Objective:To establish normal reference value ranges for dynamic balance function parameters in healthy Chinese adults aged 20-69 years. Methods:A total of 100 healthy subjects were selected and evenly divided into five age groups: 20-29, 30-39, 40-49, 50-59, and 60-69 years, with equal gender distribution in each group. Balance function was assessed using the EquiTest system （NeuroCom）, with following tests performed Sensory Organization Test （SOT）, Motor Control Test （MCT）, Adaptation Test （ADT）, and Limits of Stability （LOS） test. All parameters were statistically analyzed and expressed as ±S. Results:The normal reference ranges for SOT, MCT, ADT, and LOS parameters were established for each age group. Multiple balance function parameters demonstrated a gradual decline with advancing age, with more pronounced deterioration observed after the age of 60. Specific findings included decreased vestibular ratio and reduced visual preference in SOT, as well as prolonged reaction time, impaired directional control, and reduced maximum excursion in the backward direction during LOS testing. Conclusion:This study is the first to establish age-specific reference ranges for dynamic balance function parameters in a healthy Chinese population aged 20-69 years, providing localized and objective criteria for the assessment of balance function and supporting clinical diagnosis of balance-related disorders in China.
Humans ; Middle Aged ; Adult ; Postural Balance/physiology* ; Reference Values ; Aged ; Male ; Female ; Young Adult ; Healthy Volunteers

Objective:To investigate the key technical aspects of laparoscopic anti-reflux surgery (LARS) in complex gastroesophageal reflux disease (GERD) with hiatal hernia (HH) and evaluate the feasibility and efficacy of reoperation.Methods:A retrospective analysis was conducted on 28 patients with complex GERD treated at Zhejiang Provincial People's Hospital from Feb 2020 to May 2024. Preoperative examinations were recorded, and surgical videos were reviewed to reconstruct operative time, critical intraoperative steps, complications, and management techniques. Postoperative follow-up via telephone and outpatient visits assessed symptom relief, complications, and medication use.Results:All 28 patients (4 robotic-assisted and 24 conventional laparoscopic surgeries) successfully underwent LARS, with an operative duration of (152.6±10.3) minutes and a postoperative hospital stay of (4.0±1.9) days. Large HH 9 cases, intraoperative bleeding 6 cases, pleural rupture 3 case, and esophageal perforation 1 case, preoperative diagnoses included short esophagus 2 cases and 7 redo surgeries. The overall recurrence rate was 11%. Postoperative complications occurred in 14%. The redo surgeries group achieved 71% symptom resolution. At 1-12 months of follow-up, 82% of patients were asymptomatic, and 82% discontinued proton pump inhibitor therapy.Conclusions:Complex scenarios requiring specialized techniques in LARS increase surgical difficulty and risks. Standardized management of the hernia sac, hiatal repair, neurovascular protection, identification of anatomical landmarks in reoperations, selection of biological mesh, and adhesiolysis may reduce recurrence rates and complication risks.

This paper reviews the current situation of massive open online course (MOOC) construction both domestically and internationally, highlighting the similarities, differences, and limitations of MOOC construction across nations. Based on the full-cycle MOOC construction of the "clinical epidemiology" course at Southern Medical University, including course design, resource integration, online deployment, and teaching evaluation, this study explored the significance, implementation path, and challenges of MOOC construction. This paper also reflects on the activation of teaching content, teacher-student interaction, and teaching mode, aiming to provide a reference for the construction and continuous enhancement of MOOC in China.

This paper reviews the current situation of massive open online course (MOOC) construction both domestically and internationally, highlighting the similarities, differences, and limitations of MOOC construction across nations. Based on the full-cycle MOOC construction of the "clinical epidemiology" course at Southern Medical University, including course design, resource integration, online deployment, and teaching evaluation, this study explored the significance, implementation path, and challenges of MOOC construction. This paper also reflects on the activation of teaching content, teacher-student interaction, and teaching mode, aiming to provide a reference for the construction and continuous enhancement of MOOC in China.

