In 2022， Hainan provincial government launched the project for the prevention and control of viral hepatitis with the goals of a hepatitis B screening rate of 90%， a diagnostic rate of 90%， and a treatment rate of 80% among people aged 18 years and above by the year 2025， and the main intervention measures include population-based prevention， case screening， antiviral therapy， and health management. As of December 31， 2024， a total of 6.875 million individuals in the general population had been screened for hepatitis B， with a screening rate of 95.6%. A total of 184 710 individuals with positive HBsAg were identified， among whom 156 772 were diagnosed through serological reexamination， resulting in a diagnostic rate of 84.9%. A total of 50 742 patients with chronic hepatitis B were identified， among whom 42 921 had hepatitis B-specific health records established for health management， with a file establishment rate of 84.6%. A total of 31 553 individuals received antiviral therapy， with a treatment rate of 62.2%. A total of 2.503 million individuals at a high risk of hepatitis C were screened， among whom 4 870 tested positive for HCV antibody and 3 858 underwent HCV RNA testing， resulting in a diagnostic rate of 79.2%， and 1 824 individuals with positive HCV RNA were identified， among whom 1 194 received antiviral therapy， with a treatment rate of 65.5%. In addition， 159 301 individuals with negative HBsAg and anti-HBs and an age of 20 — 40 years were inoculated with hepatitis B vaccine free of charge. Through the implementation of the project for the prevention and control of viral hepatitis， a large number of hepatitis patients have been identified， treated， and managed in the province within a short period of time， which significantly accelerates the efforts to eliminate the crisis of viral hepatitis.

Objective:To investigate the expression of miRNA-144 in the peripheral blood of patients with type 2 diabetes foot ulcer (DFU) and its correlation with the pathogenesis of the disease.Methods:A total of 106 patients with DFU admitted to the General Hospital of the Western Theater Command of the Chinese People′s Liberation Army from March 2020 to June 2022 were retrospectively selected as the observation group, and 106 patients with type 2 diabetes mellitus (T2DM) who did not have DFU admitted to our hospital during the same period were selected as the control group. According to the median expression level of miRNA-144 in peripheral blood of DFU patients as the segmentation point, 106 patients in the observation group were divided into low expression group and high expression group. We compared the clinical data of the observation group and the control group, and analyzed the relationship between different levels of miRNA-144 expression and clinical characteristics of DFU patients; A multivariate analysis was conducted on the factors related to the occurrence and development of the disease course in DFU patients, and a column chart model was constructed for model validation.Results:The course of diabetes, fasting blood glucose (FPG), erythrocyte sedimentation rate (ESR), glycosylated hemoglobin (HbA 1c), white blood cell count (WBC), C-reactive protein (CRP), corticotropin releasing hormone (CRH), interleukin-6 (IL-6), adrenaline (E), norepinephrine (NE), cortisol (Cor) and miRNA-144 expression levels in the observation group were significantly higher than those in the control group, while transcutaneous partial pressure of oxygen (TcPO 2), ankle brachial index (ABI), triglyceride (TG) and hemoglobin (Hb) were significantly lower than those in the control group, the difference was statistically significant (all P<0.05). There were statistically significant differences in foot ulcer healing rate, Wagner grading, and ulcer course between the high expression group of miRNA-144 and the low expression group of DFU patients after 8 weeks (all P<0.05). Multivariate regression analysis showed that the duration of diabetes>5 years, HbA 1c>8.5%, TcPO 2<60 mmHg, CRP>10 mg/L, Cor>190 μg/L, and miRNA-144 expression level>35 were independent risk factors for the occurrence of DFU in T2DM patients. The total score of 315 points after constructing the nomogram prediction model for the above factors, and the corresponding probability of occurrence and development of DFU was 72.56%. Conclusions:The expression level of miRNA-144 in the peripheral blood of DFU patients is significantly related to the occurrence and development of the disease course, and the course of diabetes and the changes of HbA 1c, TcPO 2, CRP, Cor levels are independent risk factors for the occurrence and development of DFU, which should be focused on clinically.

