Objective To investigate the correlation between MR signs of ovarian tumor torsion and D-dimer.Methods A total of 45 patients with pedicle torsion confirmed by surgery and pathology were selected as the study group,and their MR signs were analyzed.Additionally,45 patients with normal MR imaging performance were selected as the control group.Firstly,the difference of D-dimer between the study group and the control group was compared.Subsequently,the study group was classified according to the patho-logical type of ovarian tumors,tumor size,MR torsion signs and surgical treatment methods,and the difference in D-dimer among these cateegories were analyzed.Results Among the 45 cases,23 cases were located in the right pelvic cavity and 22 in the left pelvic cavity.The concordance rate of MR diagnosis was 88.9%(40/45).The primary manifestations included a turbid fat space around the tumor(38/45),twisted pedicle appearing as"banded"(20/45)and"vortex"(18/45),and localized thickening of the tumor wall on the pedicle side(31/45),etc.The difference of D-dimer between the study group and the control group was statistically significant(P<0.05).The difference of D-dimer between mesangial cyst and other types of tumors and between different surgical schemes was statistically significant(P<0.05),but there was no statistical difference between different pedicle shapes and tumor sizes(P>0.05).Conclusion MR has a high diagnostic value for the identifying the pathological types of ovarian tumors and the presence of pedicle torsion.Pre-operative D-dimer levels can indicate the presence of pedicle torsion in ovarian tumors,with ovarian cystic solid tumors more likely to exhibit increased D-dimer.

Objective To investigate the correlation between MR signs of ovarian tumor torsion and D-dimer.Methods A total of 45 patients with pedicle torsion confirmed by surgery and pathology were selected as the study group,and their MR signs were analyzed.Additionally,45 patients with normal MR imaging performance were selected as the control group.Firstly,the difference of D-dimer between the study group and the control group was compared.Subsequently,the study group was classified according to the patho-logical type of ovarian tumors,tumor size,MR torsion signs and surgical treatment methods,and the difference in D-dimer among these cateegories were analyzed.Results Among the 45 cases,23 cases were located in the right pelvic cavity and 22 in the left pelvic cavity.The concordance rate of MR diagnosis was 88.9%(40/45).The primary manifestations included a turbid fat space around the tumor(38/45),twisted pedicle appearing as"banded"(20/45)and"vortex"(18/45),and localized thickening of the tumor wall on the pedicle side(31/45),etc.The difference of D-dimer between the study group and the control group was statistically significant(P<0.05).The difference of D-dimer between mesangial cyst and other types of tumors and between different surgical schemes was statistically significant(P<0.05),but there was no statistical difference between different pedicle shapes and tumor sizes(P>0.05).Conclusion MR has a high diagnostic value for the identifying the pathological types of ovarian tumors and the presence of pedicle torsion.Pre-operative D-dimer levels can indicate the presence of pedicle torsion in ovarian tumors,with ovarian cystic solid tumors more likely to exhibit increased D-dimer.

Establishing a one-stop diagnosis and treatment mode centered on patients and linked by diseases is of great significance for optimizing the medical process and improving the medical experience. In March 2024, a tertiary hospital integrated pediatric outpatient and emergency resources, established a pediatric diagnosis and treatment island through reasonable department settings, strengthened talent team construction, optimized diagnosis and treatment processes, and established supporting guarantee mechanisms. It was officially put into use in June of the same year, providing one-stop diagnosis and treatment services for children and achieving the goal of " not leaving the island for minor illnesses and not leaving the hospital for major illnesses". Before the operation of island (January May 2024), the complaint rate and waiting time for pediatric outpatient and emergency department were 39 cases per 100 000 patients and 15 to 30 minutes, respectively; After operation (June August 2024), the complaint rate and waiting time decreased to 17 cases per 100 000 people and 10 to 20 minutes respectively; The average monthly comprehensive income of outpatient and emergency departments increased by 33%. The pediatric diagnosis and treatment island mode could assist in the sustainable high-quality development of pediatrics in hospital, and provide references for optimizing outpatient and emergency department management in other tertiary public hospitals. In the future, we should further enrich the service content of the island and strengthen information technology construction.

