Objective To evaluate the feasibility and technical advantages of modified laparoscopic ileal-neobladder fistula repair.Methods A retrospective analysis was conducted on the clinical data of 4 patients who underwent radical cystectomy+orthotopic neobladder surgery and subsequently developed ileal-neobladder fistula and received modified repair surgery in our hospital during Jan.2019 and Dec.2023.Under laparoscopy,the ileum at both ends of the fistula was transected,and an end-to-end ileal anastomosis bypass was established.Results All 4 patients successfully completed the operation.Their age was 66,50,76 and 59 years,respectively.Ileal-neoblbladder fistula occurred 4,1,2 and 16 months after radical resection.The operation time was 129,98,105 and 90 minutes.The intraoperative blood loss was 50,60,70 and 50 mL.The postoperative exhaust time was 3,4,3 and 5 days.The postoperative hospital stay was 8,7,7 and 9 days,and the postoperative drainage tube indwelling time was 5,4,5 and 7 days.No obvious complications occurred after operation.During follow-up of 1 to 6 years,none recurrence or long-term stenosis of the intestinal anastomosis occurred.The symptoms of urinary tract infection improved significantly,and the bladder function remained stable.Conclusion The modified laparoscopic repair of ileal-neobladder fistula achieves minimally invasive repair by avoiding extensive adhesion separation.It has the advantages of safe operation,rapid recovery,and few complications,and is a safe option for the treatment of ileal-neobladder fistula.

Diabetes mellitus(DM)is a systemic endocrine disease associated with a disorder or defi-ciency of glucose metabolism caused by the obstruction or lack of insulin resistance.Conventional drugs for the treatment of DM have limited efficacy for its complications,and there are many drugs side effects,so it is urgent to find innovative and efficient treatment methods.Mesenchymal stem cells(MSCs)have multiple dif-ferentiation potentials,can reduce insulin resistance,promote microvascular repair,improve oxidative stress and inhibit fibrosis,and can also regulate the immune microenvironment in the body.They can also be trans-ferred to the spleen to regulate the immune microenvironment in vivo and transplant healthy mitochondria to restore the function of damaged cells,among other properties,which hold great promise for the treatment of DM complications.This article briefly reviews the current treatment and pathophysiological mechanisms of MSCs on various complications caused by DM,which is expected to provide a reference and theoretical basis for the clinical treatment of DM in the future.

Objective To evaluate the feasibility and technical advantages of modified laparoscopic ileal-neobladder fistula repair.Methods A retrospective analysis was conducted on the clinical data of 4 patients who underwent radical cystectomy+orthotopic neobladder surgery and subsequently developed ileal-neobladder fistula and received modified repair surgery in our hospital during Jan.2019 and Dec.2023.Under laparoscopy,the ileum at both ends of the fistula was transected,and an end-to-end ileal anastomosis bypass was established.Results All 4 patients successfully completed the operation.Their age was 66,50,76 and 59 years,respectively.Ileal-neoblbladder fistula occurred 4,1,2 and 16 months after radical resection.The operation time was 129,98,105 and 90 minutes.The intraoperative blood loss was 50,60,70 and 50 mL.The postoperative exhaust time was 3,4,3 and 5 days.The postoperative hospital stay was 8,7,7 and 9 days,and the postoperative drainage tube indwelling time was 5,4,5 and 7 days.No obvious complications occurred after operation.During follow-up of 1 to 6 years,none recurrence or long-term stenosis of the intestinal anastomosis occurred.The symptoms of urinary tract infection improved significantly,and the bladder function remained stable.Conclusion The modified laparoscopic repair of ileal-neobladder fistula achieves minimally invasive repair by avoiding extensive adhesion separation.It has the advantages of safe operation,rapid recovery,and few complications,and is a safe option for the treatment of ileal-neobladder fistula.