Objective:To study the survival and prognostic factors for the recurrent extracranial malignant germ cell tumors (MGCTs) in children, and to explore feasible salvage treatment.Methods:A retrospective study.Pediatric patients with recurrent extracranial MGCTs diagnosed in Shanghai Children′s Medical Center between January 2010 and January 2020 were retrospectively recruited.Comprehensive treatment regimens included surgery, chemotherapy and radiation.Kaplan-Meier survival analysis and Cox regression model were employed to analyze the survival and prognostic factors for children with recurrent extracranial MGCTs.Results:A total of 172 children with extracranial MGCTs were treated, including 21 (12.2%) recurrent cases.The median time of MGCT recurrence after the end of the first treatment was 11 months.Finally, 19 patients were recruited after excluding 2 non-eligible cases, including 10 boys and 9 girls with the age at recurrence of 26 (8-170) months.The follow-up time was 57 (13-122) months.Salvage chemotherapy, complete resection and radiotherapy were performed in 16, 14 and 4 patients, respectively.The 4-year overall survival (4yr-OS) rate was (82.5±9.2)%(19 cases). The 4yr-OS rate was significantly higher in patients managed with surgery but without adjuvant chemotherapy at the initial treatment (13 cases) than those managed with chemotherapy at the initial treatment (6 cases)[(92.3±7.4)% vs.(60.0%±21.9)%, P=0.002]. Univariant and Cox multivariant regression analyses showed that failure to achieve the normal range of alpha fetoprotein after 3 cycles of chemotherapy significantly influenced the survival of recurrent extracranial MGCTs. Conclusions:For patients with recurrent extracranial MGCTs, comprehensive treatment approaches like complete surgical resection, chemotherapy, and radiotherapy offer a favorable survival rate.Specifically, recurrent and re-treated patients who initially received surgery alone without adjuvant chemotherapy have a higher survival rate compared to those who received chemotherapy during the initial treatment.

Under the theory of preventive treatment of disease,Traditional Chinese medicine(TCM)has accumulated wealth experience in cancer prevention such as recurrence and metastasis,and cancer treatment,that plays a unique advantage on several stages of cancer.As an important treatment method of traditional Chinese medicine to prevent disease,Gao Fang has the function of correcting deviation and removing disease,and has four functions including regulating,supplementing,preventing and treating,which plays a pivotal role in the prevention and treatment of malignant tumor.Gao Fang is an effective means to treat tumor.Therefore,this article intends to discuss the effect of Gao Fang on tumor under the perspective of preventive treatment of the disease.

In the process of radical resection of abdominal malignant tumors, large blood vessels are often invaded, which not only increases the difficulty of operation, but also directly affects the curative effect and prognosis. As the concept of expanded radical surgery combined with vascular resection and reconstruction and related techniques have been gradually recognized, surgeons have begun to use autologous, allogeneic or artificial vessels to repair the defective blood vessels during surgery, so as to achieve the effect of radical surgery. However, due to the short comings of these materials, scholars have been looking for better alternatives. In view of the fact that the mesothelial cells of the peritoneum and the endothelial cells of the blood vessels have many similarities in embryology, histology and physiology, and peritoneum is also easier to obtain than autologous, allogeneic or artificial vessels. To make the autologous peritoneum into a patch for repairing the defective blood vessels is feasible in theoretical and technical. In this paper, we review the current research progress of autologous peritoneal patch to repair blood vessels of defect.