Establishing a one-stop diagnosis and treatment mode centered on patients and linked by diseases is of great significance for optimizing the medical process and improving the medical experience. In March 2024, a tertiary hospital integrated pediatric outpatient and emergency resources, established a pediatric diagnosis and treatment island through reasonable department settings, strengthened talent team construction, optimized diagnosis and treatment processes, and established supporting guarantee mechanisms. It was officially put into use in June of the same year, providing one-stop diagnosis and treatment services for children and achieving the goal of " not leaving the island for minor illnesses and not leaving the hospital for major illnesses". Before the operation of island (January May 2024), the complaint rate and waiting time for pediatric outpatient and emergency department were 39 cases per 100 000 patients and 15 to 30 minutes, respectively; After operation (June August 2024), the complaint rate and waiting time decreased to 17 cases per 100 000 people and 10 to 20 minutes respectively; The average monthly comprehensive income of outpatient and emergency departments increased by 33%. The pediatric diagnosis and treatment island mode could assist in the sustainable high-quality development of pediatrics in hospital, and provide references for optimizing outpatient and emergency department management in other tertiary public hospitals. In the future, we should further enrich the service content of the island and strengthen information technology construction.

Objective To analyze the MRI findings of invasive lesions originating from uterine smooth muscle,and to improve the preoperative accurate diagnosis ability.Methods A total of 29 patients with invasive tumors originating from uterine smooth muscle and confirmed by surgery and pathology were selected and divided into benign group and malignant group.The shape of the lesion and the signal characteristics of MRI sequences were analyzed retrospectively,the apparent diffusion coefficient(ADC)values of solid components of lesions were measured,and the ADC values of different tumors were compared.Independent sample t test was used for statistical analysis.Results A total of 26 cases were correctly diagnosed by MRI,and the diagnostic accuracy rate was 89.7%.Eighteen cases of intravenous leiomyomatosis(IVL)had a history of uterine fibroid,extrauterine lesions showed sausage or nodular-shaped with slightly higher signal on T2WI,equi signal on T1WI and diffusion weighted imaging(DWI),dynamic enhanced scanning sequence showed synchronous enhancement with myometrium of uterus;Two cases of leiomyomatosis peritonealis disseminate(LPD)had a history of uterine fibroid,solid cystic masses were found in the uterus,solid components showed equivalent or slightly higher signal on T2WI,equi signal on T1WI,equivalent or slightly higher signal on DWI,multiple solitary nodules were found in pelvic wall,uterus and rectum fossa,mesentery and omental sac,with uniform signal and clear boundary,equi signal on T2WI,T1WI and DWI,dynamic enhanced scanning sequence showed synchronous enhancement with myometrium of uterus,strengthening uniform;Of the 9 cases of leiomyosarcoma,8 cases showed solid cystic masses with T1WI high signal bleeding focus,solid components showed slightly higher signal on T2WI,equi signal on T1WI,obvious higher signal on DWI,the boundary of the mass was unclear,and the enhancement was uneven after enhancement;There were 20 cases in benign group,including 18 cases of IVL and 2 cases of LPD,the mean ADC values were(1 357.06±74.55)×10-3mm2/s,the malignant group was leiomyosarcoma,the mean ADC values were(849.56±22.80)×10-3mm2/s,there were statistical difference between the groups(P<0.05).Conclusion The MRI findings of invasive tumors originating from uterine smooth muscle are dif-ferent,the measurement of ADC value can be used as a quantitative diagnostic basis for benign and malignant determination.

Objective:To investigate the feasibility of oblique overlap anastomosis plus single flap valvuloplasty (OSF) for reconstruction after laparoscopic proximal gastrectomy.Methods:The C-shaped seromuscular flap (2.5 × 3.5 cm), which was 2 cm from the top of the remnant stomach, was extracorporeally created on the anterior wall of the remnant stomach. The stomach was opened approximately 1.0 cm above the lower edge of the mucosal flap. Four supporting stitches were sutured around the hole and the right wall of the esophageal stump was incised with a support suture to prevent the linear stapler from entering the submucosa. Liner stapler was inclined to the left side of the esophagus at an angle of about 30 degrees to the longitudinal axis of the esophagus for oblique anastomosis between the dorsal side of the esophagus and the anterior stomach and then esophagogastrostomy was performed with the length of anastomosis was 4 cm. Entry hole was suture with 3 stitches and then the linear stapler was used for closing the entry hole. Finally, the seromuscular flap was closed using barbed sutures.Results:Clinical data of 11 patients with Siewert type II esophagogastric junction adenocarcinoma who underwent radical gastrectomy and reconstruction by OSF between January 2022 and May 2023 were retrospectively collected. There were 7 males and 4 females. The average age was (69.9±7.8) years, the BMI was (21.7±7.2) kg/m 2 and the tumor size was (2.1±0.6) cm. OSF reconstruction was successfully completed in all 11 patients. The median operative time was 275 (270-428) minutes, the time for OSF reconstruction was 112 (80-140) minutes, and the blood loss was 50 (20-400) ml. The pathological stage was 0-I in 7 cases and II-III in 4 cases. The patients were fed on the 4th day (4-7 days) and discharged from hospital on the 7th day (6-9 days) after surgery. No patient had gastroesophageal reflux symptoms of grade B and above, and no patient took anti-reflux medicine. Conclusions:OSF is a safe and feasible treatment for Siewert type II esophagogastric junction adenocarcinoma.

