Objective:To explore the effect of arrhythmia in early and intermediate postoperative stages of the Fontan procedure.Methods:Patients undergoing Fontan procedure at Shanghai Children's Medical Center within 2015 to 2018 were included.Identified data obtained from retrospective，observational dataset including demographic information，patient diagnoses，baseline characteristics，operation details，ECG data，ultrasound cardiograph data，in-hospital medical intervention，in-hospital mortality，out-patient medical intervention，readmission，and complications.Results:Among the 277 children，early arrhythmia occurred in 173 cases（62.5%），medium- and long-term arrhythmia occurred in 35 cases（12.6%），and 69 cases（24.91%）had no arrhythmia，of which only 55 cases（19.9%）needed early intervention with drugs.Malignant arrhythmia was an independent predictor of poor prognosis（ OR 5.835 95% CI 1.738-19.596, P=0.004）.Among all arrhythmia，atrioventricular junction arrhythmia had the highest incidence.During the follow-up，we found that most of the arrhythmia that had occurred in the early postoperative period could return to normal in three months after the operation，while the rhythm gradually stabilized at four years after the operation，the persistent arrhythmia almost no longer returned to normal，and the normal rhythm basically did not recur.For patients who did not develop arrhythmia in the early postoperative period，the peak of new arrhythmia occurred within one year after surgery，and most of them were persistent arrhythmia. Conclusion:The development of an arrhythmia is associated with a heightened risk of subsequent failure of the Fontan circulation，especially malignant arrhythmia.However，the incidence of malignant arrhythmia is not high.In addition，most of the arrhythmias that had occurred in the early postoperative period could return to normal in three months after surgery，and the rhythm gradually stabilized in four years after surgery.While no arrhythmia in the early postoperative period，the peak of new arrhythmia occur within one year after surgery，and most of them are persistent arrhythmia.

Objective:To investigate the clinical efficacy of 3D laparoscopic radical gastrec-tomy of gastric cancer.Methods:The prospective randomized controlled study was conducted. The clinical data of 90 patients undergoing total laparoscopic radical gastrectomy of gastric cancer in Zhangzhou Affiliated Hospital of Fujian Medical University from January to December 2022 were selected. Patients were randomly divided into the 3D laparoscopic group and the 2D laparoscopic group by the method of random number table. Patients underwent 3D or 2D laparoscopic radical gastrectomy of gastric cancer. Observation indicators: (1) grouping of enrolled patients; (2) intra-operative and postoperative situations; (3) feelings of the major surgeon during the operation. Com-parison of measurement data with normal distribution between groups was conducted using the independent sample t test. Comparison of count data between groups wsa conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data between groups was conducted using the nonparametric test. Results:(1) Group of enrolled patients. A total of 90 patients eligible for total laparoscopic radical gastrectomy of gastric cancer were selected. There were 56 males and 34 females, aged (61±7)years. All 90 patients were randomly divided into the 3D laparoscopic group and the 2D laparoscopic group, with 45 cases in each group. There was no significant difference in gender, age, body mass index, hypertension, diabetes mellitus, history of abdominal surgery, surgical method, tumor site and TNM staging between the two groups ( P>0.05), indicating comparability. (2) Intraoperative and postoperative situations. The operation time of the 3D laparoscopic group and the 2D laparoscopic group were (196±12)minutes and (204±14)minutes, respectively. The digestive tract reconstruction time of the 3D laparoscopic group and the 2D laparoscopic group were (81±8)minutes and (87±12)minutes, respectively. There were significant differences in operation time and digestive tract reconstruction time between the two groups ( t=-2.85, -2.43, P<0.05). After surgery, 3 cases of the 3D laparoscopic group experienced complications (1 case of abdominal infection, 2 cases of intestinal obstruction), and 8 cases of the 2D laparoscopic group experienced complications (2 cases of anastomotic leakage, 2 cases of abdominal infection, 4 cases of intestinal obstruction). There was no significant difference in postoperative complications between the two groups ( χ2=2.59, P>0.05). (3) Feelings of the major surgeon during the operation. After surgery, the major surgeon completed a questionnaire survey. The score of image quality perception of the 3D laparoscopic group and the 2D laparoscopic group were 4.73±0.08 and 4.46±0.09, respectively. The score of hand-eye coordination experience of the 3D laparoscopic group and the 2D laparoscopic group were 4.60±0.09 and 4.55±0.08, respectively. The score of operation comfort of the 3D laparoscopic group and the 2D laparoscopic group were 4.81±0.05 and 4.62±0.08, respectively. The score of eye comfort of the 3D laparoscopic group and the 2D laparoscopic group 4.49±0.07 and 4.68±0.07, respectively. There were significant differences in the above indicators between the two groups ( t=15.04, 2.57, 13.51, -12.88, P<0.05). Conclusions:Compared with 2D laparoscopy, 3D laparoscopic radical gastrec-tomy of gastric cancer has shorter operation time and digestive tract reconstruction time, does not increase postoperative complications, and has better feelings of the major surgeon in image quality perception, hand-eye coordination experience and operation comfort.

