Objective:To evaluate the short-term efficacy of endoscopic-laparoscopic regional gastric resection combined with sentinel lymph node basin dissection in patients with early-stage gastric cancer.Methods:This is a retrospective case series study. Data of 17 consecutive early gastric cancer patients from a prospective cohort at Beijing Friendship Hospital,Capital Medical University were analyzed between August 2023 and August 2024. Sixteen cases were from the department of general surgery and 1 from the department of gastroenterology. The cohort included 9 males and 8 females,with a mean age of 61.4 years (range: 46 to 79 years). Clinical data,including demographics,pathological features,surgical procedures,and follow-up outcomes,were collected through medical records and databases. All patients were followed for over 3 months,with follow-up ending on December 5,2024.Results:A total of 17 patients were involved. Among them, 5 patients underwent endoscopic submucosal dissection (ESD) combined with laparoscopic sentinel lymph node dissection (LSBD),and another 3 patients who underwent complete ESD resection received LSBD due to pathological stage meeting the expanded indications. 6 patients who underwent non-curative ESD resection received laparoscopic gastric regional resection (LRG) combined with LSBD,and another 3 patients directly received LRG combined with LSBD. The average number of sentinel lymph nodes dissected before surgery ( M(IQR)) was 8.9 (4.5) (range: 4 to 21),and the detection rate and accuracy rate were both 100%. Postoperative pathology confirmed that there was no metastasis in the sentinel lymph nodes of 5 patients who underwent ESD combined with LSBD and 3 patients who underwent LSBD after complete ESD resection. The vertical and horizontal margins of ESD were all negative. One patient was an absolute indication for ESD. For the 6 patients who underwent non-curative ESD resection combined with LRG and LSBD,the horizontal margins were all negative. Two patients showed 1 metastasis in each of the 21 and 9 sentinel lymph nodes during the operation,and additional distal gastrectomy was performed during the operation. Postoperatively,73 and 39 lymph nodes were retrieved respectively. The former had 1 additional metastasis,while the latter had no metastasis. Among the 3 patients who underwent direct LRG combined with LSBD,the horizontal margins were negative. One patient was confirmed as an absolute indication for ESD by postoperative pathology,and one patient had 1 metastasis in 8 sentinel lymph nodes during the operation,and additional distal gastrectomy was performed. Postoperatively,there was no metastasis in 54 lymph nodes. All patients had no complications such as infection,bleeding,perforation,or death after surgery. Among the 14 patients who did not receive additional radical surgery,they were able to pass gas and defecate within 3 days after surgery,with an average hospital stay of 6 days. The nutritional indicators and gastric radionuclide emptying imaging half-emptying time were similar to those before surgery at 3 months after surgery. Conclusions:Laparoscopic and endoscopic cooperative regional gastrectomy with sentinel lymph node basin dissection has the advantages of minimal invasiveness,preservation of gastric function,and precise treatment. It maybe suitable for patients with early-stage gastric cancer at high risk of lymph node metastasis and has good short-term efficacy.