In this study, 34 deep eutectic solvents (DESs) were successfully prepared for the extraction of proanthocyanidin from Rhodiolae Crenulatae Radix et Rhizomes. The extraction process was optimized using single factor exploration and Box-Behnken design-response surface analysis. The extraction rate was significantly improved when the molar ratio of choline chloride to 1,3-propanediol was 1:3.5 and the water content was 30% (V/V) in DESs. AB-8 macroporous resin and ethyl acetate were used for separation and refining, and the oligomer-rich proanthocyanidin components were eventually obtained. The ultraviolet (UV) and infrared (IR) spectra showed that the proanthocyanidins were mainly composed of catechin and epicatechin. To further clarify the chemical composition of proanthocyanidin, an ion scan list containing 156 proanthocyanidins precursors was obtained by constructing a proanthocyanidins structural library and mass defect filtering (MDF) algorithm, combined with the full mass spectrometry (MS)/dd-MS² scan mode that turns on the "if idle pick others" function. By using ultra-high performance liquid chromatography and high-resolution MS (UHPLC/HRMS), the analysis used both targeted and non-targeted methods to detect proanthocyanidins. Finally, 50 oligomeric proanthocyanidin (OPC) compounds were identified, including 7 monomers, 22 dimers, 20 trimers, and 1 tetramer, most of which were procyanidins of proanthocyanidins (84%), and a small amount of prodelphinidin (14%) and other types of proanthocyanidins (2%), which enabled the systematic characterization of proanthocyanidin components from Rhodiolae Crenulatae Radix et Rhizomes. Meanwhile, the comparison with the grape seeds OPCs standard (United States Pharmacopeia) revealed that the proanthocyanidins in Rhodiolae Crenulatae Radix et Rhizomes were more abundant, suggesting that the proanthocyanidins in Rhodiolae Crenulatae Radix et Rhizomes has promising applications.

In this study,34 deep eutectic solvents(DESs)were successfully prepared for the extraction of proan-thocyanidin from Rhodiolae Crenulatae Radix et Rhizomes.The extraction process was optimized using single factor exploration and Box-Behnken design-response surface analysis.The extraction rate was significantly improved when the molar ratio of choline chloride to 1,3-propanediol was 1:3.5 and the water content was 30％(V/V)in DESs.AB-8 macroporous resin and ethyl acetate were used for separation and refining,and the oligomer-rich proanthocyanidin components were eventually obtained.The ultra-violet(UV)and infrared(IR)spectra showed that the proanthocyanidins were mainly composed of catechin and epicatechin.To further clarify the chemical composition of proanthocyanidin,an ion scan list containing 156 proanthocyanidins precursors was obtained by constructing a proanthocyanidins struc-tural library and mass defect filtering(MDF)algorithm,combined with the full mass spectrometry(MS)/dd-MS2 scan mode that turns on the"if idle pick others"function.By using ultra-high performance liquid chromatography and high-resolution MS(UHPLC/HRMS),the analysis used both targeted and non-targeted methods to detect proanthocyanidins.Finally,50 oligomeric proanthocyanidin(OPC)com-pounds were identified,including 7 monomers,22 dimers,20 trimers,and 1 tetramer,most of which were procyanidins of proanthocyanidins(84％),and a small amount of prodelphinidin(14％)and other types of proanthocyanidins(2％),which enabled the systematic characterization of proanthocyanidin components from Rhodiolae Crenulatae Radix et Rhizomes.Meanwhile,the comparison with the grape seeds OPCs standard(United States Pharmacopeia)revealed that the proanthocyanidins in Rhodiolae Crenulatae Radix et Rhizomes were more abundant,suggesting that the proanthocyanidins in Rhodiolae Crenulatae Radix et Rhizomes has promising applications.

