Objective:To investigate the application value of optimized mesenteric defect closure technique in laparoscopic-assisted right hemicolectomy.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 26 patients who underwent laparo-scopic-assisted right hemicolectomy at Changzhi People′s Hospital Affiliated to Changzhi Medical College from May 2023 to June 2024 were collected. There were 11 males and 15 females, aged (65.7±1.8)years. All patients received optimized mesenteric defect closure using a combined extra-corporeal-laparoscopic suturing technique. Observation indicators: (1) surgical and intraoperative conditions; (2) postoperative conditions; (3) follow-up. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M( Q1, Q3) or M(range). Count data were described as absolute numbers. Results:(1) Surgical and intraoperative conditions. All 26 patients underwent laparoscopic-assisted right hemicolectomy with optimized mesenteric defect closure. The time of optimized mesenteric defect closure was 9.8(8.8,12.8)minutes, time of digestive tract reconstruction was 10.0(8.7,13.0)minutes, operation time was (164±4)minutes, volume of intraoperative blood loss was 50(50,100)mL. One of the 26 patients had intraoperative mesenteric hematoma, which required no specific intervention. The patient recovered uneventfully and was discharged from hospital. (2) Postoperative conditions. The visual analog scale pain score of 26 patients on postoperative day 1 and day 3 were 5(4,5) and 3(2,3), respectively. Time to postoperative first anal flatus and bowel movement were both 3(3, 4)days. Time to postoperative first intake of liquid diet was 2(2,3)days, duration of postoperative abdominal drainage was 4(3,5)days, and duration of postoperative hospital stay was 9(8,12)days. The number of lymph node dissected in 26 patients was 25(18,27) and the number of positive lymph node was 1(0,2). Cases in stage Ⅰ, stage Ⅱ and stage Ⅲ of tumor TNM staging were 5, 6, 15. (3) Follow-up. All 26 patients were followed up for 15(range, 6?20)months. Of the 26 patients, one case had incom-plete intestinal obstruction on postoperative day 25, which was diagnosed as adhesive intestinal obstruction based on imaging examination and classified as Clavien-Dindo grade Ⅱ. The patient recovered and was discharged after conservative treatment. None of the 26 patients had bleeding, infection of incision, anastomotic leakage, internal hernia, or delayed gastric emptying. There was no tumor recurrence, metastasis or death.Conclusion:The optimized mesenteric defect closure tech-nique in combined extracorporeal-laparoscopic suturing procedure can be used in laparoscopic-assisted right hemicolectomy.

Objective To explore the effect of urapidil combined with nimodipine in the treatment of elderly hypertensive intracerebral hemorrhage(HICH).Methods A total of 128 elderly HICH patients admitted in our hospital from March 2022 to March 2024 were recruited and randomly di-vided into single group(64 cases)and combined group(64 cases).Both groups received routine treatment,and the single group was treated with urapidil while the combined group was given urapidil combined with nimodipine.Clinical efficacy,clinical indicators[cerebral hematoma vol-ume,intracranial pressure(ICP)],neurological function indicators[brain-derived neurotrophic factor(BDNF),neuron-specific enolase(NSE),nerve growth factor(NGF)],hemodynamic pa-rameters[perfusion index(PI),cerebrovascular reserve capacity(CVR),mean bilateral arterial flow velocity],and vascular endothelial function indicators[vascular endothelial growth factor(VEGF),endothelin-1(ET-1),angiopoietin-1(Ang-1)]were compared between the two groups.The incidence of adverse reactions was observed during treatment.Results The total effective rate was significantly higher in the combined group than the single group(89.06％vs 75.00％,P＜0.05).After treatment,the ICP,hematoma volume,PI,and levels of NSE,VEGF,ET-1 and Ang-1 in both groups were significantly lower than those before treatment(P＜0.05).These indi-cators in the combined group were significantly lower than those in the single group(P＜0.05,P＜0.01).The CVR,mean bilateral arterial flow velocity,and BDNF and NGF levels were notably increased in both groups after treatment,and the indicators were significantly higher in the com-bined group than the other group(P＜0.05,P＜0.01).There was no statistical difference in the incidence of adverse reactions between groups(P＞0.05).Conclusion Urapidil combined with ni-modipine can shrink the volume of cerebral hematoma,reduce ICP,and improve neurological function,hemodynamics and vascular endothelial function in elderly HICH patients,and the treat-ment does not increase the incidence of adverse reactions.

