Objective To evaluate the clinical application of CT-guided coaxial needle biopsy in pancreatic puncture-cutting biopsy via adipose tissue space.Methods The clinical data of 30 patients,who received CT-guided pancreatic coaxial needle biopsy via adipose tissue space at the Pingdu Hospital Area of Affiliated Hospital of Qingdao University of China from June 2021 to April 2024,were retrospectively analyzed.The patients included 20 males and 10 females with a mean age of(65.1±8.7)years.The lesions were located in the pancreatic head(n=7),pancreatic neck(n=4),pancreatic body(n=7),pancreatic tail(n=10)and uncinate process(n=2).Under CT guidance,a 17 G co-axial guiding needle was inserted to establish a puncture pass through adipose tissue space,then an 18 G biopsy needle was used to make tissue sampling.A total of 32 procedures of pancreatic puncture-cutting biopsy were performed,two of these patients received two times of biopsy.After sampling,a self-made blocking agent(a mixed liquid of gelatin sponge particles and snake venom hemagglutinin),was used to occlude the puncture channel so as to prevent complications such as bleeding,pancreatic leakage,needle tract implantation metastasis,etc.Results A total of 32 procedures of pancreatic puncture-cutting biopsy with coaxial guiding needle via adipose tissue space were performed,including two patients who received two times of biopsy.The success rate of puncturing was 100％(32/32),the success rate of sampling was 93.8％(30/32),and the accuracy of sampling was 93.8％(30/32).No serious puncture-related complications occurred in all patients.Conclusion CT-guided pancreatic coaxial needle biopsy via adipose tissue space is clinically safe,accurate in sampling and minimally-invasive.This interventional diagnostic technique is worth applying in clinical practice.

Colorectal cancer is a common malignant tumor in the gastrointestinal tract,belonging to the categories of traditional Chinese medicine such as"intestinal obstruction","anal locking hemorrhoids",and"intestinal addiction".Professor Yang Yufei created a"two-stage trilogy"therapy based on the occurrence of different side effects during chemotherapy,and is skilled in syndrome differentiation and treatment to strengthen the role of conventional Western medicine treatment and reduce its side effects.Professor Yang Yufei's traditional Chinese medicine for the treatment of chemotherapy side effects in colorectal cancer provides a new approach to clinical medication,with reasonable drug addition and reduction,precise dosage,and significant therapeutic effect.

Colorectal cancer is a common malignant tumor in the gastrointestinal tract,belonging to the categories of traditional Chinese medicine such as"intestinal obstruction","anal locking hemorrhoids",and"intestinal addiction".Professor Yang Yufei created a"two-stage trilogy"therapy based on the occurrence of different side effects during chemotherapy,and is skilled in syndrome differentiation and treatment to strengthen the role of conventional Western medicine treatment and reduce its side effects.Professor Yang Yufei's traditional Chinese medicine for the treatment of chemotherapy side effects in colorectal cancer provides a new approach to clinical medication,with reasonable drug addition and reduction,precise dosage,and significant therapeutic effect.

AIM: To explore the protective effect and mechanism of schisandrin B (Sch B) on myocardial ischemia-reperfusion injury (MIRI) in rats. METHODS: Forty SD rats were randomly divided into control group, MIRI group, MIRI +30 mg/kg Sch B (MIRI + L-Sch B) group and MIRI +60 mg/kg Sch B (MIRI + H-Sch B) group, ten in each group, Sch B were intragastrically for 7 days. Ligation of the left anterior descending branch was used to establish MIRI model, control group rats only underwent sham operation. The ardiac function parameters of ejection fraction (EF), fractional shortening (FS), maximum rate of increase in left ventricular pressure (+ dp/dt