Objective:To analyze the clinical efficacy of arthroscopic transverse release of the iliotibial band through peritrochanteric space for the treatment of external snapping hip.Methods:A total of 30 patients (12 males and 18 females) with bilateral external snapping hip underwent arthroscopic transverse release of the iliotibial band through peritrochanteric space in Department of Sports Medicine, Senior Department of Orthopaedics, the Fourth Medical Center, Chinese PLA General Hospital were retrospectively analyzed from May 2021 and June 2022. The average age was 32.5±8.2 years (range, 17-51 years). At the same time, 30 patients who underwent arthroscopic external release of the iliotibial band through the external surface of the iliotibial band (external iliotibial band group) were selected as control group, including 13 males and 17 females, aged 29.5±6.8 years (range, 11-45 years). The visual analogue scale (VAS), modified Harris hip score (mHHS), and gluteal muscle contracture disability scale (GDS) were compared between the two groups at preoperative, 6 months postoperative, and final follow-up.Results:All patients successfully completed the operation and were followed up for 17.5±3.3 months (range, 12-25 months). The VAS scores of the two groups at the last follow-up were lower than those before operation ( P<0.05). The mHHS scores before operation, 6 months after operation and at the last follow-up in the peritrochanteric space group were 76.5 (67.0, 85.5), 98.5 (94.8, 100.0) and 100.0 (97.0, 100.0), respectively, and those in the external iliotibial band group were 80.5 (70.0, 86.0), 100.0 (96.0, 100.0) and 100.0 (99.5, 100.0). The differences in mHHS scores between the two groups were statistically significant for intragroup comparisons ( P<0.05); of these, 6 months postoperatively and at the last follow-up were greater than preoperatively, with statistically significant differences ( P<0.05); the differences at 6 months postoperatively and at the last follow-up were not statistically significant ( P>0.05). There was no significant difference in mHHS scores between groups at different time points ( P>0.05). The GDS before operation, at 6 months after operation and at the last follow-up were 47.0 (35.8, 64.5), 90.0 (81.0, 94.0) and 93.5 (89.8, 98.0) in the peritrochanteric space group, and 51.0 (38.0, 64.5), 50.0 (81.0, 94.0) and 93.5 (89.8, 98.0) in the external iliotibial band group, respectively. The differences in GDS between the two groups were statistically significant for intragroup comparisons ( P< 0.05); of these, 6 months postoperatively and at the last follow-up were greater than preoperatively, with statistically significant differences ( P<0.05); the differences at 6 months postoperatively and at the last follow-up were not statistically significant ( P>0.05). There was no significant difference in GDS between groups at different time points ( P>0.05). Conclusion:Arthroscopic transverse release of the iliotibial band through peritrochanteric space for the treatment of external snapping hip can effectively reduce hip pain and improve hip function, with satisfactory clinical results, and can be used as an alternative treatment to transverse release through the external surface of the iliotibial band.

Objective The objective of this study is to examine the expression level of the S100A7A protein in both gastric cancer tissues and cells,as well as to evaluate its impact on the malignant phenotype of gastric cancer(GC)cells.Methods Immunohistochemical assay was used to detect the expression characteristics of S100A7A in 21 gastric cancer tissues and their corresponding paracancerous tissues,as well as to investigate its correlation with gastric cancer clinicopathological factors.Gastric cancer cells were genetically modified to overex-press S100A7A through plasmid transfection.Subsequently,the impact of S100A7A on the proliferation,migra-tion,and invasion capacities of gastric cancer cells was assessed using cell proliferation assays(EdU assay and plate cloning assay)as well as cell migration and invasion assays(Transwell assay and scratch assay).Results The expression of S100A7A protein was higher in GC tissues than in paracancerous tissues;Overexpression of S100A7A may increase gastric cancer cell proliferation,migration,and invasion.Conclusion S100A7A is a possible oncogene in GC and is predicted to serve as a new diagnostic and therapeutic target for the disease.

Anlotinib has strong antiangiogenic effects and leads to vessel normalization.However,the"window period"characteristic in regulating vessel normalization by anlotinib cannot fully explain the long-term survival benefits achieved through combining it with other drugs.In this study,through RNA sequencing(RNA-seq)and label-free quantitative proteomics analysis,we discovered that anlotinib regulated the expression of components of the extracellular matrix(ECM),leading to a significant reduction in ECM stiffness.Our bioinformatic analysis revealed a potential positive relationship between the ECM pathway and gefitinib resistance,poor treatment outcomes for programmed death 1(PD-1)targeting,and unfavourable prognosis following chemotherapy in lung cancer patients.We administered anlotinib in combination with these antitumour drugs and visualized their distribution using fluorescent labelling in various tumour types.Notably,our results demonstrated that anlotinib prolonged the retention time and distribution of antitumour drugs at the tumour site.Moreover,the combination therapy induced notable loosening of the tumour tissue structure.This reduction was associated with decreased interstitial fluid pressure and tumour solid pressure.Additionally,we observed that anlotinib effectively suppressed the Ras homologue family member A(RhoA)/Rho-associated protein kinase(ROCK)signalling pathway.These findings suggest that,in addition to its antiangiogenic and vessel normalization effects,anlotinib can increase the distribution and retention of antitumour drugs in tumours by modulating ECM expression and physical properties through the RhoA/ROCK signalling pathway.These valuable insights contribute to the development of combination therapies aimed at improving tumour targeting in cancer treatment.

Humans ; Acetabulum ; Consensus ; Developmental Dysplasia of the Hip/therapy* ; Hip Joint ; Treatment Outcome ; China

