.13, cleaved caspase-9/β-actin: 1.31±0.12 vs. 1.81±0.09, all P < 0.05). However, there was no statistically significant difference in various indicators between the SFN group and the Control group. Conclusion:SFN can activate the Keap1/Nrf2 signaling pathway to alleviate DQ induced acute liver injury in mice.

Objective To explore the clinical significance of serum activated protein C(APC)and heme ox-ygenase-1(HO-1)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with type Ⅱ respiratory failure treated with non-invasive mechanical ventilation(NIV).Methods A total of 265 AECOPD patients with type Ⅱ respiratory failure admitted to the Second People's Hospital of Panzhihua City from April 2021 to April 2023 were selected as the study group,and another 200 stable chronic obstruc-tive pulmonary disease(COPD)patients and 200 healthy individuals were selected as the stable COPD group and healthy group.The serum APC and HO-1 levels of the three groups were compared.After receiving NIV treatment,the study group was divided into a poor prognosis group(40 cases)and a good prognosis group(225 cases)based on their prognosis within 28 days.General information,laboratory indicators,and serum APC and HO-1 levels were compared between the two groups.Multivariate Logistic regression model was used to analyze the influencing factors of poor prognosis.Receiver operating characteristic(ROC)curve was used to analyze the efficacy of serum APC and HO-1 in predicting patient prognosis.Results Compared with the healthy group,serum APC levels decreased in the stable COPD group,serum HO-1 levels increased(P＜0.05).Compared with the stable COPD group,serum APC levels decreased in the study group,serum HO-1 levels increased(P＜0.05).Compared with the good prognosis group,serum APC,pH,arterial oxygen partial pressure(PaO2)before NIV decreased in the poor prognosis group,serum HO-1,arterial partial pressure of carbon dioxide(PaCO2)levels,acute physiology and chronic health evaluation(APACHE)Ⅱ scores increased(P＜0.05).The results of the multivariate Logistic regression model showed that PaCO2,APACHE Ⅱ score and HO-1 elevated were risk factors for poor patient prognosis,while the Forced Expiratory Volume in 1 Sec-ond/excepted value(FEV1％Pred),forced expiratory volume in the first second/forced vital capacity(FEV1/FVC),PaO2,APC,pH elevated were protective factors(P＜0.05).ROC curve results showed that the area under the curve,sensitivity and specificity of the combined detection of two indicators for predicting poor prognosis in AECOPD patients with type Ⅱ respiratory failure treated with NIV were 0.914,87.50％and 94.22％respectively,which were significantly better than those of single indicator detection.Conclusion The decrease of serum APC level and the increase of serum HO-1 level are relate to the poor prognosis of AECO-PD patients with type Ⅱ respiratory failure treated with NIV,detection of serum APC combine with HO-1 has relatively high predictive value for the poor prognosis of the patients.

Objective:To investigate the status of We-Media platforms opened and opera-ted by surgeons in tertiary first-class hospitals nationwide and analyze its influence on patients and surgeons.Methods:The retrospective cross-sectional investigation study was conducted. The investigation was conducted on the surgeons who had opened We-Media platforms in their units or associations through the contact of all members of the second Elite Committee of Chinese Digestive Surgery of the Chinese Journal of Digestive Surgery from November 5 to 30, 2021. Questionnaires were distributed through wechat, and the software platform was Questionnaire Star. Observation indicators: (1) results of questionnaire survey; (2) basic information of surgeons running We-Media platforms; (3) daily workload and research background of surgeons running We-Media platforms; (4) information related to We-Media platforms; (5) influence of running We-Media platforms on patients; (6) influence of running We-Media platforms on surgeons; (7) feelings and suggestion of surgeons after running We-Media platforms. Measurement data with normal distribution were expressed as Mean± SD, and count data were expressed as absolute numbers and percentages. Results:(1) Results of questionnaire survey: a total of 229 complete and valid questionnaires were collected in this survey. (2) Basic information of surgeons running We-Media platforms: of 229 surgeons, there were 195 males and 34 females, aged (40±8)years. There were 120 surgeons aged from 36-45 years, 80 surgeons aged <35 years and 29 surgeons aged >45 years. There were 86.46% (198/229) of surgeons from teaching hospitals and 74.67%(171/229) of surgeons from provincial cities. Of 229 surgeons, junior, intermediate, deputy senior and senior titles accounted for 17.90%(41/229), 27.51%(63/229), 37.12%(85/229) and 17.47%(40/229), respectively. Surgeons with working years ≤5 years, 6-10 years, 11-15 years and ≥16 years accounted for 19.21%(44/229), 22.27%(51/229), 26.64%(61/229) and 31.88%(73/229), respectively. Hepatobiliary and pancreatic surgeons, esophageal and gastrointestinal surgeons were the main specialties, accounting for 48.03%(110/229) and 14.41%(33/229), respectively. The original intentions of opening We-Media platforms (multiple choice) included increasing patient population and improving the income, accumulating cases to facilitate clinical research projects, increasing the popularity of the industry and gain peer recognition, increasing social awareness and improving spiritual satisfaction, passive assignments form units or hospitals, which accounted for 52.84% (121/229), 54.15%(124/229), 64.19%(147/229), 58.08%(133/229), 17.90%(41/229), respectively. (3) Daily workload and research background of surgeons running We-Media platforms: 60.26%(138/229) of surgeons participated in offline social welfare activities 1-3 times per year and 26.64%(61/229) of surgeons participated >3 times per year. There were 47.60% (109/229) of surgeons performing 5-10 operations per week and 33.19%(76/229) of surgeons performing >10 operations per week. In terms of scientific researches, 38.43%(88/229) of surgeons had not published high-quality