[Purpose]To evaluate the liver and kidney safety of traditional Chinese medicine(TCM)compounds in the treatment of gastric cancer.[Methods]The clinical data of gastric cancer patients who attended in Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2012 to February 2022 were collected.The results of liver and renal func-tion tests were rated according to National Cancer Institute-Common Terminology Criteria for Ad-verse Events(NCI-CTCAE)V5.0.The patients were divided into 4 groups:TCM group,TCM+chemotherapy/targeted/antivascular therapy group,TCM+TCM preparation group and TCM+chemotherapy/targeted/antivascular therapy+TCM preparation group,and the effects of TCM on liver and renal functions were analyzed.[Results]A total of 7 943 patients were included in the analysis,of which 2 941 cases receiving TCM ≥12 months,1 468 months ≥36 months,and 687 months≥60 months.The highest incidence rate of liver function abnormality was 13.71％,the highest in-cidence rate of grade 3/4 abnormality was 2.58％;the highest incidence of creatinine abnormality was 2.32％,the highest incidence rate of grade 3/4 abnormality was 0.37％in patients with differ-ent duration of taking TCM.Most of liver and renal function abnormalities occurred in the early stage of drug taking.The incidence of liver and renal function abnormalities in the TCM group was lower than that of the other three groups.The incidence of grade 3/4 abnormality for direct biliru-bin(DBIL)in the TCM group was 0.14％,for aspartate transaminase(AST)was 0.11％,for alka-line phosphatase(ALP)was 0.16％,for alanine aminotransferase(ALT)was 0.06％and for total bilirubin(TBIL)was 0.07％,and there was no grade 3/4 creatinine abnormality observed.The ab-normal liver and renal function indexes were not increased with the increase of the length of herbal medicine taking.[Conclusion]The study shows that long term taking TCM drugs and stan-dardized prescriptions for gastric cancer patients are safe.