Objective:To explore the effect of postoperative stent placement time on flexible ureteroscopy lithotripsy (FURL) in the treatment of kidney calculi.Methods:A retrospective analysis of 126 patients with kidney calculi admitted to Guangyuan Central Hospital from April 2017 to November 2018. All patients were treated with FURL. The patients were divided into two groups according to the time of stent placement after FURL: conventional tube placement group ( n=91) and short-term tube placement group ( n=35). The postoperative stent placement time of patients in the conventional tube placement group was 4 weeks, and the postoperative stent placement time of patients in the short-term tube placement group was 2 weeks. The postoperative outcome indicators (hospitalization time and stone-free rate), postoperative complication indicators (postoperative hematuria, renal hematoma, urinary tract infection and fever) and postoperative pain were compared between the two groups. The measurement data was expressed as mean±standard deviation ( Mean± SD), and the Student′s t test was used for comparison between groups; the Chi-square test was used for comparison between counting data. Results:There were not significant differences in hospitalization time [(7.22±1.02) d vs (7.26±1.22) d], stone-free rate 1 month after surgery (84.6% vs 82.8%), stone-free rate 2 month after surgery (93.4% vs 88.5%), postoperative hematuria (10.9% vs 11.4%), renal hematoma (3.3% vs 0) and fever (2.2% vs 0) between the conventional tube placement group and short-term tube placement group ( P>0.05). Compared with the conventional tube placement group, the short-term tube group had lower urinary tract infection rates (17.6% vs 2.9%), the difference was statistically significant ( P<0.05). There was not significant difference in the average use rate of opioids [(1.05±0.45) vs (1.00±0.50), P>0.05], acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) [(1.52±0.55) vs (1.45±0.45), P>0.05] between the two groups during hospitalization. There was not statistically significant difference in the incidence of abdominal pain after discharge from the hospital [(1.25±0.55) vs (1.15±0.45)]. The number of applications of acetaminophen and NSAIDs in the conventional tube placement group was greater than that in the short-term tube placement group [(1.45±0.46) vs (1.25±0.30)] after one month, the difference was statistically significant ( P<0.05). Conclusions:Short-term tube placement after renal FURL surgery is as effective as traditional long-term stenting, achieving the same stone-free effect and reducing early postoperative complications. For the reduction of postoperative infection and postoperative pain, short-term stenting has certain advantages.

Objective To investigate radiation dose diffent type of anesthesia affected radiation dose when we do interventional therapy for child patent ductus arteriosus (PDA).Methods From 201 1 to 2014,we collected 50 children(3-6 years old)with PDA which received interventional therapy were included in the study.They were divided into two groups:group A (25 cases,male/fe-male=7/18,mean weight=1 5.32 kg±2.41 5 kg)underwent interventional therapy of PDA under general anesthesia,and group B (25 cases,male/female=13/12,mean weight=1 6.40 kg±2.056 kg)using local anesthesia.The surgery were operated by the same doctor,we used DSA children cardiovascular film AE mode (ped CARD)to monitor the surgery,image frames 1 5-30 f/s,used the non-ionic contrast agent (Iodixanol 320 mg I/mL)and recorded the child cumulative incidence of skin surface dose (AK),dose area product(DAP),and time of fluoroscopy,and do statistical analysis.Results All 50 cases were performed the surgery successfully. There were no significant difference of age,weight and gender between groups (age:t=1.924,P =0.06;weight:t =1.703,P =0.095;gender:χ2 =3.00,P =0.083).The cumulative incidence of skin surface dose (AK),dose area product (DAP)and time of fluoroscopy were (0.061±0.025)Gy,(5.08±2.19)Gy·cm2 and (3.15±1.16)min in A group,and (0.094±0.046)Gy,(8.41±3.587)Gy·cm2 , (6.86±3.27)min in B group.The sequence and image number of two groups were same.There were significantly differences of cumulative incidence of skin surface dose (AK),dose area product (DAP)and time of fluoroscopy between two groups (AK:t =3.152,P =0.003;DAP:t =3.957,P =0.000;time of fluoroscopy:t =5.346,P =0.000).The radiation doses of A group significantly lower than B group,compared with B group,the radiation dose were 40 percent [(1-5.08/8.41)%]lower in A group,the 1.1 7 times discrepancy of time of fluoroscopy between two group [(3.1 5-6.86)/3.1 5].Conclusion Radiation dose is associated with type of anesthesia. Compared with local anesthesia,radiation dose reduced 40% using general anesthesia during interventional therapy for PDA.