Objective:To compare the short-term efficacy of hip arthroscopic surgery assisted by platelet-rich plasma (PRP) and hip arthroscopy alone in the treatment of femoroacetabular impingement (FAI).Methods:A retrospective cohort study was performed on the clinical data of 133 FAI patients admitted to Fourth Medical Center of PLA General Hospital from January 2019 to January 2021. The patients included 86 males and 47 females, aged 19-71 years [(39.1±12.6)years]. A total of 67 patients were treated with hip arthroscopy alone (hip arthroscopy group), and 66 patients were treated with PRP after hip arthroscopy under ultrasound guidance (hip arthroscopy+PRP group). The two groups were compared before, at 12 months after surgery and at the last follow-up regarding the following items: Visual Analogue Scale (VAS), Modified Harris Hip Score, International Hip Outcome Tool-12 (iHOT-12), and Hip Outcome Score Activities of Daily Living Scale (HOS-ADL). The incidence rate of complications after surgery was compared between the two groups.Results:A total of 108 patients were followed up for 24-36 months [(28.5±3.8)months], while 25 patients were lost to follow-up because of withdrawal of consent, wrong telephone number, etc, including 11 patients (16.4%) in the hip arthroscopy group and 14 patients (21.2%) in the hip arthroscopy+PRP group. The values of VAS in the hip arthroscopy group before, at 12 months after surgery and at the last follow-up were 5.00(5.00, 7.00)points, 3.00(2.00, 3.75)points, and 1.00(0.00, 2.00)points, respectively; the values of Modified Harris Hip Score were 49.00(39.00, 57.00)points, 76.00(69.25, 82.00)points, and 86.00(82.00, 88.00)points, respectively; the values of iHOT-12 were 0.45(0.28, 0.58)points, 0.69(0.58, 0.80)points, and 0.81(0.70, 0.92)points, respectively; the values of HOS-ADL were 0.52(0.42, 0.68)points, 0.87(0.75, 0.93)points, and 0.93(0.86, 0.99)points, respectively. The scores of VAS in the hip arthroscopy + PRP group before, at 12 months after surgery and at the last follow-up were 6.00(5.00, 7.00)points, 3.00(2.00, 3.75)points, and 1.00(0.00, 2.00)points, respectively; the values of Modified Harris Hip Score were 46.50(37.00, 56.75)points, 78.00(72.00, 84.00)points, and 84.50(82.00, 88.00)points, respectively; the values of iHOT-12 were 0.42(0.26, 0.51)points, 0.66(0.58, 0.74)points, and 0.81(0.68, 0.88)points, respectively; the values of HOS-ADL were 0.54(0.38, 0.65)points, 0.87(0.72, 0.96)points, and 0.94(0.86, 1.00)points, respectively. In both groups, VAS, Modified Harris Hip Score, iHOT-12, and HOS-ADL were significantly improved at 12 months after surgery and at the last follow-up compared with those before surgery, and were further improved at the last follow-up compared with those at 12 months after surgery (all P<0.01). There were no significant differences in VAS, Modified Harris Hip Score, iHOT-12 and HOS-ADL between the two groups before, at 12 months after surgery and at the last follow-up (all P>0.05). There was no significant difference in the incidence rates of postoperative hip pain and clicking between the two groups (both P>0.05). Conclusion:Hip arthroscopy can considerably improve short-term hip symptoms and function in FAI patients, but the use of PRP treatment after hip arthroscopy cannot further improve its short-term efficacy in FAI patients.

As one of the hallmarks of cancer, metabolic reprogramming leads to cancer progression, and targeting glycolytic enzymes could be useful strategies for cancer therapy. By screening a small molecule library consisting of 1320 FDA-approved drugs, we found that penfluridol, an antipsychotic drug used to treat schizophrenia, could inhibit glycolysis and induce apoptosis in esophageal squamous cell carcinoma (ESCC). Gene profiling and Ingenuity Pathway Analysis suggested the important role of AMPK in action mechanism of penfluridol. By using drug affinity responsive target stability (DARTS) technology and proteomics, we identified phosphofructokinase, liver type (PFKL), a key enzyme in glycolysis, as a direct target of penfluridol. Penfluridol could not exhibit its anticancer property in PFKL-deficient cancer cells, illustrating that PFKL is essential for the bioactivity of penfluridol. High PFKL expression is correlated with advanced stages and poor survival of ESCC patients, and silencing of PFKL significantly suppressed tumor growth. Mechanistically, direct binding of penfluridol and PFKL inhibits glucose consumption, lactate and ATP production, leads to nuclear translocation of FOXO3a and subsequent transcriptional activation of BIM in an AMPK-dependent manner. Taken together, PFKL is a potential prognostic biomarker and therapeutic target in ESCC, and penfluridol may be a new therapeutic option for management of this lethal disease.

Objective:To construct the curriculum content system of Extreme Environmental medicine based on the trainees' competency.Methods:After analysis of Chinese doctors' post competency demand, and the characteristics of military students, qualitative and quantitative methods were used to construct the curriculum system. The consistency of expert opinions was represented by Kendall's W coefficient, using chi-square test. The hierarchy and weights of all items were analyzed by the analytic hierarchy process, using consistency ratio ( CR) , which was incorporated into this system after passing the test ( CR<0.1) . Results:The selective experts were all authoritative and positivity, the assessments were consistency. Finally, it formed 5 primary items, 15 secondary items, and 54 third items of educational materials and 13 knowledge modules and 1 comprehensive seminar.Conclusions:Based on the demand of Chinese doctors' post competency, a curriculum system of extreme environment medicine has been constructed, through combined application of qualitative and quantitative research methods.