Objective:To investigate the clinical efficacy of Di'ao Xinxuekang Capsules combined with injectable pancreatic kallidinogenase in the treatment of diabetic retinopathy. Methods:This study was a prospective research. A total of 90 patients with diabetic retinopathy treated at The People's Hospital of Liaoning Province from September 2021 to March 2024 were included in this study. The patients were randomly assigned to an observation group and a control group, with 45 patients in each group, using the random number table method. The control group received treatment with injectable pancreatic kallidinogenase, while the observation group underwent treatment with Di'ao Xinxuekang Capsules in addition to injectable pancreatic kallidinogenase. Both groups were treated for 14 days. The clinical efficacy, changes in visual acuity after treatment compared with before treatment, ocular hemodynamic indicators (peak systolic velocity and resistance index), and the incidence of adverse reactions were compared between the two groups. Results:The response rate in the observation group was significantly higher than that in the control group [90.91% (40/45) vs. 73.33% (33/45), χ2 = 8.61, P<0.05]. Before treatment, there were no significant differences between the two groups regarding visual acuity values, retinal thickness, and ocular hemodynamic parameters ( t = 0.11, 0.05, 0.47, 1.08, all P>0.05). After 14 days of treatment, the visual acuity in the observation group was significantly higher than that in the control group [(1.06 ± 0.11) vs. (0.81 ± 0.06), t = 12.62, P<0.001]. The peak systolic velocity in the observation group was significantly greater than that in the control group [(31.85 ± 1.92) cm/s vs. (27.01 ± 1.33) cm/s, t = 8.01, P<0.001]. The retinal thickness in the observation group was significantly lower than that in the control group [(311.5 ± 45.2) μm vs. (350.3 ± 59.3) μm, t = -3.49, P<0.001]. The resistance index in the observation group was significantly lower than that in the control group [(0.59 ± 0.02) vs. (0.68 ± 0.04), t = -12.57, P<0.001]. There was no significant difference in the incidence of adverse reactions between the observation and control groups [8.89% (4/45) vs. 6.67% (3/45), χ2 = 0.16, P>0.05]. Conclusions:Di'ao Xinxuekang Capsules combined with injectable pancreatic kallidinogenase for the treatment of diabetic retinopathy can effectively enhance clinical efficacy, improve patients' visual acuity and ocular hemodynamic indicators, and is considered safe.

Objective:To investigate the clinical efficacy of Zhibitai capsules combined with liraglutide in the treatment of type 2 diabetes mellitus (T2MD) complicated by metabolic-associated fatty liver disease (MAFLD). Methods:This study used a prospective design. A total of 92 patients with T2DM complicated by MAFLD who were admitted to The People's Hospital of Liaoning Province from September 2023 to September 2024 were included in this study. They were randomly divided into an observation group and a control group, with 46 patients in each group. Both groups received lifestyle intervention and standard antidiabetic treatment. The control group received subcutaneous injections of liraglutide, while the observation group was treated with liraglutide combined with Zhibitai capsules. All patients were treated for 3 months. Blood glucose levels, glycated hemoglobin, blood lipid levels, liver function, and hemodynamic parameters were compared between the two groups both before and after treatment. The controlled attenuation parameter of liver fat was measured using Fibro Touch. Results:After treatment, there were no statistically significant differences in fasting blood glucose, 2-hour postprandial blood glucose, and glycated hemoglobin levels between the two groups (all P > 0.05). The high-density lipoprotein cholesterol level in the observation group was significantly higher than that in the control group [(1.31 ± 0.40) mmol/L vs. (0.90 ± 0.30) mmol/L, t = -5.56, P < 0.001]. The levels of total cholesterol [(3.70 ± 0.80) mmol/L vs. (4.40 ± 0.90) mmol/L], triglycerides [(1.50 ± 0.40) mmol/L vs. (2.60 ± 0.50) mmol/L], and low-density lipoprotein cholesterol [(1.80 ± 0.50) mmol/L vs. (2.60 ± 0.60) mmol/L] in the observation group were significantly lower than those in the control group ( t = 3.94, 11.65, 6.39, all P < 0.001). The controlled attenuation parameter of liver fat in the observation group was significantly lower than that in the control group [(249.20 ± 7.60) dB/m vs. (264.70 ± 8.70) dB/m, t = 9.10, P < 0.001]. The level of total bilirubin in the observation group was significantly higher than that in the control group [(16.40 ± 1.50) μmol/L vs. (15.00 ± 1.40) μmol/L, t = -4.63, P < 0.05], while the levels of other liver function indicators in the observation group were significantly lower than those in the control group ( t = 4.83, 9.57, 3.66, all P < 0.001). After treatment, whole blood viscosity at high shear rates, whole blood viscosity at lower shear rates, plasma viscosity, and platelet aggregation levels were all significantly lower in the observation group compared with the control group ( t = 2.13, 2.62, 2.97, 6.15, 4.00, all P < 0.05). Conclusions:Zhibitai capsules combined with liraglutide can improve blood glucose levels, lipid profiles, and liver function, while also decreasing blood viscosity in patients with T2MD complicated by MAFLD.