Objective:To investigate the application value of optimized mesenteric defect closure technique in laparoscopic-assisted right hemicolectomy.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 26 patients who underwent laparo-scopic-assisted right hemicolectomy at Changzhi People′s Hospital Affiliated to Changzhi Medical College from May 2023 to June 2024 were collected. There were 11 males and 15 females, aged (65.7±1.8)years. All patients received optimized mesenteric defect closure using a combined extra-corporeal-laparoscopic suturing technique. Observation indicators: (1) surgical and intraoperative conditions; (2) postoperative conditions; (3) follow-up. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M( Q1, Q3) or M(range). Count data were described as absolute numbers. Results:(1) Surgical and intraoperative conditions. All 26 patients underwent laparoscopic-assisted right hemicolectomy with optimized mesenteric defect closure. The time of optimized mesenteric defect closure was 9.8(8.8,12.8)minutes, time of digestive tract reconstruction was 10.0(8.7,13.0)minutes, operation time was (164±4)minutes, volume of intraoperative blood loss was 50(50,100)mL. One of the 26 patients had intraoperative mesenteric hematoma, which required no specific intervention. The patient recovered uneventfully and was discharged from hospital. (2) Postoperative conditions. The visual analog scale pain score of 26 patients on postoperative day 1 and day 3 were 5(4,5) and 3(2,3), respectively. Time to postoperative first anal flatus and bowel movement were both 3(3, 4)days. Time to postoperative first intake of liquid diet was 2(2,3)days, duration of postoperative abdominal drainage was 4(3,5)days, and duration of postoperative hospital stay was 9(8,12)days. The number of lymph node dissected in 26 patients was 25(18,27) and the number of positive lymph node was 1(0,2). Cases in stage Ⅰ, stage Ⅱ and stage Ⅲ of tumor TNM staging were 5, 6, 15. (3) Follow-up. All 26 patients were followed up for 15(range, 6?20)months. Of the 26 patients, one case had incom-plete intestinal obstruction on postoperative day 25, which was diagnosed as adhesive intestinal obstruction based on imaging examination and classified as Clavien-Dindo grade Ⅱ. The patient recovered and was discharged after conservative treatment. None of the 26 patients had bleeding, infection of incision, anastomotic leakage, internal hernia, or delayed gastric emptying. There was no tumor recurrence, metastasis or death.Conclusion:The optimized mesenteric defect closure tech-nique in combined extracorporeal-laparoscopic suturing procedure can be used in laparoscopic-assisted right hemicolectomy.

Objective To analyze the key driving factors for patent management and scientific and technological achieve-ment transformation in medical institutions in the Yangtze River Delta region,and to provide a scientific basis for improving the efficiency of regional medical scientific and technological achievement transformation.Methods A convenience sampling method was used to conduct a questionnaire survey among 480 medical staff from tertiary hospitals in three provinces and one city(An-hui,Jiangsu,Shanghai,Zhejiang)of the Yangtze River Delta region from November 2024 to January 2025.SPSS 23.0 software was used for univariate analysis,multiple linear regression analysis,and regional difference comparisons.Results Univariate a-nalysis showed that region,age,education level,and professional title had statistically significant effects on patent output(P＜0.05).Multiple linear regression analysis further indicated that cognitive factors(score:19.01±8.73,β=0.230,P＜0.001),support factors(score:25.84±11.33,β=0.211,P=0.004),and incentive factors(score:25.93±10.85,β=0.136,P=0.036)were key drivers of patent output.Significant regional differences were observed,with Anhui Province scoring lower across all dimensions compared to Jiangsu,Zhejiang,and Shanghai(total score:74.18 vs.101.16-107.40,P＜0.001).Conclusion Enhancing medical staff's awareness of patents,improving institutional support and incentive mechanisms,and nar-rowing regional development gaps are core optimization pathways for promoting the transformation of medical scientific and techno-logical achievements in the Yangtze River Delta region.