Purpose To explore the consistency between T2 mapping and three-dimensional water-selective cartilage(3D-WATSc)sequence measurement of knee cartilage volume.Materials and Methods A total of 30 healthy volunteers were recruited and underwent 3D-WATSc and T2 mapping sequence scans of the left knee joint in the Affiliated Lihuili Hospital of Ningbo University from May to December 2022.A total of 20 subjects'T2 mapping sequences were randomly selected and eight groups of raw images with different TE(13,26,39,52,65,78,91,104 ms)were analyzed.The quality of the raw images was rated by two observers,and the consistency of two observers'scores were subjected by Kappa test.The TE value with the best image quality was determined via Welch analysis of variance and Games-Howell text post hoc test.Based on T2 mapping and 3D-WATSc sequences,semi-automatic segmentation measurements were performed on the cartilage volume of femoral condyle,tibial plateau and patellar posterior margin in 30 subjects.Intra group correlation coefficient(ICC)and Bland-Altman plot were used to test the consistency of cartilage volume between two observers under T2 mapping sequence,as well as between T2 mapping and 3D-WATSc sequences.Results The consistency of the scores of the two observers was moderate except for poor consistency at TE 104 ms(Kappa=0.318)and no statistical difference at TE 78 ms(P=0.052),with Kappa values greater than 0.40 and P<0.05,further analysis showed that the cartilage display quality score was optimal at TE 26 ms(M=2.90).Comparing TE 26 ms with the scores of the other seven groups in Games Howell text,except for TE 26 ms and TE 13 ms(M=2.55),TE 26 ms and TE 39 ms(M=2.62),which had no statistically significant difference in scores(P>0.05),there were significant differences in scores between TE 26 ms and the other TE groups(all P<0.05).On the T2 mapping(TR 2 000 ms,TE 26 ms)sequence,the ICC values of the cartilage volumes of each part segmented by two observers were all greater than 0.6,P<0.05,with the consistency of femoral condyle cartilage volume being the best(ICC=0.877,P<0.01).The consistency of the cartilage volumes of each part measured by 3D-WATSc and T2 mapping sequences was good(ICC>0.75,P<0.01),with the consistency of tibial plateau cartilage volume being the best(ICC=0.857,P<0.01).Conclusion The T2 mapping original grayscale image(TR 2 000 ms,TE 26 ms)can clearly display the morphology of knee joint cartilage,the consistency between T2 mapping and 3D-WATSc sequences in quantifying knee cartilage volume is good,and the T2 mapping single sequence provides a reliable scanning scheme for one-stop quantitative analysis of knee joint cartilage morphology and function.

Objective:To investigate the clinical efficacy of 3D laparoscopic radical gastrec-tomy of gastric cancer.Methods:The prospective randomized controlled study was conducted. The clinical data of 90 patients undergoing total laparoscopic radical gastrectomy of gastric cancer in Zhangzhou Affiliated Hospital of Fujian Medical University from January to December 2022 were selected. Patients were randomly divided into the 3D laparoscopic group and the 2D laparoscopic group by the method of random number table. Patients underwent 3D or 2D laparoscopic radical gastrectomy of gastric cancer. Observation indicators: (1) grouping of enrolled patients; (2) intra-operative and postoperative situations; (3) feelings of the major surgeon during the operation. Com-parison of measurement data with normal distribution between groups was conducted using the independent sample t test. Comparison of count data between groups wsa conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data between groups was conducted using the nonparametric test. Results:(1) Group of enrolled patients. A total of 90 patients eligible for total laparoscopic radical gastrectomy of gastric cancer were selected. There were 56 males and 34 females, aged (61±7)years. All 90 patients were randomly divided into the 3D laparoscopic group and the 2D laparoscopic group, with 45 cases in each group. There was no significant difference in gender, age, body mass index, hypertension, diabetes mellitus, history of abdominal surgery, surgical method, tumor site and TNM staging between the two groups ( P>0.05), indicating comparability. (2) Intraoperative and postoperative situations. The operation time of the 3D laparoscopic group and the 2D laparoscopic group were (196±12)minutes and (204±14)minutes, respectively. The digestive tract reconstruction time of the 3D laparoscopic group and the 2D laparoscopic group were (81±8)minutes and (87±12)minutes, respectively. There were significant differences in operation time and digestive tract reconstruction time between the two groups ( t=-2.85, -2.43, P<0.05). After surgery, 3 cases of the 3D laparoscopic group experienced complications (1 case of abdominal infection, 2 cases of intestinal obstruction), and 8 cases of the 2D laparoscopic group experienced complications (2 cases of anastomotic leakage, 2 cases of abdominal infection, 4 cases of intestinal obstruction). There was no significant difference in postoperative complications between the two groups ( χ2=2.59, P>0.05). (3) Feelings of the major surgeon during the operation. After surgery, the major surgeon completed a questionnaire survey. The score of image quality perception of the 3D laparoscopic group and the 2D laparoscopic group were 4.73±0.08 and 4.46±0.09, respectively. The score of hand-eye coordination experience of the 3D laparoscopic group and the 2D laparoscopic group were 4.60±0.09 and 4.55±0.08, respectively. The score of operation comfort of the 3D laparoscopic group and the 2D laparoscopic group were 4.81±0.05 and 4.62±0.08, respectively. The score of eye comfort of the 3D laparoscopic group and the 2D laparoscopic group 4.49±0.07 and 4.68±0.07, respectively. There were significant differences in the above indicators between the two groups ( t=15.04, 2.57, 13.51, -12.88, P<0.05). Conclusions:Compared with 2D laparoscopy, 3D laparoscopic radical gastrec-tomy of gastric cancer has shorter operation time and digestive tract reconstruction time, does not increase postoperative complications, and has better feelings of the major surgeon in image quality perception, hand-eye coordination experience and operation comfort.