Objective:To investigate the clinical efficacy of Di'ao Xinxuekang Capsules combined with injectable pancreatic kallidinogenase in the treatment of diabetic retinopathy. Methods:This study was a prospective research. A total of 90 patients with diabetic retinopathy treated at The People's Hospital of Liaoning Province from September 2021 to March 2024 were included in this study. The patients were randomly assigned to an observation group and a control group, with 45 patients in each group, using the random number table method. The control group received treatment with injectable pancreatic kallidinogenase, while the observation group underwent treatment with Di'ao Xinxuekang Capsules in addition to injectable pancreatic kallidinogenase. Both groups were treated for 14 days. The clinical efficacy, changes in visual acuity after treatment compared with before treatment, ocular hemodynamic indicators (peak systolic velocity and resistance index), and the incidence of adverse reactions were compared between the two groups. Results:The response rate in the observation group was significantly higher than that in the control group [90.91% (40/45) vs. 73.33% (33/45), χ2 = 8.61, P<0.05]. Before treatment, there were no significant differences between the two groups regarding visual acuity values, retinal thickness, and ocular hemodynamic parameters ( t = 0.11, 0.05, 0.47, 1.08, all P>0.05). After 14 days of treatment, the visual acuity in the observation group was significantly higher than that in the control group [(1.06 ± 0.11) vs. (0.81 ± 0.06), t = 12.62, P<0.001]. The peak systolic velocity in the observation group was significantly greater than that in the control group [(31.85 ± 1.92) cm/s vs. (27.01 ± 1.33) cm/s, t = 8.01, P<0.001]. The retinal thickness in the observation group was significantly lower than that in the control group [(311.5 ± 45.2) μm vs. (350.3 ± 59.3) μm, t = -3.49, P<0.001]. The resistance index in the observation group was significantly lower than that in the control group [(0.59 ± 0.02) vs. (0.68 ± 0.04), t = -12.57, P<0.001]. There was no significant difference in the incidence of adverse reactions between the observation and control groups [8.89% (4/45) vs. 6.67% (3/45), χ2 = 0.16, P>0.05]. Conclusions:Di'ao Xinxuekang Capsules combined with injectable pancreatic kallidinogenase for the treatment of diabetic retinopathy can effectively enhance clinical efficacy, improve patients' visual acuity and ocular hemodynamic indicators, and is considered safe.