English articles as the first author or co-first author, 24.89%(57/229) of surgeons had published 1-3 articles and 36.68%(84/229) of surgeons had published >3 articles. There were 51.09%(117/229) of surgeons without any longitu-dinal projects, 13.54%(31/229) of surgeons with national projects, 35.37%(81/229) of surgeons with provincial and ministerial projects. (4) Information related to We-Media platforms: there were 65.50%(150/229) of surgeons running wechat public account, 55.02%(126/229) of surgeons running consultation platform, 31.44%(72/229) of surgeons running TikTok, 21.40%(49/229) of surgeons running wechat video account (some surgeons operated multiple We-Media platforms). The time of operating the platform was <1 year in 35.81%(82/229) of surgeons, 1-3 years in 42.79%(98/229) of surgeons, >3 years in 21.40%(49/229) of surgeons, respectively. The contents of We-Media platforms were updated >2 weeks in 45.85%(105/229) of surgeons. There were 63.32%(145/229) of surgeons with We-Media platforms win-ning emotional support from their department or hospital, 12.66%(29/229) of surgeons with We-Media platforms winning financial support. There were 82.53%(189/229) of surgeons operating We-Media platforms by theirselves. The We-Media plat-form operation was smooth in 47.16%(108/229) of surgeons, unsustainable in 50.22%(115/229) of surgeons and suspended in 2.62%(6/229) of surgeons. On average, it took less than 30 minutes for 60.70%(139/229) of surgeons and 30-60 minutes for 27.07%(62/229) of surgeons to operate the We-Media platforms of surgeons every times, respec-tively. The background message or consulta-tion was allowed in 89.08%(204/229) of surgeons. The number of leaving messages was <5 times in 52.84%(121/229) of surgeons and >50 times in 6.99%(16/229) of surgeons. On average, each content in 59.39%(136/229) of surgeons were "liked" or "viewed" <100 times, and each content in 29.26%(67/229) of surgeons were "liked" or "viewed" 100-300 times. There were 60.26%(138/229) of surgeons having content with the highest "liked" or "viewed" clicks <1 000 times and 6.99%(16/229) of surgeons having content with the highest "liked" or "viewed" clicks >10 million times. On average, each content in 74.67%(171/229) of surgeons were "forwarded" <100 times, and each content in 6.55%(15/229) of surgeons were "forwarded" >300 times, respectively. The number of followers was <1 million in 87.34%(200/229) of surgeons. The We-Media audiences (multiple choices) included related professional peers, related health care professionals, patients of surgeons, general public, accounting for 42.36%(97/229), 31.00%(71/229), 52.40%(120/229), 53.71%(123/229), respectively. (5) Influence of running We-Media platforms on patients: 34.93%(80/229) of surgeons believed that the operation of We-Media platform significantly increased the number of outpatient and inpatient patients of themselves, 29.69%(68/229) of surgeons believed that the operation of We-Media platform significantly increased the number of outpatient and inpatient patients in their departments, respectively. In the view of 75.98%(174/229) of surgeons, the percent of outpatient and inpatient patients by We-Media platforms was <10%. After 6 months of We-Media operation, 39.74%(91/229) and 25.33%(58/229) of surgeons believed that inpatient and outpatient compliance was significantly improved, respectively, and 46.29% (106/229) of surgeons believed that preopera-tive and pre-chemotherapy or pre-radiotherapy conversations saved more time. (6) Influence of running We-Media platforms on surgeons: 20.09%(46/229) and 6.55%(15/229) of surgeons attributed the success to "long-term, sustainable, absorbed operation" and "important contents of We-Media platforms and wide audiences". There were 72.49%(166/229) of surgeons yet to be successful. There were 26.64% (61/229) and 22.27%(51/229) of surgeons believing that opening We-Media platforms was conducive to the association's employment and multicenter clinical research. Operating We-Media platforms was conducive to professional knowledge improvement, clinical research ability enhancement and teaching level of students, which was believed by 54.59%(125/229), 40.17%(92/229) and 48.91%(112/229) of surgeons, respectively. Although the total income in 88.65%(203/229) of surgeons increased less than 20% after 6 months of operation, 47.60%(109/229) of surgeons believed that "the sense of achievement or pleasure in work has been significantly improved", and 48.91%(112/229) of surgeons did not have the idea of quitting. There were 7.42%(17/229) of surgeons with the idea of quitting the operation of We-Media platforms. (7) Feelings and suggestions of surgeons after running We-Media platforms: the proportion of surgeons who hoped to get help from departments, hospitals, associations and the society were 61.57%(141/229), 72.05%(165/229), 47.16%(108/229) and 53.28%(122/229), respectively. Only 9.61%(22/229) of surgeons did not require help. Commercial advertisement was allowed by 40.17%(92/229) of surgeons and forbidden by 59.83%(137/229) of surgeons. In terms of alternative suggestion, 70.74%(162/229) of surgeons believed that it was necessary for the We-Media platforms to involve more doctors of different specialties, but 40.61%(93/229) of surgeons believed that relevant departments or associations should strengthen supervision under the current situation. In addition, 32.75%(75/229) of surgeons believed that the operation of We-Media platform requires more investment. The were 27.95%(64/229) of surgeons giving specific suggestions on running We-Media platforms, 7.81%(5/64) of which did not suggest a blind try.Conclusions:Most surgeons who open and operate We-Media platforms in China are faced with problems such as busy work, limited time and energy, low-income increase, and lack of professional promotion and maintenance teams and external support. Even so, there are still many surgeons who have achieved success through long-term persistence and high-quality content output, thus increasing the number of patient visits, improving their own ability and industry influence, and bringing a greater sense of professional achievement.