Objective:To investigate the feasibility of oblique overlap anastomosis plus single flap valvuloplasty (OSF) for reconstruction after laparoscopic proximal gastrectomy.Methods:The C-shaped seromuscular flap (2.5 × 3.5 cm), which was 2 cm from the top of the remnant stomach, was extracorporeally created on the anterior wall of the remnant stomach. The stomach was opened approximately 1.0 cm above the lower edge of the mucosal flap. Four supporting stitches were sutured around the hole and the right wall of the esophageal stump was incised with a support suture to prevent the linear stapler from entering the submucosa. Liner stapler was inclined to the left side of the esophagus at an angle of about 30 degrees to the longitudinal axis of the esophagus for oblique anastomosis between the dorsal side of the esophagus and the anterior stomach and then esophagogastrostomy was performed with the length of anastomosis was 4 cm. Entry hole was suture with 3 stitches and then the linear stapler was used for closing the entry hole. Finally, the seromuscular flap was closed using barbed sutures.Results:Clinical data of 11 patients with Siewert type II esophagogastric junction adenocarcinoma who underwent radical gastrectomy and reconstruction by OSF between January 2022 and May 2023 were retrospectively collected. There were 7 males and 4 females. The average age was (69.9±7.8) years, the BMI was (21.7±7.2) kg/m 2 and the tumor size was (2.1±0.6) cm. OSF reconstruction was successfully completed in all 11 patients. The median operative time was 275 (270-428) minutes, the time for OSF reconstruction was 112 (80-140) minutes, and the blood loss was 50 (20-400) ml. The pathological stage was 0-I in 7 cases and II-III in 4 cases. The patients were fed on the 4th day (4-7 days) and discharged from hospital on the 7th day (6-9 days) after surgery. No patient had gastroesophageal reflux symptoms of grade B and above, and no patient took anti-reflux medicine. Conclusions:OSF is a safe and feasible treatment for Siewert type II esophagogastric junction adenocarcinoma.

Intracellular overexpression of cytoglobin (Cygb) has been shown to reduce extracellular matrix deposition and promote liver fibrosis recovery, but its mechanism is not yet clear. This study constructed and expressed a fusion protein (TAT-Cygb) of cell penetrating peptide TAT and Cygb, to investigate the effect of fusion protein TAT-Cygb on regulating hepatic stellate cells (HSCs) ferroptosis. Cultured human hepatic stellate cells line (LX2) were treated with TAT-Cygb and erastin in vitro, respectively. The effects of ferroptosis phenotype in LX2 cells induced by TAT-Cygb, including cell viability, cell morphology, iron ion (Fe²⁺) content, lipid peroxidation product levels, and antioxidant system indicators, were investigated using trypan blue staining, transmission electron microscopy, Prussian blue staining, and reagent kits detection. After co-treatment with TAT-Cygb and ferrostain-1, the levels of Fe²⁺, reactive oxygen species (ROS), malondialdehyde (MDA), 4-hydroxynonenal (4-HNE), nicotinamide adenine dinucleotide phosphate (NADPH) and glutathione (GSH) were measured by reagent kits. The protein expression levels of alpha smooth actin (α-SMA), collagen I and fibronectin were detected by Western blot, and the protein expression level of epidermal growth factor receptor (EGFR) and desmin relevant to fibrosis were observed by immunofluorescence. The results showed that TAT-Cygb could significantly reduce the viability of LX2 cells and trigger events relevant to ferroptosis, including promoting intracellular Fe²⁺ accumulation, and inducing mitochondrial morphological changes, and intensifying lipid peroxidation products accumulation, and decreasing the level of antioxidant indexes, which played a similar role as erastin; Fer-1 significantly weakened the increase in Fe²⁺, ROS, MDA, 4-HNE levels induced by TAT-Cygb, as well as the decrease in NADPH and GSH levels, while also weakening the TAT-Cygb-induced over-expression levels of α-SMA, collagen I and fibronectin, and TAT-Cygb-induced under-expression levels of EGFR and desmin. This cellular level study indicated that TAT-Cygb can induce ferroptosis of activated HSCs. This study revealed the potential mechanism of TAT-Cygb anti-liver fibrosis, and provided the experimental basis for further research on the molecular mechanism of TAT-Cygb realizing biological function by regulating the ferroptosis pathway.