【Objective】 To investigate the effect of adequate amount of tranexamic acid(TXA)before operation on blood loss and safety in posterior lumbar fusion with multiple segments. 【Methods】 A retrospective analysis was conducted on 105 patients with lumbar spinal stenosis, submitted to our hospital for multilevel PLIF, from March 2017 to December 2019. According to the intervention method, they were divided into control group, group A and group B (n =30, 39 and 36, respectively). TXA was not used in the control group. Dripping of saline solution(100 mL) containing TXA 2g and 1g was given in Group A and Group B, and extra intravenous pumping of TXA [10 mg/(kg·h)] during surgery was conducted in Group B besides the pre-operation dripping of TXA. Total blood loss, dominant blood loss, recessive blood loss, intraoperative blood loss, postoperative drainage volume, transfusion rate and hemoglobin (Hb), hematocrit (Hct), prothrombin time international standardized ratio (PT - INR), platelet count (Plt), D - dimer (D - D), C-reactive protein (CRP), neutrophil percentage (NP), alanine aminotransferase (ALT), and blood urea nitrogen (BUN) before and after operation were compared in the three groups. Postoperative drug-related adverse events were traced. 【Results】 1)The total blood loss, dominant blood loss(mL), intraoperative blood loss(mL), drainage volume(mL) within and after 24h after surgery, and the transfusion rate(%) in group A and B were 892.6±193.5 vs 887.7±320.8, 409.1±109.2 vs, 408.6±98.3, 193.7±69.3 vs 189.6±65.6, 130.5±53.4 vs 128.3±53.5, 63.1±17.6 vs 60.9±13.5 and 7.7 (3/39) vs 8.3 (3/36), respectively, which were significantly lower than that in group C as 1 296.8±329.2, 807.6±231.5, 270.9±65.5, 365.4±127.8, 172.3±66.4 and 36.7(11/30), respectively (P< 0.05). There were no significant differences in the above indexes between group A and group B (P < 0.05). The differences in recessive blood loss was not significant by groups(P<0.05). 2) Compared with pre-operation, the levels of Hb, Hct and Plt in the three groups at 3d after operation decreased: Hb(g/L) 91.5±14.0, 107.6±16.4 and 105.9±17.1; Hct(%) 25.6±3.1, 31.2±3.9 and 30.5±4.4; Plt(×10⁹/L)146.6±31.8, 172.8 ±40.1 and 169.7±39.5(P < 0.05); while D-D, CRP and NP increased: D-D(mmol/L)365.6±67.1, 280.9±50.5 and 286.1±53.1; CRP(mg/L): 65.4±22.0, 53.4±19.6 and 56.8±17.7; NP(%): 87.3±15.6, 73.1±13.7, and 71.9±11.8(P < 0.05), and Pt-INR, ALT and BUN showed no significant changes (P > 0.05). The changes of Hb, Hct, Plt, D-D, CRP and NP in group A and B were significantly lower than those in group C at 3 days after operation [Hb (g/L) : 107.6±16.4, 105.9±17.1, 91.5±14.0; Hct (%) : 31.2±3.9, 30.5±4.4, 25.6±3.1; Plt (×10⁹/L) : 172.8 ±40.1, 169.7±39.5, 146.6±31.8; D-D (mmol/L) : 280.9±50.5, 286.1±53.1, 365.6±67.1; CRP (mg/L) : 53.4±19.6, 56.8±17.7, 65.4±22.0; NP (%) : 73.1±13.7, 71.9±11.8, 87.3±15.6] (P < 0.05), and no significant differences in the above index were noticed between group A and B(P> 0.05).3)No lower limb deep vein thrombosis nor pulmonary embolism were found in group A and group B after operation, and all the incisions were healed in the first stage, and no serious complications such as drug allergy, cardiovascular and cerebrovascular accident, epidural hematoma, epilepsy occurred. 【Conclusion】 The preoperative TXA administration with sufficient single dose showed equivalent hemostatic effect in comparison with intraoperative continuous administration additional to preoperative dripping, which is simple and convenient and does not increase the risk of thrombosis.

【Objective】 To compare the hemostatic effect and safety of single infusion of tranexamic acid with different loading dose before spinal surgery. 【Methods】 150 patients with scoliosis orthopaedic surgery were randomly divided into group C, group H and group L with 50 cases in each group. Before skin incision, group H and group L received intravenous loading dose TXA of 20 mg/kg and 10 mg/kg, respectively, followed by continuous intravenous pumping of TXA of 10 mg/kg/h until the end of the operation. Group C received intravenous infusion of 0.9% sodium chloride injection at the same time. Intraoperative infusion volume, blood loss, red blood cell transfusion volume, urine volume and postoperative drainage volume were recorded. Prothrombin time (PT), activated partial prothrombin time (APTT), D-dimer (D-D), blood platelet count (BPC), hemoglobin (Hb), hematocrit (HCT), tissue plasminogen activator (t-PA) and plasminogen activator inhibitor -1(PAI-1) were detected before and after surgery. Adverse events such as lower extremity deep vein thrombosis (DVT), pulmonary embolism, acute kidney injury (AKI), epilepsy and myocardial infarction were followed. 【Results】 The amount of blood loss and transfusion in group H and group L was lower than that in group C (P<0.05), and that in group H was lower than that in group L (P<0.05). The drainage volume of the three groups decreased gradually from 1 to 3 days after the operation. The drainage volume of group H and group L at different time points was lower than that of group C(P<0.05), and that of group H at different time points was lower than that of group L(P<0.05). Compared with the preoperative results, the postoperative BPC, Hb and HCT in the three groups decreased (P<0.05), and the postoperative D-D and t-PA increased (P<0.05). The postoperative changes of the above indexes in group H and group L were lower than those in group C(P<0.05), and the postoperative changes of the above indexes in group H were lower than those in group L(P<0.05). There was no significant change in PAI-1 in group H and group L (P>0.05), while there was a significant decrease in PAI-1 in group C (P<0.05). B-ultrasonography of both lower limbs showed no DVT formation on 1d, 7d and 28d after surgery, and no adverse events such as pulmonary embolism, AKI, epilepsy and myocardial infarction were found after 28 d follow-up. 【Conclusion】 The application of high load dose of TXA in spinal surgery produces better hemostasis, and it has no effect on the incidence of near and long term postoperative adverse events.

