Objective This study aims to explore the efficacy and complication rates of the transcranial approach(TCA)and extended endoscopic endonasal approach(EEEA)for the treatment of craniopharyngiomas based on the QST classification,providing a scientific reference for clinical decision-making on surgical approach.Methods A total of 151 patients who underwent craniopharyngioma surgery at our center from January 2018 to December 2023 were enrolled.The patients were categorized into Q-CP(suprasellar type),S-CP(infundibular type),and T-CP(tuberal type)according to the QST classification.Systematic collection and analysis were performed on the outcomes of TCA and EEEA treatments,respectively.The differences in effectiveness between the two approaches were evaluated based on the QST classification.Results The improvement rate of visual symptoms was overall higher in the EEEA group than in the TCA group(59.1%vs.36.5%,P=0.006),and the visual deterioration rate was lower(3.0%vs.14.1%,P=0.006).However,the incidence of cerebrospinal fluid leakage was higher in the EEEA group(15.2%vs.3.5%,χ2=4.986,P=0.026).The incidence of postoperative seizures(8.2%vs.0,P=0.019),brain contusions(10.6%vs.0,P=0.005),and subdural hematoma(9.4%vs.0%,P=0.01)was higher in the TCA group.For patients with Q-CP type,the EEEA group had a higher rate of total tumor resection(92.9%vs.65.2%,P=0.025)and a lower recurrence rate(3.6%vs.21.7%,P=0.047),with shorter hospital stays and lower postoperative costs.The TCA group had higher intraoperative blood loss in this type(300 mL vs.200 mL,Z=-2.261,P=0.024).For S-CP type patients,the EEEA group showed a higher rate of total tumor resection(91.3%vs.74.2%)and a lower recurrence rate(0 vs.12.9%,P=0.031),with lower postoperative hospital costs.In T-CP type,due to the deeper location,EEEA showed limitations in protecting hypothalamic function and the TCA group had a better postoperative hypothalamic function score(P=0.035).Conclusion Based on QST classification,EEEA has advantages in Q-CP and S-CP types and is recommended as the preferred surgical procedure;In the T-CP type,TCA surgery is more helpful in protecting hypothalamic function.

The sustainable utilization and development of marine Chinese medicine are of great significance for protecting marine ecosystems,inheriting traditional Chinese medicine(TCM)culture,and promoting high-quality development of the TCM industry.Through generations of efforts,China has established a solid foundation in marine traditional Chinese medicine(MTCM)research,including the accumulation of traditional application experience,construction of research platforms,professional talent cultivation,establishment of high-level academic exchange platforms,policy support,and industrial environment optimization,with a series of breakthrough achievements.However,challenges persist in sustainable utilization and industrial development,such as unclear dynamic status of marine biological resources(some even depleted),disconnection between research and conservation due to weak awareness,insufficient R&D investment hindering landmark achievements,lack of national-level research platforms,and low industrial scale/intensification.To address these issues,strategic measures should be implemented,including strengthening dynamic monitoring and management of marine Chinese medicine resources,advancing artificial breeding and aquaculture technologies,establishing a national technology innovation center,increasing R&D investment through special funds,innovating research approaches,developing high-value products,and promote the integrated development of the entire industry chain of marine traditional Chinese medicine.Additionally,interdisciplinary collaboration,international cooperation,and public education should be enhanced to achieve effective resource conservation and rational utilization,form a marine traditional Chinese medicine industry cluster with a complete industrial chain,significant driving effect,and concentrated brand effect,ultimately contributing to human health and China's maritime power strategy.

The sustainable utilization and development of marine Chinese medicine are of great significance for protecting marine ecosystems,inheriting traditional Chinese medicine(TCM)culture,and promoting high-quality development of the TCM industry.Through generations of efforts,China has established a solid foundation in marine traditional Chinese medicine(MTCM)research,including the accumulation of traditional application experience,construction of research platforms,professional talent cultivation,establishment of high-level academic exchange platforms,policy support,and industrial environment optimization,with a series of breakthrough achievements.However,challenges persist in sustainable utilization and industrial development,such as unclear dynamic status of marine biological resources(some even depleted),disconnection between research and conservation due to weak awareness,insufficient R&D investment hindering landmark achievements,lack of national-level research platforms,and low industrial scale/intensification.To address these issues,strategic measures should be implemented,including strengthening dynamic monitoring and management of marine Chinese medicine resources,advancing artificial breeding and aquaculture technologies,establishing a national technology innovation center,increasing R&D investment through special funds,innovating research approaches,developing high-value products,and promote the integrated development of the entire industry chain of marine traditional Chinese medicine.Additionally,interdisciplinary collaboration,international cooperation,and public education should be enhanced to achieve effective resource conservation and rational utilization,form a marine traditional Chinese medicine industry cluster with a complete industrial chain,significant driving effect,and concentrated brand effect,ultimately contributing to human health and China's maritime power strategy.

