Objective To compare the short-term outcomes of single-port video-assisted thoracoscopic(VATS)pulmonary surgery using a chest-wall-muscle-sparing incision versus a standard incision.Methods A total of 215 patients undergoing single-port video-assisted thoracoscopic lung surgery in the Department of Cardiothoracic Surgery,The First Hospital of Anhui University of Science&Technology from February 2024 to May 2025 were recruited in this clinical observation.Clinical data were retrospectively analyzed.The patients were divided into a chest wall muscle sparing incision group and a chest wall standard incision group.Short-term prognoses of the two groups were compared.Results A total of 180 patients was included:80 in the chest wall muscle sparing incision group and 100 in the chest wall standard incision group.The two groups had similar baseline characteristics,includ-ing body-mass index(23.86±3.70 vs.23.45±3.20 kg/m2;P>0.05).All procedures were completed successfully without perioperative mortality,conversion to thoracotomy,or extension of the incision.The standard incision group had 4 latissimus dorsi injuries and 5 patients with shoulder joint dysfunction on the 30th day after discharge,charac-terized by chest wall muscle tightness accompanied by chest pain and limited upper limb mobility(P<0.05).Although skin-to-skin incision time was slightly longer in the muscle-sparing group(P=0.06),pain scores at every assessed time point were significantly lower(P<0.05),and no patient developed shoulder dysfunction.No significant differences were observed in incisional fat-liquefaction rate,incision length,operative time,blood loss,or chest-tube duration(P>0.05).Conclusion The chest wall muscle sparing incision in single-port video-assisted thoracoscopic lung surgery not only preserves the latissimus dorsi and serratus anterior muscles,significantly reduces postoperative incision pain,and minimizes chest wall muscles and shoulder dysfunction,exhibiting clear minimally invasive advantages in single-port VATS lung surgery.

The polymerase 1 and transcript release factor (PTRF)-cytoplasmic phospholipase A2 (cPLA2) phospholipid remodeling pathway facilitates tumor proliferation in glioma. Nevertheless, blockade of this pathway leads to the excessive activation of oncogenic receptors on the plasma membrane and subsequent drug resistance. Here, CD26/dipeptidyl peptidase 4 (DPP4) was identified through screening of CRISPR/Cas9 libraries. Suppressing PTRF-cPLA2 signaling resulted in the activation of the epidermal growth factor receptor (EGFR) pathway through phosphatidylcholine and lysophosphatidylcholine remodeling, which ultimately increased DPP4 transcription. In turn, DPP4 interacted with EGFR and prevented its ubiquitination. Linagliptin, a DPP4 inhibitor, facilitated the degradation of EGFR by blocking its interaction with DPP4. When combined with the cPLA2 inhibitor AACOCF3, it exhibited synergistic effects and led to a decrease in energy metabolism in glioblastoma cells. Subsequent in vivo investigations provided further evidence of a synergistic impact of linagliptin by augmenting the sensitivity of AACOCF3 and strengthening the efficacy of temozolomide. DPP4 serves as a novel target and establishes a constructive feedback loop with EGFR. Linagliptin is a potent inhibitor that promotes EGFR degradation by blocking the DPP4-EGFR interaction. This study presents innovative approaches for treating glioma by combining linagliptin with AACOCF3 and temozolomide.

Objective To compare the short-term outcomes of single-port video-assisted thoracoscopic(VATS)pulmonary surgery using a chest-wall-muscle-sparing incision versus a standard incision.Methods A total of 215 patients undergoing single-port video-assisted thoracoscopic lung surgery in the Department of Cardiothoracic Surgery,The First Hospital of Anhui University of Science&Technology from February 2024 to May 2025 were recruited in this clinical observation.Clinical data were retrospectively analyzed.The patients were divided into a chest wall muscle sparing incision group and a chest wall standard incision group.Short-term prognoses of the two groups were compared.Results A total of 180 patients was included:80 in the chest wall muscle sparing incision group and 100 in the chest wall standard incision group.The two groups had similar baseline characteristics,includ-ing body-mass index(23.86±3.70 vs.23.45±3.20 kg/m2;P>0.05).All procedures were completed successfully without perioperative mortality,conversion to thoracotomy,or extension of the incision.The standard incision group had 4 latissimus dorsi injuries and 5 patients with shoulder joint dysfunction on the 30th day after discharge,charac-terized by chest wall muscle tightness accompanied by chest pain and limited upper limb mobility(P<0.05).Although skin-to-skin incision time was slightly longer in the muscle-sparing group(P=0.06),pain scores at every assessed time point were significantly lower(P<0.05),and no patient developed shoulder dysfunction.No significant differences were observed in incisional fat-liquefaction rate,incision length,operative time,blood loss,or chest-tube duration(P>0.05).Conclusion The chest wall muscle sparing incision in single-port video-assisted thoracoscopic lung surgery not only preserves the latissimus dorsi and serratus anterior muscles,significantly reduces postoperative incision pain,and minimizes chest wall muscles and shoulder dysfunction,exhibiting clear minimally invasive advantages in single-port VATS lung surgery.