The ocular surface is composed of a variety of tissues,of which limbal stem/progenitor cells(LSCs)are es-sential for maintaining the steady state of the ocular surface.Once LSCs become diseased,resulting in limbal corneal stem cell deficiency(LSCD),the ocular surface epithelial cells will change their cellular identity through processes such as epi-thelial-mesenchymal transition(EMT),transdifferentiation and dedifferentiation.Cell differentiation is tightly controlled by genetic programming and plays a key role in the transformation of the cellular state.The EMT process allows epithelial cells to exhibit mesenchymal cell characteristics,which may cause subepithelial fibrosis in corneal disease and is regulated by a variety of factors.Transdifferentiation is the transformation of one type of differentiated cell into another.In ocular surface stress,conjunctival epithelium may be transformed into corneal epithelium,and non-ocular surface cells may be trans-formed into corneal epithelium,but this process faces ethical and cellular stability challenges.Dedifferentiation,on the other hand,refers to the restoration of a differentiated cell's ability to divide and differentiate,and ocular surface cells also undergo de-differentiation under certain conditions and may be involved in the repair process of the ocular surface.Inten-sive study of these cellular changes provides new ideas for the treatment of ocular surface diseases,although the exact mechanisms are not yet fully understood.Microenvironmental signaling plays a crucial role in this process,so care must be taken when applying the findings to avoid triggering other pathological changes.

Objective To investigate whether transcutaneous electrical acupoint stimulation(TEAS)can improve the muscle strength,endurance and work efficiency of calf muscles in healthy young men,aiming to explore a new method for preventing and combating microgravity-induced muscle atrophy in space environments.Methods 40 healthy young men aged 18-35 years were randomly divided into a Control group(Pseudo Transcutaneous Electrical Acupoint Stimulation)and a Experimental group(Transcutaneous Electrical Acupoint Stimulation)in a 1∶1 ratio,with 20 participants in each group.In the Control group,the indicator light of the stimulator was covered,and the device was turned on,but the electrodes did not contact the skin,The device automatically turned offafter 3 seconds.In the Experimental group,the TEAS device was connected to the current and TEAS intervention was performed.The electrical stimulation waveform was a sperse-dense wave with a frequency of 4/20 Hz,and the intensity was determined by patient tolerance.The acupoints selected for electrical stimulation in both groups were bilateral Zusanli(ST36)、Liangqiu(ST34),Taixi(KI3),and Fuliu(KI7).Zusanli and Liangqiu were paired,and Taixi and Fuliu were paired.The intervention frequency was 30 min/time,1 time/day,6 days/week,for 2 weeks.The relative peak torque at 60°/s,relative peak torque at 180°/s,and average power at 180°/s of the bilateral calf muscles were measured using an isokinetic dynamometer at 0th,7th,and 14d day of the experiment.Results After 1 week of TEAS,compared with Control group,there were no significant changes in the relative peak torque at 60°/s,relative peak torque at 180°/s and average power at 180°/s of the bilateral anterior calf muscles in the Experimental group(all P>0.05);however,compared with Control group,the relative peak torque at 60°/s and the relative peak torque at 180°/s of the bilateral posterior calf muscles in the Experimental group were significantly increased(all P<0.05).After 2 weeks TEAS;compared with the Control group,there were no significant changes in the relative peak torque at 60°/s,relative peak torque at 180°/s and average power at 180°/s of the bilateral anterior calf muscles in the Experimental group(all P>0.05);however,the relative peak torque at 60°/s,relative peak torque at 180°/s,and average power at 180°/s of the bilateral posterior calf muscles were significantly increased in the Experimental group(all P<0.05).Conclusion TEAS of Zusanli,Liangqiu,Fuliu and Taixi acupoints on the lower limbs for 2 weeks can effectively improve the maximum muscle strength,endurance and work efficiency of the posterior calf muscles in healthy young men.