Objective This study aims to explore the efficacy and complication rates of the transcranial approach(TCA)and extended endoscopic endonasal approach(EEEA)for the treatment of craniopharyngiomas based on the QST classification,providing a scientific reference for clinical decision-making on surgical approach.Methods A total of 151 patients who underwent craniopharyngioma surgery at our center from January 2018 to December 2023 were enrolled.The patients were categorized into Q-CP(suprasellar type),S-CP(infundibular type),and T-CP(tuberal type)according to the QST classification.Systematic collection and analysis were performed on the outcomes of TCA and EEEA treatments,respectively.The differences in effectiveness between the two approaches were evaluated based on the QST classification.Results The improvement rate of visual symptoms was overall higher in the EEEA group than in the TCA group(59.1%vs.36.5%,P=0.006),and the visual deterioration rate was lower(3.0%vs.14.1%,P=0.006).However,the incidence of cerebrospinal fluid leakage was higher in the EEEA group(15.2%vs.3.5%,χ2=4.986,P=0.026).The incidence of postoperative seizures(8.2%vs.0,P=0.019),brain contusions(10.6%vs.0,P=0.005),and subdural hematoma(9.4%vs.0%,P=0.01)was higher in the TCA group.For patients with Q-CP type,the EEEA group had a higher rate of total tumor resection(92.9%vs.65.2%,P=0.025)and a lower recurrence rate(3.6%vs.21.7%,P=0.047),with shorter hospital stays and lower postoperative costs.The TCA group had higher intraoperative blood loss in this type(300 mL vs.200 mL,Z=-2.261,P=0.024).For S-CP type patients,the EEEA group showed a higher rate of total tumor resection(91.3%vs.74.2%)and a lower recurrence rate(0 vs.12.9%,P=0.031),with lower postoperative hospital costs.In T-CP type,due to the deeper location,EEEA showed limitations in protecting hypothalamic function and the TCA group had a better postoperative hypothalamic function score(P=0.035).Conclusion Based on QST classification,EEEA has advantages in Q-CP and S-CP types and is recommended as the preferred surgical procedure;In the T-CP type,TCA surgery is more helpful in protecting hypothalamic function.

Objective To explore correlation between cerebral microbleeds(CMBs)and cognitive dysfunction in patients with cerebral small vessel disease.Methods A total of 80 patients with cerebral small vessel disease admitted to Department of Encephalopathy in Nanjing University of Chinese Medicine Affiliated Lianyungang Hospital from January 2020 to December 2022 were selected as research objects.They were divided into CMBs positive group(50 cases)and CMBs negative group(30 cases)based on the presence or absence of CMBs in the cerebral hemisphere.General clinical data of two groups were compared.Cognitive function was assessed by using Montreal cognitive assessment scale(MoCA).Results Age and incidence rate of hypertension in CMBs positive group were significantly higher than those in CMBs negative group(P<0.05).Total score of MoCA,scores of visuospatial and executive function,abstract thinking and delayed recall in CMBs positive group were significantly lower than those in CMBs negative group(P<0.05).Conclusion CMBs are closely related to the potential mechanism,clinical diagnosis and degree assessment of cognitive dysfunction in patients with cerebral small vessel disease.

A retrospective data collection was conducted on 16 patients who underwent secondary resection of bladder cancers using β-knife resection. The postoperative follow-up period is 12(10, 15)months, and no perioperative complications were detected. Among them, there were 3 cases of tumor recurrence, 2 cases continued to undergo β-knife resection, and 1 case underwent radical cystectomy. The safety of β-knife secondary electric cutting is high, and it can correct the insufficient first TURBT.

A retrospective data collection was conducted on 16 patients who underwent secondary resection of bladder cancers using β-knife resection. The postoperative follow-up period is 12(10, 15)months, and no perioperative complications were detected. Among them, there were 3 cases of tumor recurrence, 2 cases continued to undergo β-knife resection, and 1 case underwent radical cystectomy. The safety of β-knife secondary electric cutting is high, and it can correct the insufficient first TURBT.