Gastrointestinal stromal tumor(GIST),with a certain malignant potential,are currently the most common subepithelial tumors of the gastrointestinal tract.Early diagnosis and prediction of malignant potential are very important for the formulation of a treatment plan and determining the prognosis of GIST.Deep learning technology has made significant progress in the diagnosis of digestive tract diseases,and it can also effectively assist physicians in diagnosing GIST and predicting their malignant potential,preoperatively.The application of deep learning technology in the diagnosis of GIST includes CT,gastrointestinal endoscopy and endoscopic ultrasound.This paper aims to review the application of deep learning technology in the diagnosis and prediction of malignant potential of GIST.

Objective:To investigate the clinical characteristics, treatment and prognosis of primary vitreoretinal lymphoma (PVRL) diagnosed and treated in our hospital during the past 10 years.Methods:A retrospective clinical study. From 2011 to 2021, 126 eyes of 67 patients with PVRL who were diagnosed and treated in Department of Ophthalmology, Eye-ENT Hospital, Fudan University were included in the study. Among them, there were 23 males (34.3%, 23/67) and 44 females (65.7%, 44/67); the average age was 57.1 years. There were 59 cases with both eyes (88.1%, 59/67) and 8 cases with one eye (11.9%, 8/67). At the initial eye diagnosis, 22 cases had a clear history of primary central nervous system lymphoma (PCNSL); 5 cases were found to have intracranial lesions by head imaging examination; 40 cases had no central nervous system involvement. Twenty cases were treated with glucocorticoids due to misdiagnosed uveitis. All patients received intravitreal injection of methotrexate (IVM) treatment. The treatment regimen was twice a week in the induction period for 2 weeks, once a week in the consolidation period for 1 month, and once a month in the maintenance period. Patients with PCNSL or both eyes received concurrent systemic chemotherapy (chemotherapy), and some in combination with radiation therapy to the brain (radiotherapy). The mean follow-up time was 39.3 months. The clinical manifestations, treatment and prognosis of the patients were retrospectively analyzed. The visual acuity before and after treatment was compared by t test. Results:Among the 22 cases with a clear history of PCNSL at the initial eye diagnosis, the average time from intracranial diagnosis to eye diagnosis was 22.9 months. Among the 40 cases without central nervous system involvement at first, 14 cases (20.9%, 14/67) developed central nervous system lesions during follow-up period. The mean time from ocular diagnosis to intracranial diagnosis was 9.9 months. Among the 126 eyes, 42 eyes (33.3%, 42/126) had anterior segment inflammation. vitreous inflammation type, retinal type, and vitreous retinal type were 58 (46.0%, 58/126), 7 (5.6%, 7/126), and 61 (48.4%, 61/126) eyes, and 9 of them (7.1%, 9/126) had optic nerve involvement at the same time. Patients received an average of 12 IVM treatments. IVM combined with systemic chemotherapy in 59 cases (88.1%, 59/67), of which 16 cases were combined with brain radiotherapy. All patients achieved complete remission after completing the treatment cycle (100.0%, 67/67). After treatment, 21 eyes (16.7%, 21/126) had ocular recurrence; 22 (32.8%, 22/67) had intracranial recurrence; 8 cases (11.9%, 8/67) died. The mean progression-free survival of patients was 23.7 months; the mean survival time was 43.6 months; the 5-year overall survival rate was 72.5%.Conclusions:The manifestations of PVRL are complex and diverse, and most of them are accompanied by involvement of the central nervous system. It can be divided into vitreitis type, retinal type and vitreoretinal type, and the optic nerve can be involved at the same time; IVM combined with systemic treatment can completely relieve the disease.