Objective To analyze the key driving factors for patent management and scientific and technological achieve-ment transformation in medical institutions in the Yangtze River Delta region,and to provide a scientific basis for improving the efficiency of regional medical scientific and technological achievement transformation.Methods A convenience sampling method was used to conduct a questionnaire survey among 480 medical staff from tertiary hospitals in three provinces and one city(An-hui,Jiangsu,Shanghai,Zhejiang)of the Yangtze River Delta region from November 2024 to January 2025.SPSS 23.0 software was used for univariate analysis,multiple linear regression analysis,and regional difference comparisons.Results Univariate a-nalysis showed that region,age,education level,and professional title had statistically significant effects on patent output(P＜0.05).Multiple linear regression analysis further indicated that cognitive factors(score:19.01±8.73,β=0.230,P＜0.001),support factors(score:25.84±11.33,β=0.211,P=0.004),and incentive factors(score:25.93±10.85,β=0.136,P=0.036)were key drivers of patent output.Significant regional differences were observed,with Anhui Province scoring lower across all dimensions compared to Jiangsu,Zhejiang,and Shanghai(total score:74.18 vs.101.16-107.40,P＜0.001).Conclusion Enhancing medical staff's awareness of patents,improving institutional support and incentive mechanisms,and nar-rowing regional development gaps are core optimization pathways for promoting the transformation of medical scientific and techno-logical achievements in the Yangtze River Delta region.

Aim To apply coronary angiography derived index of microcirculatory resistance(caIMR)to evaluate the effect of coronary microcirculation perfusion on myocardial remodeling after interventional therapy in patients with acute anterior ST segment elevation myocardial infarction(STEMI).Methods This was a cross-sectional study.The analysis was performed among the patients who were hospitalized for acute anterior STEMI in the First Department of the Second Affiliated Hospital of Dalian Medical University from January 2021 to July 2022 and received percutaneous coro-nary intervention(PCI)with regtelar follow-up visits.The patients were divided into low caIMR(L-caIMR)group,me-dium caIMR(M-caIMR)group and high caIMR(H-caIMR)group according to the results of caIMR.The results of ech-ocardiography at perioperative period,1 month,3 months,6 months and 1 year were analyzed and compared,including left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDD),interventricular septum thickness(IVST),mitral orifice flow velocity E/A,mitral annular septum e'and mitral annular wall e',etc.The difference of interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and other inflammatory factors in peripheral blood of the three groups were also compared.Results A total of 75 patients diagnosed with acute anterior STEMI were recrui-ted,including 55 males.The L-caIMR group,M-caIMR group,and H-caIMR group had 26,26 and 23 cases,respec-tively.Compared with the L-caIMR group,the LAD and IVST in the M-caIMR group and the H-caIMR group exhibited an increasing tendency one month after PCI,and the increase in the H-caIMR group was more significant than that in the M-caIMR group(P＜0.05).The ejection fraction in the H-caIMR group was notably lower than that in the L-caIMR group and the M-caIMR group at 1 and 3 months after PCI(P＜0.05).Compared with the L-caIMR group,the mitral flow velocity E/A at 6 months after PCI,and the e'at the septal side and the lateral wall of the mitral annulus at 1,3,and 6 months after PCI were significantly reduced in the M-caIMR and H-caIMR groups(P＜0.05).Compared with the L-caIMR group,the levels of IL-1β,IL-6,and TNF-α showed an increasing trend in the M-caIMR group and the H-caIMR group,and the increase was greater in the H-caIMR group than that in the M-caIMR group(P＜0.05).Multivariate anal-ysis revealed that caIMR was a factor influencing the levels of IL-1 β and IL-6(P＜0.05).Conclusion CMD may be involved in the process of myocardial remodeling in patients with acute anterior STEMI after PCI,in which inflammation plays a role.