Objective:To investigate the key technical aspects of laparoscopic anti-reflux surgery (LARS) in complex gastroesophageal reflux disease (GERD) with hiatal hernia (HH) and evaluate the feasibility and efficacy of reoperation.Methods:A retrospective analysis was conducted on 28 patients with complex GERD treated at Zhejiang Provincial People's Hospital from Feb 2020 to May 2024. Preoperative examinations were recorded, and surgical videos were reviewed to reconstruct operative time, critical intraoperative steps, complications, and management techniques. Postoperative follow-up via telephone and outpatient visits assessed symptom relief, complications, and medication use.Results:All 28 patients (4 robotic-assisted and 24 conventional laparoscopic surgeries) successfully underwent LARS, with an operative duration of (152.6±10.3) minutes and a postoperative hospital stay of (4.0±1.9) days. Large HH 9 cases, intraoperative bleeding 6 cases, pleural rupture 3 case, and esophageal perforation 1 case, preoperative diagnoses included short esophagus 2 cases and 7 redo surgeries. The overall recurrence rate was 11%. Postoperative complications occurred in 14%. The redo surgeries group achieved 71% symptom resolution. At 1-12 months of follow-up, 82% of patients were asymptomatic, and 82% discontinued proton pump inhibitor therapy.Conclusions:Complex scenarios requiring specialized techniques in LARS increase surgical difficulty and risks. Standardized management of the hernia sac, hiatal repair, neurovascular protection, identification of anatomical landmarks in reoperations, selection of biological mesh, and adhesiolysis may reduce recurrence rates and complication risks.

Objective:To investigate the impact of lifestyle, apolipoprotein E (ApoE) gene, and their interaction on the risk for cognitive frailty in the elderly population in China.Methods:The study participants were from the Chinese Longitudinal Healthy Longevity Survey. The information about their lifestyles were collected by questionnaire survey, and a weighted lifestyle score was constructed based on β coefficients associated with specific lifestyles to assess the combined lifestyle. ApoE genotypes were assessed by rs429358 and rs7412 single nucleotide polymorphisms. Cognitive frailty was assessed based on cognitive function and physical frailty. Cox proportional hazards regression model was used to analyze the association of lifestyle and ApoE gene with the risk for cognitive frailty and evaluate the multiplicative and additive interactions between lifestyle and ApoE gene. Results:A total of 5 676 elderly persons, with median age [ M ( Q1, Q3)] of 76 (68, 85) years, were included, in whom 615 had cognitive frailty. The analysis by Cox proportional hazards regression model indicated that moderate and high levels of dietary diversity could reduce the risk for cognitive frailty by 18% [hazard ratio ( HR)=0.82, 95% CI: 0.68-1.00] and 28% ( HR=0.72, 95% CI: 0.57-0.91), respectively; moderate and high levels of physical activity could reduce the risk by 31% ( HR=0.69, 95% CI: 0.56-0.85) and 23% ( HR=0.77, 95% CI: 0.64-0.93), respectively. Healthy lifestyle was associated with a 40% reduced risk for cognitive frailty ( HR=0.60, 95% CI: 0.46-0.78). ApoE ε4 allele was associated with a 26% increased risk for cognitive frailty ( HR=1.26, 95% CI: 1.02-1.56). No multiplicative or additive interactions were found between lifestyle and ApoE gene. Conclusions:Dietary diversity and regular physical activity have protective effects against cognitive frailty in elderly population. Healthy lifestyle can reduce the risk for cognitive frailty in elderly population regardless of ApoE ε4 allele carriage status.

Objective:To summarize the experience using laparoscopic Heller myotomy combined with Dor fundoplication for the treatment of achalasia of cardia.Methods:This is a retrospective analysis. From Mar 2020 to Mar 2023 8 patients admitted at Zhejiang Provincial People's Hospital were treated surgically, including 5 males and 3 females with a mean age of (47±15) years.Results:Dysphagia was the most common preoperative symptom, followed by acid reflux. All patients underwent preoperative gastroscopy and esophageal high-resolution manometry. Most patients underwent gastrointestinal barium series,ultrasound endoscopy, and chest/abdomen/esophageal CT. All patients underwent laparoscopic Heller myotomy + Dor fundoplication, 2 cases suffered from intraoperative esophageal mucosal injury, and received intraoperative mucosal repair. Mean postoperative hospital stay was (4.38±2.23) days, and 2 cases complaining dysphagia within 1 month after surgery, treated conservatively recovered and discharged. The Eckardt score was significantly lower in all patients after surgery than before surgery ( P=0.011). Conclusion:Laparoscopic Heller myotomy combined with Dor fundoplication has good short and medium-term efficacy in the treatment of patients with achalasia of the cardia.