Primary vitreoretinal lymphoma (PVRL) is a rare and aggressive high-grade non-Hodgkin lymphoma. PVRL always with non-specific symptoms and has therefore been called as masquerade syndrome. Thus, the early and correct diagnosis of PVRL is a difficulty. For PVRL, the imaging findings can be specific but variety, histological diagnosis is still the gold standard. Its diagnosis needs to be combined with clinical manifestations, imaging features, pathological diagnosis and molecular biology. With the advancement of technology, especially in the field of the cytokines detection and the gene expression profiling research, molecular biology diagnosis of PVRL is becoming a research hotspot and an important auxiliary diagnostic method.

Objective To design and evaluate a new type of acromion & clavicle anatomic plate with combinatorial hinge more suitable for acromioclavicular joint dislocation and distal clavicular fracture.Methods The new type of acromion & clavicle anatomic plate with combinatorial hinge we had designed was used in 21 patients (21 shoulders) who were treated for acromioclavicular joint dislocation or distal clavicular fracture from October 2016 to April 2017 at Department Ⅰ of Orthopaedics,The 2nd People's Hospital of Lu'an.They were 15 men and 6 women,aged from 24 to 63 years(average,41.5 ±4.2 years).Of the 14 cases of acromioclavicular joint dislocation,7 were type Ⅲ,5 type Ⅳ and 2 type Ⅴ,according to the Rockwood classification;all the 7 distal clavicular fractures were Neer type Ⅱ.They were all treated by open reduction and internal fixation with our self-designed acromion & clavicle plate with combinatorial hinge.They were followed up at the outpatients department at 3 weeks,3,6,12 and 15 months postoperatively for evaluation of their shoulder functions by Constant-Murley score,changes in coracoclavicular clearance before and after operation and loss of coracoclavicular clearance after removal of internal fixation by X-ray.Results All the 21 patients were effectively followed up for 15 to 20 months (average,18 months).As for their Constant-Murley scores,preoperation (49.7±4.9) ＜3 weekspostoperation (57.6±5.9) ＜3 monthspostoperation (83.2±5.7) ＜6 months postoperation (90.4 ±4.0) ＜ 12 months postoperation (94.3 ±4.2) ＜ 15 months postoperation (98.1 ±4.2),with significant differences between different time points (P ＜ 0.05).The postoperative coracoclavicular clearances at different time points were all significantly decreased than the preoperative value (P ＜ 0.05).With the aid of our new type of acromion & clavicle anatomic plate,the shoulder functions of the patients were gradually improved,the postoperative acromioclavicular joint and reduction of the distal clavicular fracture were stable,and no re-dislocation occurred after removal of internal fixation.Conclusion Our new handy type of acromion & clavicle anatomic plate with combinatorial hinge can provide more effective internal fixation for acromioclavicular joint dislocation and clavicular distal fracture,facilitating functional recovery of the shoulder.

Objective To study the paracrine effect of hypoxic preconditioned umbilical cord mesenchymal stem cells (UCMSCs) on the proliferation,migration and osteogenic differentiation of osteoblasts.Methods UCMSCs were cultured under hypoxia and normal oxygen condition before two UCMSCs conditioned media were obtained.After that,MG-63 cells were cultured in three groups:hypoxia conditioned medium group,normoxia conditioned medium group and DMEM control group.The proliferation of MG-63 cells was detected by mosmann tetrazoline colorimetry( MTT) method after 1,3 and 5 days.The migratory ability of MG-63 cells was detected by scratch assay .After 21 days′culture , the formation of osteogenic calcium nodules was detected by Alizarin red staining.ELISA method was used to detect the content of vascular endothelial growth factor ( VEGF) in hypoxia and normoxia conditioned medium.Results The MTT test showed that the proliferation ability of MG-63 cells in hypoxia conditioned medium group and normoxia conditioned medium group was greater than in the DMEM control group.The difference was statistically significant ( P <0.05).Furthermore, the proliferation ability of cells in hypoxia conditioned medium group were much greater than cells in normoxia culture medium group.The difference was statistically significant (P<0.05).Scrath assay showed that the migratory ability of MG-63 cells in hypoxia conditioned medium group and normoxia conditioned medium group was greater than cells in DMEM control group,and cells in hypoxia conditioned medium group was much greater than cells in normoxia conditioned medium group. After 21 days′culture,we found that the number of calcium nodules was the largest in hypoxia conditioned medium group, followed by normoxia conditioned medium group and DMEM control group.ELISA showed that the content of VEGF in hypoxia conditioned medium was higher than that in normoxia conditioned medium and the difference was statistically significant (P<0.01).Conclusion The paracrine function of UCMSCs can be enhanced by hypoxia,thus improving the proliferation,migration and osteogenic differentiation of osteoblasts.