Objective:To investigate the relevant data on radiation dose in interventional radiodiagnosis and radiology of adults in Beijing and to provide a basis for establishing relevant diagnostic reference levels (DRLs) in this region.Methods:A total of 30 medical institutions in Beijing were surveyed, covering interventional radiodiagnosis and radiology surgeries for coronary artery, structural heart diseases, permanent cardiac pacemaker implantation, electrophysiological study and radiofrequency ablation, nervous systems, abdominal systems, and the blood vessels of the lower limbs. The primary parameters investigated included the air kerma area product ( PKA) and incident air kerma ( Ka, r). The 75 th percentiles of radiation dose were considered DRLs, which were analyzed at both the overall and individual medical institution levels. Results:A total of 3 331 cases of the abovementioned radiodiagnosis and radiology surgeries were collected. The DRLs (i.e., PKA and Ka, r) of various diagnostic examinations were 37.87 Gy·cm 2 and 509.00 mGy for coronary artery, 9.34 Gy·cm 2 and 48.00 mGy for electrophysiological study and radiofrequency ablation, 218.50 Gy·cm 2 and 901.70 mGy for nervous systems, 81.00 Gy·cm 2 and 302.20 mGy for the abdominal system, and 83.37 Gy·cm 2 and 214.69 mGy for the blood vessels of the lower limbs. In contrast, the DRLs (i.e., PKA and Ka, r) for interventional radiodiagnosis and radiology were determined at 135.00 Gy·cm 2 and 1 897.58 mGy for coronary artery, 26.91 Gy·cm 2 and 172.30 mGy for structural heart diseases, 27.77 Gy·cm 2 and 87.75 mGy for permanent cardiac pacemaker implantation, 34.46 Gy·cm 2 and 247.00 mGy for electrophysiological study and radiofrequency ablation, 214.36 Gy·cm 2 and 1 282.80 mGy for the nervous system, 196.64 Gy·cm 2 and 875.71 mGy for abdominal system, and 108.25 Gy·cm 2 and 523.25 mGy for the blood vessels of the lower limbs. Conclusions:The DRLs of radiation dose in interventional radiodiagnosis and radiology in Beijing were determined through a survey and statistic analysis. These findings suggest that for certain interventional procedures, the optimized radiation protection should be enhanced.

Objective:To investigate the role and underlying mechanism of parthanatos death in neonatal SD rats with bilirubin encephalopathy(BE).Methods:Eighty 3-day-old neonatal SD rats were selected and randomly divided into control group and BE group.The BE model was established by intraperitoneal injection of bilirubin solution,and the pathological changes in the hippocampus were observed by hematoxylin-eosin(HE)staining and Nissl staining.The protein expressions of the phosphorylation of the core histone protein H2AX(termed gamma H2AX),poly ADP-ribose polymerasw-1(PARP-1)and apoptosis-inducing factor(AIF)in hippocampus were detected by Western blot.Immuno-fluorescence staining was used to detect the expression and distribution of AIF in hippocampus.Results:Compared with the control group,neonatal SD rats developed jaundice 12 hours after bilirubin injection,accompanied by slow weight gain.HE staining and Nissl staining showed that the hippocampus in BE group were damaged and the content of Nissl bodies was decreased.Western blot results showed that the expression of γ-H2AX protein in hippocampus began to increase at 72 h after modeling(P＜0.05),and the levels of PARP-1 and AIF protein in hippocampus increased signif-icantly at 72 h after modeling(P＜0.05).Immunofluorescence staining showed increased AIF expression and nuclear translocation.Conclusion:Intraperitoneal injection of bilirubin can induce DNA damage in hippocampal neurons of neonatal SD rats and activate the PARP-1/AIF pathway to cause parthanatos death of hippocampal neurons.