Objective:To investigate the clinical effect of digital technology in the treatment of secondary deformity of orbitozygomatic fracture.Methods:The clinical data of 20 patients with secondary deformity of orbitozygomatic fracture treated in the Department of Plastic Surgery, the First Affiliated Hospital of Air Force Medical University from October 2015 to May 2019 were retrospectively analyzed, including 14 males and 6 females, aged 18-56 years. A computed tomography scan of the skull was performed before the operation. The data was three-dimensional(3D) reconstructed by Mimics software. The digital model was used to determine the surgical plan. Then the 3D head model was printed, osteotomy guide plate and reduction guide plate were used to guide osteotomy and reduction during surgery. Using Mimics software, the angle between orbital horizontal level and bilateral tragus linkage(A-OT value), the absolute value of the distance difference between bilateral zygomatic process point and facial midline (face width difference), and the absolute value of the distance difference between bilateral zygomatic process points and the vertical line passing through the central point of bony external auditory canal(facial process difference) were measured before and 3 days after operation. The exophthalmos of the affected side was measured by Hertel exophthalmos meter before and 6 months after operation. The paired t-test was used for comparison before and after operation. P<0.05 was statistically significant. Results:All the wounds healed well and the 20 patients were followed up for 6 months to 3 years. Before and after surgery, the A-OT values were (8.41 ± 2.46)° and (2.67 ± 0.55)°, with statistically significant difference ( t=11.242, P<0.001). Face width differences were (9.12 ± 1.02) mm and (1.51 ± 0.40) mm, with statistically significant difference( t=33.946, P<0.001). Facial process differences were (9.22 ± 0.95) mm and (1.53 ± 0.61) mm, with statistically significant difference ( t=33.484, P<0.001). Except for 4 patients with enucleation, the exophthalmos of the other patients was (7.81 ± 1.25) mm before operation and (12.78 ± 0.65) mm 6 months after operation. The difference was statistically significant ( t=-13.183, P<0.001). There was no diplopia and abnormal eye movement after operation. Conclusions:The application of digital technology in the treatment of secondary deformity of orbitozygomatic fracture is helpful to accurately diagnosis and reduction, and to improve the surgical effect.

Objective:To investigate the clinical effect of digital technology in the treatment of secondary deformity of orbitozygomatic fracture.Methods:The clinical data of 20 patients with secondary deformity of orbitozygomatic fracture treated in the Department of Plastic Surgery, the First Affiliated Hospital of Air Force Medical University from October 2015 to May 2019 were retrospectively analyzed, including 14 males and 6 females, aged 18-56 years. A computed tomography scan of the skull was performed before the operation. The data was three-dimensional(3D) reconstructed by Mimics software. The digital model was used to determine the surgical plan. Then the 3D head model was printed, osteotomy guide plate and reduction guide plate were used to guide osteotomy and reduction during surgery. Using Mimics software, the angle between orbital horizontal level and bilateral tragus linkage(A-OT value), the absolute value of the distance difference between bilateral zygomatic process point and facial midline (face width difference), and the absolute value of the distance difference between bilateral zygomatic process points and the vertical line passing through the central point of bony external auditory canal(facial process difference) were measured before and 3 days after operation. The exophthalmos of the affected side was measured by Hertel exophthalmos meter before and 6 months after operation. The paired t-test was used for comparison before and after operation. P<0.05 was statistically significant. Results:All the wounds healed well and the 20 patients were followed up for 6 months to 3 years. Before and after surgery, the A-OT values were (8.41 ± 2.46)° and (2.67 ± 0.55)°, with statistically significant difference ( t=11.242, P<0.001). Face width differences were (9.12 ± 1.02) mm and (1.51 ± 0.40) mm, with statistically significant difference( t=33.946, P<0.001). Facial process differences were (9.22 ± 0.95) mm and (1.53 ± 0.61) mm, with statistically significant difference ( t=33.484, P<0.001). Except for 4 patients with enucleation, the exophthalmos of the other patients was (7.81 ± 1.25) mm before operation and (12.78 ± 0.65) mm 6 months after operation. The difference was statistically significant ( t=-13.183, P<0.001). There was no diplopia and abnormal eye movement after operation. Conclusions:The application of digital technology in the treatment of secondary deformity of orbitozygomatic fracture is helpful to accurately diagnosis and reduction, and to improve the surgical effect.

Objective:To discuss the feasibility of offering specialized courses of critical care medicine in undergraduate clinical medicine education, so as to alleviate the shortage of critical care medicine staffs and lay a foundation for improving the success rate for the treatment of critical cases.Methods:The undergraduates majoring in clinical medicine from 2008 to 2011 in Guizhou Medical University (the former Guiyang Medical College) were enrolled. After they had been enrolled in the undergraduate education for 3 years and were ready for Grade four, which meant basic medicine teaching had been completed and clinical medicine teaching was about to start, they were introduced and preached to each discipline, including critical care medicine. The undergraduates were free to choose professional direction of clinical training in Grade four. Students majoring in clinical medicine from 2012 to 2014 were free to choose their major direction when they entered the school.Results:From September 2011 to July 2019, the university had cultivated 246 undergraduates majoring in clinical critical care medicine from 2008 to 2014, and the critical care medicine professional team of affiliated hospital had undertaken 540 teaching hours. By July 2019, all students had graduated on time, with an employment rate of 100%. Forty students took postgraduate programs in our school and other schools, accounting for 16.3%.Conclusions:Professional education of critical care medicine in the undergraduate course of clinical medicine can mobilize students' interest in learning and subjective initiative, which is conducive to career selection. During the clinical training, the students can identify and timely cure critical care cases in the early stage, and partly alleviate the current shortage of critical care medical staffs.