[Summary]Diabetic kidney disease(DKD)caused a huge medical burden to society and has become an increasingly serious public health problem.Different from steroidal mineralocorticoid receptor antagonist,Finerenone,as a new non-steroidal mineralocorticoid receptor antagonist,has higher selectivity and effectiveness.It can effectively delay the progression of DKD through anti-inflammatory and anti-fibrosis effects,reduce urinary protein,and has a low incidence of hyperkalemia and a cardioprotective effect.This article summarizes the benefits of Finerenone in DKD,its advantages over other mineralocorticoid-receptor antagonists,and its efficacy in combination with other drugs for the treatment of DKD.

Purpose To explore the consistency between T2 mapping and three-dimensional water-selective cartilage(3D-WATSc)sequence measurement of knee cartilage volume.Materials and Methods A total of 30 healthy volunteers were recruited and underwent 3D-WATSc and T2 mapping sequence scans of the left knee joint in the Affiliated Lihuili Hospital of Ningbo University from May to December 2022.A total of 20 subjects'T2 mapping sequences were randomly selected and eight groups of raw images with different TE(13,26,39,52,65,78,91,104 ms)were analyzed.The quality of the raw images was rated by two observers,and the consistency of two observers'scores were subjected by Kappa test.The TE value with the best image quality was determined via Welch analysis of variance and Games-Howell text post hoc test.Based on T2 mapping and 3D-WATSc sequences,semi-automatic segmentation measurements were performed on the cartilage volume of femoral condyle,tibial plateau and patellar posterior margin in 30 subjects.Intra group correlation coefficient(ICC)and Bland-Altman plot were used to test the consistency of cartilage volume between two observers under T2 mapping sequence,as well as between T2 mapping and 3D-WATSc sequences.Results The consistency of the scores of the two observers was moderate except for poor consistency at TE 104 ms(Kappa=0.318)and no statistical difference at TE 78 ms(P=0.052),with Kappa values greater than 0.40 and P<0.05,further analysis showed that the cartilage display quality score was optimal at TE 26 ms(M=2.90).Comparing TE 26 ms with the scores of the other seven groups in Games Howell text,except for TE 26 ms and TE 13 ms(M=2.55),TE 26 ms and TE 39 ms(M=2.62),which had no statistically significant difference in scores(P>0.05),there were significant differences in scores between TE 26 ms and the other TE groups(all P<0.05).On the T2 mapping(TR 2 000 ms,TE 26 ms)sequence,the ICC values of the cartilage volumes of each part segmented by two observers were all greater than 0.6,P<0.05,with the consistency of femoral condyle cartilage volume being the best(ICC=0.877,P<0.01).The consistency of the cartilage volumes of each part measured by 3D-WATSc and T2 mapping sequences was good(ICC>0.75,P<0.01),with the consistency of tibial plateau cartilage volume being the best(ICC=0.857,P<0.01).Conclusion The T2 mapping original grayscale image(TR 2 000 ms,TE 26 ms)can clearly display the morphology of knee joint cartilage,the consistency between T2 mapping and 3D-WATSc sequences in quantifying knee cartilage volume is good,and the T2 mapping single sequence provides a reliable scanning scheme for one-stop quantitative analysis of knee joint cartilage morphology and function.