Objective To evaluate the efficiency of multimodal analgesia for the patients who had the posterior lumbar spine surgery.Methods Sixty-four cases of patients who were scheduled to the posterior lumbar spine surgery were randomly divided into two groups, multimodal analgesia group (n =32) and control group(n=32).Multimodal analgesia group patients were given oxycodone acetaminophen 1 day before and the next day after operation, during the operation the patients received injiection of multimodal drugs (consisting of ropivacaine 150 mg, flurbiprofen 50 mg, phenylephrine 0.4 ml, normal saline 50 ml) around the incisions by infiltrated injection before the skin incision closed, then had controlled intravenous analgesia.In the control group, the incisions were sutured without the local infiltration analgesia.Then only had patient controlled intravenous analgesia after operati on.Visual analogue scale(VAS) ,Japanese Orthopedic Association(JOA) and Prolo lumbar function score was recorded respectively perioperatively.Results (1) VAS: the patients of multimodal analgesia group had significantly lower rest pain scores and activity pain scores at 6, 12,24 hours, first moving than the control group((3.1±1.6) ,(2.8±1.1),(2.4±0.9) ,(2.3±1.1) vs.(3.5±1.8) ,(3.4± 1.3), (3.4±0.8), (3.0± 1.5), P＜0.05).There was no significant difference at the discharge between the two groups (P＞0.05).(2)JOA:JOA scores of the patients of multimodal analgesia group were obviously higher than that of the control group at 1,3,7 days after operation (P＜0.05).There was no significant difference at the discharge between the two groups (P＞0.05).(3) Prolo lumbar function score : Prolo scores of the patients of the multimodal analgesia group were obviously higher than that of control group at 1,3,7 days after operation (P ＜0.05).There was no significant difference at the discharge between the two groups(P＞0.05).Conclusion Multimodal Analgesia is shown to safely provide excellent pain control and functional recovery.It can reduce visual analogue pain score and improve lumbar function after surgery.

Objective To compare the efficacy and safety of intravesical instillation of pirarubicin (T HP) to prevent the post -operative recurrence of superficial bladder cancer with same dose variable concentration .Methods A tota1 of 56 cases of superficial bladder cancer after transurethral resection (TURBT ) were randomly divided into two groups(High concentration group :25 cases , Low concentration group :31 cases) .Infusion dose of THP is 30 mg .The concentration of THP is 1 .0 g/L in H group ,0 .6 g/L in L group .Both groups were installed within 24 hours after operation .Both groups were installed once a week for 8 weeks after the first installation ,then once a month until 1 year after operation .All cases were followed up ,the tumor recurrence time ,recurrence rates and complications were compared .Results All cases except 2 in L group received 6 -30 months follow up ,with an average time of 17 .6 months .In H group ,1 patients recurred during the follow-up period ,with a recurrence rate of 4 .0% and recurrence time of 12 .4 months ,while in L group ,3 cases recurred ,with a recurrence rate of 10 .3% and an average recurrence time of 9 .8 months .Adverse reactions were main1y Urinary irritation symptoms .The difference of recurrence rate and average recurrence time in each group were statistically significant (P< 0 .05) ,while the difference of adverse reactions were not statistically significant (P>0 .05) .Conclusion This study shows that high concentration THP intravesical instillation could effectively reduce the recur-rence rate and delay the recurrence time .Each concentration was well tolerated .