Lipid homeostasis is considered to be related to intestinal metabolic balance, while its role in the pathogenesis and treatment of ulcerative colitis (UC) remains largely unexplored. The present study aimed to identify the target lipids related to the occurrence, development and treatment of UC by comparing the lipidomics of UC patients, mice and colonic organoids with the corresponding healthy controls. Here, multi-dimensional lipidomics based on LC-QTOF/MS, LC-MS/MS and iMScope systems were constructed and used to decipher the alteration of lipidomic profiles. The results indicated that UC patients and mice were often accompanied by dysregulation of lipid homeostasis, in which triglycerides and phosphatidylcholines were significantly reduced. Notably, phosphatidylcholine 34:1 (PC34:1) was characterized by high abundance and closely correlation with UC disease. Our results also revealed that down-regulation of PC synthase PCYT1α and Pemt caused by UC modeling was the main factor leading to the reduction of PC34:1, and exogenous PC34:1 could greatly enhance the fumarate level via inhibiting the transformation of glutamate to N-acetylglutamate, thus exerting an anti-UC effect. Collectively, our study not only supplies common technologies and strategies for exploring lipid metabolism in mammals, but also provides opportunities for the discovery of therapeutic agents and biomarkers of UC.

Objective:To investigate the application value of 3D printed model in hemostasis training for laparoscopic sleeve gastrectomy.Methods:The retrospective and descriptive study was conducted. Data were collected from six surgeons who participated in hemostasis training for laparoscopic sleeve gastrectomy using 3D printed model at Zhejiang Provincial People′s Hospital in July 2023. All participants were male, aged (33.5±9.9)years. A 3D printed model simulating bleeding during laparoscopic sleeve gastrectomy was created using hydrogel. Videos were recorded to document the surgeons′ hemostasis techniques and outcomes during laparoscopic sleeve gastrectomy. Two external expert reviewers blindly assessed the training videos using the objective structured assess-ment of technical skills (OSATS) scoring system to evaluate mesentery mobilization, vessel exposure, vessel clipping and bleeding after vessel clipping. Observation indicators: (1) face validity and content validity of the 3D printed model; (2) validity verification of the 3D printed model. Measurement data with normal distribution were represented as Mean± SD. Comparison between groups was conducted using the t test. Results:(1) Face validity and content validity of the 3D printed model. The surgeons′ scores for overall impression, fidelity, texture, appearance, workspace and tactile similarity of the 3D printed model were 4.5±0.6, 4.0±0.6, 3.7±0.5, 4.2±0.8, 3.8±0.8 and 4.2±0.4, respectively. The surgeons′ scores for similarity to real scenarios, operation convenience, learning curve shortening and operation skills improving, patient risk reduction, trainee′s interest enhancing, confidence increasing and recommendation for promotion were 4.0±0.6, 4.2±0.8, 4.3±0.8, 4.3±0.5, 4.3±0.5, 4.0±0.6 and 4.8±0.4, respectively. (2) Validity verification of the 3D printed model. The OSATS scores and operation time to treat bleeding during laparoscopic sleeve gastrectomy for expert surgeons were 18.7±0.6 and (125±12)seconds, respectively, versus 13.7±1.5 and (212±51)seconds for junior doctors, showing significant differences between the two groups ( t=5.30, -2.89, P<0.05). Conclusion:The 3D printed model effectively simulates bleeding scenarios during laparoscopic sleeve gastrectomy and distinguishes between different technical levels of expertise.

To study the effect of oral lienal polypeptide on cough and inflammation in mice, in order to expand the clinical application of immune modulator lienal polypeptide and provide a new strategy for relieving cough and inflammation. METHODS: The cough model of mice was induced by concentrated ammonia. The cough frequency and tolerance latency of mice within 6 minutes were recorded every day. The histopathological changes of spleen and lung were evaluated by HE staining and spleen index. TNF-α, IL-1β and IL-6 levels in spleen and lung of mice was detected by ELISA. RESULTS: Oral administration of spleen polypeptide could prolong the tolerance latency of mice to concentrated ammonia to a certain extent and significantly reduce the cough frequency of mice. HE staining showed that oral spleen polypeptide could significantly reduce the alveolar surface area and improve lung expansion in mice. The results of ELISA showed that oral spleen polypeptide decreased the levels of some proinflammatory factors in spleen and lung. CONCLUSION: Lienal polypeptide can alleviate cough and emphysema like symptoms induced by ammonia, improve immune ability and inflammation in mice.