Objective:To investigate the clinical efficacy of Zhibitai capsules combined with liraglutide in the treatment of type 2 diabetes mellitus (T2MD) complicated by metabolic-associated fatty liver disease (MAFLD). Methods:This study used a prospective design. A total of 92 patients with T2DM complicated by MAFLD who were admitted to The People's Hospital of Liaoning Province from September 2023 to September 2024 were included in this study. They were randomly divided into an observation group and a control group, with 46 patients in each group. Both groups received lifestyle intervention and standard antidiabetic treatment. The control group received subcutaneous injections of liraglutide, while the observation group was treated with liraglutide combined with Zhibitai capsules. All patients were treated for 3 months. Blood glucose levels, glycated hemoglobin, blood lipid levels, liver function, and hemodynamic parameters were compared between the two groups both before and after treatment. The controlled attenuation parameter of liver fat was measured using Fibro Touch. Results:After treatment, there were no statistically significant differences in fasting blood glucose, 2-hour postprandial blood glucose, and glycated hemoglobin levels between the two groups (all P > 0.05). The high-density lipoprotein cholesterol level in the observation group was significantly higher than that in the control group [(1.31 ± 0.40) mmol/L vs. (0.90 ± 0.30) mmol/L, t = -5.56, P < 0.001]. The levels of total cholesterol [(3.70 ± 0.80) mmol/L vs. (4.40 ± 0.90) mmol/L], triglycerides [(1.50 ± 0.40) mmol/L vs. (2.60 ± 0.50) mmol/L], and low-density lipoprotein cholesterol [(1.80 ± 0.50) mmol/L vs. (2.60 ± 0.60) mmol/L] in the observation group were significantly lower than those in the control group ( t = 3.94, 11.65, 6.39, all P < 0.001). The controlled attenuation parameter of liver fat in the observation group was significantly lower than that in the control group [(249.20 ± 7.60) dB/m vs. (264.70 ± 8.70) dB/m, t = 9.10, P < 0.001]. The level of total bilirubin in the observation group was significantly higher than that in the control group [(16.40 ± 1.50) μmol/L vs. (15.00 ± 1.40) μmol/L, t = -4.63, P < 0.05], while the levels of other liver function indicators in the observation group were significantly lower than those in the control group ( t = 4.83, 9.57, 3.66, all P < 0.001). After treatment, whole blood viscosity at high shear rates, whole blood viscosity at lower shear rates, plasma viscosity, and platelet aggregation levels were all significantly lower in the observation group compared with the control group ( t = 2.13, 2.62, 2.97, 6.15, 4.00, all P < 0.05). Conclusions:Zhibitai capsules combined with liraglutide can improve blood glucose levels, lipid profiles, and liver function, while also decreasing blood viscosity in patients with T2MD complicated by MAFLD.

Objective:To evaluate the short-term efficacy of endoscopic-laparoscopic regional gastric resection combined with sentinel lymph node basin dissection in patients with early-stage gastric cancer.Methods:This is a retrospective case series study. Data of 17 consecutive early gastric cancer patients from a prospective cohort at Beijing Friendship Hospital,Capital Medical University were analyzed between August 2023 and August 2024. Sixteen cases were from the department of general surgery and 1 from the department of gastroenterology. The cohort included 9 males and 8 females,with a mean age of 61.4 years (range: 46 to 79 years). Clinical data,including demographics,pathological features,surgical procedures,and follow-up outcomes,were collected through medical records and databases. All patients were followed for over 3 months,with follow-up ending on December 5,2024.Results:A total of 17 patients were involved. Among them, 5 patients underwent endoscopic submucosal dissection (ESD) combined with laparoscopic sentinel lymph node dissection (LSBD),and another 3 patients who underwent complete ESD resection received LSBD due to pathological stage meeting the expanded indications. 6 patients who underwent non-curative ESD resection received laparoscopic gastric regional resection (LRG) combined with LSBD,and another 3 patients directly received LRG combined with LSBD. The average number of sentinel lymph nodes dissected before surgery ( M(IQR)) was 8.9 (4.5) (range: 4 to 21),and the detection rate and accuracy rate were both 100%. Postoperative pathology confirmed that there was no metastasis in the sentinel lymph nodes of 5 patients who underwent ESD combined with LSBD and 3 patients who underwent LSBD after complete ESD resection. The vertical and horizontal margins of ESD were all negative. One patient was an absolute indication for ESD. For the 6 patients who underwent non-curative ESD resection combined with LRG and LSBD,the horizontal margins were all negative. Two patients showed 1 metastasis in each of the 21 and 9 sentinel lymph nodes during the operation,and additional distal gastrectomy was performed during the operation. Postoperatively,73 and 39 lymph nodes were retrieved respectively. The former had 1 additional metastasis,while the latter had no metastasis. Among the 3 patients who underwent direct LRG combined with LSBD,the horizontal margins were negative. One patient was confirmed as an absolute indication for ESD by postoperative pathology,and one patient had 1 metastasis in 8 sentinel lymph nodes during the operation,and additional distal gastrectomy was performed. Postoperatively,there was no metastasis in 54 lymph nodes. All patients had no complications such as infection,bleeding,perforation,or death after surgery. Among the 14 patients who did not receive additional radical surgery,they were able to pass gas and defecate within 3 days after surgery,with an average hospital stay of 6 days. The nutritional indicators and gastric radionuclide emptying imaging half-emptying time were similar to those before surgery at 3 months after surgery. Conclusions:Laparoscopic and endoscopic cooperative regional gastrectomy with sentinel lymph node basin dissection has the advantages of minimal invasiveness,preservation of gastric function,and precise treatment. It maybe suitable for patients with early-stage gastric cancer at high risk of lymph node metastasis and has good short-term efficacy.