Rheumatoid arthritis （RA） is a chronic autoimmune disease characterized by synovitis as its pathological basis. Although current therapeutic drugs can alleviate symptoms， they are often accompanied by a high risk of side effects. In recent years， the use of flavonoids from traditional Chinese medicine （TCM） in the treatment of RA has garnered significant attention. Studies have shown that the mechanisms by which flavonoids treat RA include inhibiting the release of pro-inflammatory factors， regulating multiple cellular signaling pathways， alleviating oxidative stress， modulating immune system functions， inhibiting bone destruction， and suppressing angiogenesis. Due to their notable anti-inflammatory， antioxidant， and immunomodulatory activities， flavonoids hold promise as potential therapeutic agents for RA. A substantial number of articles in this field have been published. By reviewing Chinese and international literature and applying bibliometric and visual analysis using CiteSpace， this paper explored research hotspots and frontiers in this field， systematically reviewed the structures and anti-RA mechanisms of TCM flavonoids， provided a theoretical basis for their use in RA treatment and clinical applications， and offered new perspectives and references for the discovery of novel TCM-based anti-RA drugs.

Rheumatoid arthritis （RA） is a chronic autoimmune disease characterized by synovitis as its pathological basis. Although current therapeutic drugs can alleviate symptoms， they are often accompanied by a high risk of side effects. In recent years， the use of flavonoids from traditional Chinese medicine （TCM） in the treatment of RA has garnered significant attention. Studies have shown that the mechanisms by which flavonoids treat RA include inhibiting the release of pro-inflammatory factors， regulating multiple cellular signaling pathways， alleviating oxidative stress， modulating immune system functions， inhibiting bone destruction， and suppressing angiogenesis. Due to their notable anti-inflammatory， antioxidant， and immunomodulatory activities， flavonoids hold promise as potential therapeutic agents for RA. A substantial number of articles in this field have been published. By reviewing Chinese and international literature and applying bibliometric and visual analysis using CiteSpace， this paper explored research hotspots and frontiers in this field， systematically reviewed the structures and anti-RA mechanisms of TCM flavonoids， provided a theoretical basis for their use in RA treatment and clinical applications， and offered new perspectives and references for the discovery of novel TCM-based anti-RA drugs.

[Purpose]To evaluate the liver and kidney safety of traditional Chinese medicine(TCM)compounds in the treatment of gastric cancer.[Methods]The clinical data of gastric cancer patients who attended in Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2012 to February 2022 were collected.The results of liver and renal func-tion tests were rated according to National Cancer Institute-Common Terminology Criteria for Ad-verse Events(NCI-CTCAE)V5.0.The patients were divided into 4 groups:TCM group,TCM+chemotherapy/targeted/antivascular therapy group,TCM+TCM preparation group and TCM+chemotherapy/targeted/antivascular therapy+TCM preparation group,and the effects of TCM on liver and renal functions were analyzed.[Results]A total of 7 943 patients were included in the analysis,of which 2 941 cases receiving TCM ≥12 months,1 468 months ≥36 months,and 687 months≥60 months.The highest incidence rate of liver function abnormality was 13.71％,the highest in-cidence rate of grade 3/4 abnormality was 2.58％;the highest incidence of creatinine abnormality was 2.32％,the highest incidence rate of grade 3/4 abnormality was 0.37％in patients with differ-ent duration of taking TCM.Most of liver and renal function abnormalities occurred in the early stage of drug taking.The incidence of liver and renal function abnormalities in the TCM group was lower than that of the other three groups.The incidence of grade 3/4 abnormality for direct biliru-bin(DBIL)in the TCM group was 0.14％,for aspartate transaminase(AST)was 0.11％,for alka-line phosphatase(ALP)was 0.16％,for alanine aminotransferase(ALT)was 0.06％and for total bilirubin(TBIL)was 0.07％,and there was no grade 3/4 creatinine abnormality observed.The ab-normal liver and renal function indexes were not increased with the increase of the length of herbal medicine taking.[Conclusion]The study shows that long term taking TCM drugs and stan-dardized prescriptions for gastric cancer patients are safe.