ObjectiveTo investigate the anatomical features of three-dimensional （3D） reconstruction of the hepatic pedicle based on the Laennec’s capsule， as well as its application value in the development of extra-sheath dissection/occlusion clamp and precise hepatectomy. MethodsA retrospective analysis was performed for the abdominal contrast-enhanced CT data of 100 patients without anatomical abnormalities of the hepatic pedicle in The General Hospital of Western Theater Command from January 2021 to June 2024. The Hisense CAS system combined with the 3D U-net deep learning algorithm was used for 3D reconstruction of the hepatic pedicle at the level of Laennec’s capsule， and the hepatic pedicle was measured in terms of the length， outer diameter， and angle of the main trunk and branches. An extra-sheath hepatic pedicle dissection/occlusion clamp was developed based on the above measurements， and a total of 30 patients scheduled for right hemihepatectomy were enrolled and randomly divided into device group and control group， with 15 patients in each group. The two groups were compared in terms of hepatic pedicle handling time， time of operation， intraoperative blood loss， and the incidence rate of bile duct injury. The independent-samples t test was used for comparison of continuous data between two groups， and the Fisher’s exact test was used for comparison of categorical data between two groups. ResultsThe results of 3D reconstruction revealed four variants in the main trunk branches of the hepatic pedicle， with type Ⅰ （left-right branching） accounting for 88% （88/100）， type Ⅱ （trifurcation type） accounting for 5% （5/100）， type Ⅲ （right anterior branching） accounting for 5% （5/100）， and type Ⅳ （special type） accounting for 2% （2/100）. The outer diameter of the main hepatic pedicle was 24.10±6.16 mm， the length of the left main branch was 20.59±6.38 mm， and the length of the right main branch was 21.99±7.98 mm. Compared with the control group， the device group had significantly shorter hepatic pedicle handling time （14.10±1.30 minutes vs 17.50±2.00 minutes， t=-5.620， P=0.001） and time of operation （217.00±28.28 minutes vs 241.87±19.49 minutes， t=-2.804， P=0.009）. The device group had a significantly lower incidence rate of bile duct injury than the control group （0 vs 20%， P=0.031）. Conclusion3D reconstruction based on the Laennec’s capsule can accurately display the anatomical variations of the hepatic pedicle. The extra-sheath hepatic pedicle dissection/occlusion clamp developed based on such data can optimize the process of hepatic pedicle management and improve surgical safety， and therefore， it holds promise for clinical application.

Objective:To develop a convolutional neural network model of whole slide imaging of cerebrospinal fluid cells for rapid and accurate identification and classification of tumor cells in cerebrospinal fluid.Methods:A total of 8 692 cerebrospinal fluid cytology smears from Huashan Hospital Affiliated to Fudan University from January 2nd, 2019, to December 27th, 2024. As randomly assigned, the training set included 4 941 benign and 1 745 malignant samples, while the validation set comprised of 1 368 benign and 638 malignant samples. Whole-slide digital images were acquired using a cytopathology scanner, cells (clusters) were annotated for classification, and a deep learning model was constructed via tiled image patches for cell detection and classification. Model performance was evaluated using accuracy, sensitivity, specificity, and other indicators. The classification efficiency of manual microscopy was compared.Results:The model achieved a mean precision of 96.75% for cerebrospinal fluid cell classification. For malignant tumor cells, the classification accuracy was 96.61% (mAP=98.36%, AUC=0.97). Subtype classification accuracies for epithelial/epithelioid tumors and small round cell tumors were 97.13% (AUC=0.98) and 95.58% (AUC=0.93), respectively. Compared with manual microscopy, which took (9.70±0.82) minutes for classifying 200 cells, (18.27±1.21) minutes for 500 cells, and often exceeded 60 minutes or infeasible for full slides, the AI model took (3.46±0.49) seconds for 200 cells, (6.76±0.82) seconds for 500 cells, and a median of 48.57 seconds for full slides ( P<0.001), representing an efficiency improvement of approximately 161-170 times, significantly enhancing diagnostic efficiency. Conclusion:This fully automated hierarchical deep learning model enables efficient and accurate tumor cell identification and classification in CSF, providing an effective auxiliary tool for the rapid diagnosis of meningeal carcinomatosis.