Objective To explore the correlation between sarcopenia and body fat percentage(BF%)in elderly male patients with type 2 diabetes mellitus(T2DM).Methods A total of 291 elderly male T2DM patients who were hospitalized in the Endocrinology Department of Xuanwu Hospital,Capital Medical University were enrolled in this study from December 2018 to September 2019.All the patients were divided into sarcopenia group(n=35)and non sarcopenia group(n=256).BF%,skeletal muscle mass index(SMI),grip strength,gait speed,HbA1c,hemoglobin(Hb),blood uric acid(SUA),albumin and vitamin D(Vit D)were measured in all the participants.Results Compared with the non sarcopenia group,age,HbA1c and BF%were increased,while BMI,Vit D,SMI,Hb,SUA,ALB,grip strength,and gait speedwere decreased in sarcopenia group(P＜0.05 or P＜0.01).Pearson correlation analysis showed that SMI was positively correlated with BMI,Vit D,Hb,and SUA(P＜0.05 or P＜0.01),and negatively correlated with HbA1c(P＜0.01).Grip strength and gait speed are positively correlated with Vit D and Hb(P＜0.01),and negatively correlated with BF%(P＜0.01).Logistic regression analysis showed that age and BF%were risk factors for sarcopenia,while BMI and Vit D were protective factors for sarcopenia.Conclusions High BF%significantly increases the risk of sarcopenia in elderly male T2DM patients.

Objective:To investigate the clinical efficacy of oxcarbazepine versus carbamazepine combined with baclofen in the treatment of trigeminal neuralgia. Methods:A total of 74 patients with trigeminal neuralgia who received treatment in Haiyang People's Hospital from May 2019 to May 2021 were prospectively included in this study. They were randomly divided into an observation group and a control group ( n = 37 per group). The observation group was treated with oxcarbazepine combined with baclofen, while the control group was treated with carbamazepine combined with baclofen. Both groups were treated for 4 successive weeks. Clinical efficacy, adverse reactions, Visual Analogue Scale (VAS) scores before and after treatment, levels of pain transmitters [substance P (SP), 5-hydroxytryptamine (5-HT), β-endorphin (β-EP)], and quality of life were compared between the two groups. Results:The total effective rate in the observation group was 97.3% (36/37), which was significantly higher than 83.8% (31/37) in the control group (χ 2 = 3.95, P < 0.05). Before treatment, there were no significant differences in VAS score, SP, 5-HT, β-EP levels, and EQ-5D Health-Related Quality of Life Questionnaire (EQ-5D) score between the two groups (all P > 0.05). After treatment, VAS score, SP, 5-HT levels, and EQ-5D score in each group were significantly decreased compared with those before treatment. After treatment, VAS score, SP and 5-HT levels in the observation group were significantly lower than those in the control group [(3.1±0.8) points vs. (4.2±0.9) points, (240.1 ± 34.1) ng/L vs. (314.1±40.1) ng/L, (38.2 ± 6.1) ng/L vs. (52.1±9.1) ng/L, all P < 0.001]. After treatment, β-EP level in each group was significantly increased compared with that before treatment ( P < 0.001). After treatment, β-EP level in the observation group was significantly higher than that in the control group [(268.1 ± 38.1) ng/L vs. (214.1 ± 29.0) ng/L, P < 0.001]. After treatment, EQ-5D scores in the observation group were significantly lower than those in the control group (all P < 0.001). There was no significant difference in incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Oxcarbazepine combined with baclofen has superior efficacy in the treatment of trigeminal neuralgia to carbamazepine combined with baclofen. The former can more obviously relieve pain, reduce pain neurotransmitter levels, improve quality of life, and has less adverse reactions.