Objective:To investigate the epidemiology of human papillomavirus (HPV) infection and gene subtypes among women in Qingdao form 2015 to 2019, so as to provide scientific support for the prevention and treatment of HPV related cervical cancer in Qingdao.Methods:A total of 26396 female cervical exfoliated cell specimens were collected at the Affiliated Hospital of Qingdao University from January 2015 to October 2019, then 17 high-risk HPV genotypes and 6 low-risk HPV genotypes were detected by PCR and reverse dot blot in vitro, and prevalence and year, genotype and age distribution were analyzed.Results:The total prevalence of HPV was 18.17%. The prevalence of single infection, double infection and multiple infection were 13.41%, 3.40% and 1.35% respectively. The infection rate of 7 high-risk subtypes (HPV52, 16, 58, 53, 56, 51, 68) and 3 low-risk subtypes (HPV81, 42, 43) exceeded 1%. The HPV prevalence of different age groups was significantly different and the prevalence showed a bimodal pattern among different age groups. There were two peaks in the ≤25 years group and 46-50 years group, which were 23.61% and 19.63% respectively. There was no significant difference in genotype distribution among different age groups.Conclusions:The cervical HPV infection rate of women in Qingdao is at a medium level, and single infection is the main pattern in different genotypes and age groups. In addition to the vaccine coverage subtypes, the prevalence of other subtypes such as HPV 53, 56, 51 and 68 in this region is also high. Therefore, regular HPV screening is still needed after vaccination to find out HPV genotypes which are not covered by the vaccine. It is suggested that the government optimize the HPV vaccine coverage genotypes to prevent the occurrence of HPV infection associated with cervical cancer.

Objective:To explore the effect of negative affect on internet addiction among college students, and the mediating effect of fatigue.Methods:Totally 8 371 freshmen from North China University of Science and Technology were assessed with Chen Shuhui Chinese Network Scale, Fatigue Assessment Scale and Positive Negative Emotion Scale.SPSS 23.0 was used to analyze the data and test the intermediary effect.Results:Both of the total score of internet addiction scale and the scores of each factor were negatively correlated with positive emotions scores ( r=-0.337- -0.269, P<0.01). However, theose were positively correlated with the negative emotion scores( r=0.338-0.417, P<0.01), the fatigue severity scores( r=0.029-0.040, P<0.01), and the environment specific score and the result score of fatigue( r=0.021-0.028, P<0.05). The emotion and fatigue of college students could predict internet addiction, which could explain 36.9% variation of total score of internet addiction( F=979.336, P<0.01). Fatigue played a part in mediating between internet addiction and negative emotions. Conclusion:Negative emotions not only directly affect the degree of internet addiction of college students, but also indirectly affect the degree of internet addiction of college students through part of the intermediary role of fatigue.

227 cases of international telemedicine consultations were studied, to summarize the experiences, identify the process and characteristics of such consultation. Based on such, standardized management is applied in such aspects as organizational framework, consultation contents and forms, process, expenses, quality control, implementation and outcomes, and problems found. These efforts keep improving consultation quality in order to promote development of China′s international telemedicine consultation and new models.

Objective To investigated the clinical distributions and antimicrobial susceptibility of Streptococcus agalactia strains isolated from the patients .Methods The identification and susceptibility of the strains were mainly measured by automatic VITEK‐Ⅱ system ,the K‐B disc diffusion tests were used for the resistance test of erythromycin ,meropenem ,and D‐test .Results The iso‐lates were mainly from urine (63 .1% ) ,genital tract(7 .8% ) and wound secretion(6 .7% ) .They were obtained from patients in dif‐ferent situations ,including 110 patients who were older than 50 years old (61 .5% ) ,113 female patients (63 .1% ) ,12 gravidas (6 .7% ) ,3 vertical transmitted newborns(1 .7% ) ,and 82 patients with cancer ,undergoing chemo radiotherapy ,with diabetes ,tuber‐culosis or after operations(45 .8% ) .The resistant rates of the isolated Streptococcus agalactia to erythromycin and clindamycin were 42 .9% -93 .3% and 41 .9% -80 .0% respectively .The positive rate of D‐test was 4 .1% .The strains were highly resistant to tet‐racycline(>80% ) ,while the resistance to penicillin was below 10% except in 2008 .All isolates were susceptible to vancomycin and meropenem .Only one strain was resistant to Quinupristin‐dalfopristin .Conclusion Streptococcus agalactia infection in adults most‐ly cause genitourinary tract ,skin and soft tissue infections .There were more females than males with Streptococcus agalactia infec‐tion .Penicillin andβ‐lactams are still the first choice for the treatment .Erythromycin ,clindamycin and tetracycline should be used with caution under the guidance of laboratory susceptibility test results .