Objective To explore the feasibility and safety of ultrasound-guided percutaneous microwave ablation for unresectable pancreatic cancer.Methods Totally 84 patients who underwent ultrasound-guided percutaneous microwave ablation for unresectable pancreatic cancer were enrolled,and the technical success rate,complete ablation rate,complication rate,pain relief rate and survival time,etc.were observed.Results The median age of 84 cases was 61.5 years.Totally 86 tumors,including 44.19％(38/86)at the head/neck and 55.81％(48/86)at the body/tail of pancreas were detected,and a total of 85 ablation sessions were performed with the median ablation energy applied per tumor of 9.90(1.08,21.60)kJ and the complete ablation rate of 42.86％(36/84).The technical success rate was 100％(85/85).Thirty-nine complication events occurred in 25 cases,no ablation-related death.Among 34 patients underwent ablation mainly for pain symptoms,the pain score decreased from(6.22±1.12)points before treatment to(1.94±1.64)points after treatment(P＜0.001).During 6.8(3.3,12.9)months' follow-up,the mean survival time was(8.5±6.7)months,and all 47 patients died due to tumor progression.Conclusion Ultrasound-guided percutaneous microwave ablation was safe and feasible for unresectable pancreatic cancer.

Objective To investigate the protective effect of high-altitude hypoxia acclimatization against hepatic ischemia-reperfusion injury(HIRI)in rats,as well as the mechanism of action of high-altitude hypoxia acclimatization in activating autophagy.Methods A total of 56 male Sprague-Dawley rats were randomly divided into plain sham-operation group(P-S group),plain model group(P-M group),acute high-altitude hypoxia sham-operation group(AHH-S group),acute high-altitude hypoxia model group(AHH-M group),high-altitude hypoxia acclimatization sham-operation group(HHA-S group),high-altitude hypoxia acclimatization model group(HHA-M group),and high-altitude hypoxia acclimatization model group with the adenosine monophosphate-activated protein kinase(AMPK)inhibitor compound C(HHA-M-CC group),with 8 rats in each group.The rats in the acute high-altitude hypoxia groups and the high-altitude hypoxia acclimatization groups were placed in a low-pressure oxygen chamber at an altitude of 5 000 meters for 1 week and 12 weeks,respectively;the rats in the sham-operation groups were given laparotomy to expose the portal vein without vascular clamping;the rats in the HHA-M-CC group were given abdominal injection of 20 mg/kg CC at 1 hour before surgery,while those in the other groups were given injection of an equal volume of normal saline.An automatic biochemical analyzer was used to measure the levels of liver function parameters including alanine aminotransferase(ALT),aspartate aminotransferase(AST),and total bilirubin(TBil);HE staining was used to observe liver histopathological changes;transmission electron microscopy was used to observe the formation of autophagosomes in liver tissue;RT-qPCR was used to measure the mRNA expression levels of AMPK and Unc-51 like autophagy activating kinase 1(ULK1)in liver tissue;Western Blot was used to measure the protein expression levels of phosphorylated AMPK(p-AMPK),phosphorylated ULK1(p-ULK1),Beclin-1,and microtubule-associated protein 1 light chain 3 Ⅱ(LC3Ⅱ).An analysis of variance was used for comparison of continuous data between multiple groups,and the least significant difference t-test was sued for comparison between two groups.Results Compared with the AHH-M and HHA-M-CC groups,the HHA-M group had significantly reductions in the levels of ALT,AST,and TBil(all P<0.05),alleviation of liver histopathological injury,a significant reduction in Suzuki score(all P<0.05),a reduction in the degree of abnormal morphological structure of hepatocytes under transmission electron microscopy,and significant increases in the number of autophagosomes,the mRNA expression levels of AMPK and ULK1(all P<0.05),and the protein expression levels of p-AMPK,p-ULK1,Beclin-1,and LC3Ⅱ(all P<0.05).Conclusion High-altitude hypoxia acclimatization can alleviate HIRI in SD rats by activating the AMPK/ULK1 signaling pathway and enhancing autophagy in hepatocytes.

Objective To compare the image quality of readout-segmented diffusion weighted imaging(RESOLVE-DWI)and integrated slice-by-slice shimming diffusion weighted imaging(iShim-DWI)in patients with nasopharyngeal carcinoma.Methods A retrospective study was conducted on 26 patients with nasopharyngeal carcinoma confirmed by pathology.The imaging data included RESOLVE-DWI and iShim-DWI.The signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of the two sequences were compared by one deputy chief imaging technician.And two experienced radiologists used the 5-point scoring scheme to compare the lesion clarity,image artifacts,and antideformation ability of the two sequences,repectively.Results The SNR and CNR of the iShim-DWI sequence were significantly higher than those of RESOLVE-DWI sequence(P＜0.01).While the subjective scores of lesion clarity,image artifacts,and antideformation ability on RESOLVE-DWI were significantly better than those of iShim-DWI,and the differences were statistically significant(P＜0.01).Conclusion Both RESOLVE-DWI and iShim-DWI obtained good images.With sufficient SNR and CNR,RESOLVE-DWI has clearer lesions and surrounding structures,higher image resolution,fewer artifacts,and better antideformation ability,thus providing clinical advantages in evaluating patients with good physical tolerance.