Objective:To compare the treatment outcomes of neoadjoint therapy combined with liver transplantation versus radical hepatectomy for patients with surgically resectable hilar cholangiocarcinoma.Methods:A retrospective study was performed on the data of 64 patients with resectable hilar cholangiocarcinoma operated from January 2009 to December 2014 at the Organ Transplantation Department of the First Central Hospital of Tianjin. There were 43 males and 21 females, with an average age of 61.2 years. There were 45 patients who underwent radical hepatectomy in the liver resection group, and 19 patients who underwent combined neoadjuvant therapy (radiotherapy combined with 5-fluorouracil intravenous drip, transcatheter lumen radiotherapy, capecitabine oral administration) and liver transplantation in the liver transplantation group. The recurrence rates and survival rate were compared between groups.Results:The 1, 3 and 5 years cumulative survival rates of the liver transplantation group were 89.5%, 73.7% and 63.2%, respectively, which were significantly better than those of the liver resection group (80.0%, 53.3% and 35.6%) ( P<0.05). The postoperative tumor recurrence rate in the liver transplantation group was 31.6% (6/19), which was significantly lower than that in the liver resection group of 60.0% (27/45) ( P<0.05). Subgroup analysis using postoperative pathological results showed the cumulative survival rates of patients without lymph node metastasis (N 0) and those with negative resection margins (R 0) were not significantly different between groups ( P>0.05). However, for patients with regional lymph node invasion (N 1) and with R 0 resection margin, the cumulative survival rates at 1, 3 and 5 years after liver transplantation were 83.3%, 66.7% and 50.0%, respectively, which were significantly superior to the 64.3%, 28.6% and 14.3% of the liver resection group ( P<0.05). Conclusion:Hepatectomy is recommended for patients with N 0 R 0 resectable hilar cholangiocarcinoma. For patients with hilar cholangiocarcinoma with marginally resectable N 1R 0, neoadjuvant therapy combined with liver transplantation resulted in significantly better long-term overall survival than resection.

A 47-year-old male patient with bipolar disorder was given olanzapine tablets 10 mg orally once daily combined with lithium carbonate sustained-release tablets 0.3 g orally once daily due to manic episode. On the 6th day of medication, the patient received irbesartan and hydrochlorothiazide (containing irbesartan 150 mg and hydrochlorothiazide 12.5 mg in each tablet) 1 tablet orally once daily due to elevated blood pressure. Due to the aggravation of the patient′s manic symptoms, the dose of lithium carbonate was increased to 0.9 g/d from the 11th day of medication. After 13 days of combination therapy, the patient′s body temperature rised (up to 39.0 ℃) and headache and tremor of both hands appeared. Laboratory test showed that his lithium concentration was 1.58 mmol/L (target plasma concentration was 0.80-1.20 mmol/L) and lithium poisoning was diagnosed. Lithium carbonate sustained-release tablets and other oral drugs were stopped immediately and symptomatic and supportive treatments such as rehydration, cooling, and diuresis were given. Meanwhile, vital signs were monitored. On the 2nd day of drug withdrawal, the plasma lithium concentration decreased to 1.14 mmol/L, the body temperature returned to normal, and the tremor of hands was relieved. On the 8th day after drug withdrawal, the plasma lithium concentration decreased to 0.45 mmol/L, and the symptoms and abnormal signs disappeared.