Objective:To analyze the epidemiological characteristics and delay in detection of reported brucellosis cases in Nangang District of Harbin City, Heilongjiang Province, in order to provide a basis for improving targeted measures for brucellosis prevention and control.Methods:Data on brucellosis reported in Nangang District of Harbin City between 2018 and 2022 were obtained from the China Disease Prevention and Control Information System. A descriptive analysis was conducted to outline the epidemiological status, epidemiological features, and sources of cases. Seasonal patterns of brucellosis were assessed using the concentration degree and seasonal index methods. Joinpoint regression model was used to analyze the trend of delay in detection.Results:From 2018 to 2022, a total of 4 428 cases of brucellosis were reported in Nangang District, with 1 183 cases (26.72%) reported in 2018 and 528 cases (11.92%) reported in 2022. The gender ratio of the cases was 2.80 ∶ 1.00 (3 264 ∶ 1 164). Most cases occurred in individuals aged 30 to 59 years (73.19%, 3 241/4 428). Occupationally, farmers comprised the majority of cases (88.73%, 3 929/4 428), followed by homemakers/unemployed individuals (3.73%, 165/4 428), and students (2.03%, 90/4 428). Regarding case origin, 31.48% (1 394/4 428) were from Harbin City, while 64.97% (2 877/4 428) originated from other cities within Heilongjiang Province, predominantly from Suihua City (38.89%, 1 722/4 428). Additionally, 157 cases (3.55%, 157/4 428) were reported from outside Heilongjiang Province, all of which were from Inner Mongolia Autonomous Region and Jilin Province. Brucellosis incidence showed weak seasonality ( M = 0.230), with the epidemic period spanning from March to August. During this period, seasonal indices C exceeded 100%, peaking in July (168.02%). From 2018 to 2022, the average annual delay rate in case detection was 20.14% (892/4 428). The delayed detection rates of brucellosis cases in each year were 30.68% (363/1 183), 17.86% (200/1 120), 17.23% (117/679), 12.75% (117/918), and 17.99% (95/528), respectively (average annual percentage change = - 17.52%, P = 0.090). Conclusions:Brucellosis in Nangang District of Harbin Citydemonstrates weak seasonality, with peak incidence occurring from March to August. Detection delays remain a concern, highlighting the need for sustained surveillance and the implementation of integrated, multi-sectoral prevention and control measures.

Acute pancreatitis(AP)is a severe digestive system emergency characterized by high morbidity and mortality,with a complex pathogenesis involving multiple signaling pathways.Among them,the RhoA/ROCK signaling pathway plays a crucial role in the onset and progression of AP,influencing pancreatic inflammation,fibrosis,microcirculatory regulation,and interactions with other signaling pathways.Studies have shown that inhibiting the RhoA/ROCK signaling pathway can effectively alleviate AP severity,reduce inflammatory cytokine levels,and improve pancreatic microcirculation,offering new therapeutic insights and potential strategies for AP treatment.Therefore,this review systematically summarizes the structure and function of the RhoA/ROCK signaling pathway,explores its mechanistic role in AP progression,and further discusses its potential clinical applications.By integrating existing research findings,this paper aims to provide new perspectives on the role of this signaling pathway in AP and offer a theoretical foundation for future basic research and clinical applications.

Objective To investigate the protective effect of high-altitude hypoxia acclimatization against hepatic ischemia-reperfusion injury(HIRI)in rats,as well as the mechanism of action of high-altitude hypoxia acclimatization in activating autophagy.Methods A total of 56 male Sprague-Dawley rats were randomly divided into plain sham-operation group(P-S group),plain model group(P-M group),acute high-altitude hypoxia sham-operation group(AHH-S group),acute high-altitude hypoxia model group(AHH-M group),high-altitude hypoxia acclimatization sham-operation group(HHA-S group),high-altitude hypoxia acclimatization model group(HHA-M group),and high-altitude hypoxia acclimatization model group with the adenosine monophosphate-activated protein kinase(AMPK)inhibitor compound C(HHA-M-CC group),with 8 rats in each group.The rats in the acute high-altitude hypoxia groups and the high-altitude hypoxia acclimatization groups were placed in a low-pressure oxygen chamber at an altitude of 5 000 meters for 1 week and 12 weeks,respectively;the rats in the sham-operation groups were given laparotomy to expose the portal vein without vascular clamping;the rats in the HHA-M-CC group were given abdominal injection of 20 mg/kg CC at 1 hour before surgery,while those in the other groups were given injection of an equal volume of normal saline.An automatic biochemical analyzer was used to measure the levels of liver function parameters including alanine aminotransferase(ALT),aspartate aminotransferase(AST),and total bilirubin(TBil);HE staining was used to observe liver histopathological changes;transmission electron microscopy was used to observe the formation of autophagosomes in liver tissue;RT-qPCR was used to measure the mRNA expression levels of AMPK and Unc-51 like autophagy activating kinase 1(ULK1)in liver tissue;Western Blot was used to measure the protein expression levels of phosphorylated AMPK(p-AMPK),phosphorylated ULK1(p-ULK1),Beclin-1,and microtubule-associated protein 1 light chain 3 Ⅱ(LC3Ⅱ).An analysis of variance was used for comparison of continuous data between multiple groups,and the least significant difference t-test was sued for comparison between two groups.Results Compared with the AHH-M and HHA-M-CC groups,the HHA-M group had significantly reductions in the levels of ALT,AST,and TBil(all P<0.05),alleviation of liver histopathological injury,a significant reduction in Suzuki score(all P<0.05),a reduction in the degree of abnormal morphological structure of hepatocytes under transmission electron microscopy,and significant increases in the number of autophagosomes,the mRNA expression levels of AMPK and ULK1(all P<0.05),and the protein expression levels of p-AMPK,p-ULK1,Beclin-1,and LC3Ⅱ(all P<0.05).Conclusion High-altitude hypoxia acclimatization can alleviate HIRI in SD rats by activating the AMPK/ULK1 signaling pathway and enhancing autophagy in hepatocytes.

Acute pancreatitis(AP)is a severe digestive system emergency characterized by high morbidity and mortality,with a complex pathogenesis involving multiple signaling pathways.Among them,the RhoA/ROCK signaling pathway plays a crucial role in the onset and progression of AP,influencing pancreatic inflammation,fibrosis,microcirculatory regulation,and interactions with other signaling pathways.Studies have shown that inhibiting the RhoA/ROCK signaling pathway can effectively alleviate AP severity,reduce inflammatory cytokine levels,and improve pancreatic microcirculation,offering new therapeutic insights and potential strategies for AP treatment.Therefore,this review systematically summarizes the structure and function of the RhoA/ROCK signaling pathway,explores its mechanistic role in AP progression,and further discusses its potential clinical applications.By integrating existing research findings,this paper aims to provide new perspectives on the role of this signaling pathway in AP and offer a theoretical foundation for future basic research and clinical applications.

Objective:To analyze the epidemiological characteristics and delay in detection of reported brucellosis cases in Nangang District of Harbin City, Heilongjiang Province, in order to provide a basis for improving targeted measures for brucellosis prevention and control.Methods:Data on brucellosis reported in Nangang District of Harbin City between 2018 and 2022 were obtained from the China Disease Prevention and Control Information System. A descriptive analysis was conducted to outline the epidemiological status, epidemiological features, and sources of cases. Seasonal patterns of brucellosis were assessed using the concentration degree and seasonal index methods. Joinpoint regression model was used to analyze the trend of delay in detection.Results:From 2018 to 2022, a total of 4 428 cases of brucellosis were reported in Nangang District, with 1 183 cases (26.72%) reported in 2018 and 528 cases (11.92%) reported in 2022. The gender ratio of the cases was 2.80 ∶ 1.00 (3 264 ∶ 1 164). Most cases occurred in individuals aged 30 to 59 years (73.19%, 3 241/4 428). Occupationally, farmers comprised the majority of cases (88.73%, 3 929/4 428), followed by homemakers/unemployed individuals (3.73%, 165/4 428), and students (2.03%, 90/4 428). Regarding case origin, 31.48% (1 394/4 428) were from Harbin City, while 64.97% (2 877/4 428) originated from other cities within Heilongjiang Province, predominantly from Suihua City (38.89%, 1 722/4 428). Additionally, 157 cases (3.55%, 157/4 428) were reported from outside Heilongjiang Province, all of which were from Inner Mongolia Autonomous Region and Jilin Province. Brucellosis incidence showed weak seasonality ( M = 0.230), with the epidemic period spanning from March to August. During this period, seasonal indices C exceeded 100%, peaking in July (168.02%). From 2018 to 2022, the average annual delay rate in case detection was 20.14% (892/4 428). The delayed detection rates of brucellosis cases in each year were 30.68% (363/1 183), 17.86% (200/1 120), 17.23% (117/679), 12.75% (117/918), and 17.99% (95/528), respectively (average annual percentage change = - 17.52%, P = 0.090). Conclusions:Brucellosis in Nangang District of Harbin Citydemonstrates weak seasonality, with peak incidence occurring from March to August. Detection delays remain a concern, highlighting the need for sustained surveillance and the implementation of integrated, multi-sectoral prevention and control measures.