Objective To study the expression of HIF-1αand and its correlation with gastric cancer recurrence, and to identify its prog-nosis evaluation in gastric cancer recurrence. Methods 80 patients with gastric cancer recurrence after radical surgery were selected as the observation group, and 50 patients without gastric cancer recurrence 5 or more than 5 years after surgery were selected as the control group. The immunohistochemical situation and expression of VEGF of the two groups were compared, and the correlation of HIF-1αand VEGF and gastric cancer recurrence were analyzed. Results The positive expression rate of HIF-1αand VEGF were 77. 50% and 73. 75% respectively in the observation group, which were significantly higher than 12. 00% and 10. 00% in the control group. Univariate analysis showed that the related indices such as degree of differentiation, depth of invasion, lymph node metastasis, vascular invasion, and TNM clinical stage were associated with VEGF expression and positive expression of HIF-1α. The Spearman correlation analysis showed that HIF-1α and VEGF was positively correlated (r=0. 458,P=0. 000). 1-year survival rate of HIF-1α-positive group was 45. 16%, and the average survival time was (8. 62 ± 2. 32) months, which was significantly lower than 77. 77% and (18. 96 ± 3. 14) months respectively in the negative group. Cox risk model analysis showed that HIF-1αand VEGF expression were high risk factors for gastric cancer recurrence. Conclusion HIF-1αand VEGF expression have a very colse correlation with gastric cancer recurrence, and it can be used as evaluation of gastric cancer recurrence and prognosis.

Objective To explore the clinical application value of MRA (TOF and PC)in cerebrovacular arteriovenous malforma-tion imaging when DAS as a reference gold standard.Methods 60 patients clinically suspected cerebral vascular malformations were enrolled in our study.They were all underwent MRA (TOF and PC)and DSA examinations successively within three days.Then, the imaging of feeding arteries,vascular malformation masses and venous drainages were compared and analyzed.Results Of all 60 patients with AVM,their feeding arteries and arterioles images were showed better by DSA and MRA-TOF technology than by MRA-PC.The difference was statistically significant (χ2/P DSA?PC - 4.1 75/0.000,χ2/P TOF ?PC - 3.508/0.000 ),no statistically difference was found between DSA and MRA-TOF findings,(χ2/P DSA?TOF -0.740/0.459).However,their venous drainages and venules show better with DSA and MRA-PC technology than with MRA-TOF method,the difference was statistically significant (χ2/P DSA?TOF -2.445/0.014,χ2/P PC?TOF -3.443/0.001),no statistically difference was found between DSA and MRA-PC findings (χ2/P DSA?PC -1.085/0.278).Conclusion MRA-TOF to display cerebral arteries and MRA-PC to show cerebral venues are basically consistent with the DSA,MRA-TOF and MRA-PC cannot replace each other when showing cerebral arteries and venous.

Objective To evaluate the clinical value of sentinel lymph nodes (SLN) in predicting pelvic lymph node status for early cervical squamous cell carcinoma,and approach the clinical significance of SLN detection for guiding radical abdominal trachelectomy (RAT).Outcomes of follow up and fertility were also observed.Methods A total of 31 patients with stage Ⅰ a2-Ⅰ bl squamous cell carcinoma planned to be given RAT and pelvic lymphadenectomy were enrolled.99mTe-labeled phytate was injected before surgery.Intraoperatively,SLN were identified,excised,and submitted to fast frozen section.Systematic bilateral pelvic lymphadenectomy was performed,and then RAT was performed in patients with negative SLN.All nodes were sent for routine pathological examination and immunostained with anti-cytokeratin antibody to detect micrometastases.Results SLN were detected in all patients (100％,31/31).A total of 109 SLN were identified with a mean number of 3.5 per patient.Of these,SLN of 2 patients were positive on frozen sections and proved to be metastasis by final pathologic examination and quitted the RAT.No missed micrometastasis was found using immunohistochemical staining in SLN and other lymph nodes using histologically node-negative cases.No false negative cases was found and the negative value was 100％ (31/31).The sensitivity,accuracy,and false negative rates were 100％,100％,and 0,respectively.Perioperative complications occured in 5 patients including 2 cases of bladder injury and 3 cases of uterine artery injury.No relapses occurred during follow-up.Five of 19 patients with procreative desire conceived pregnancies (4 spontaneous abortion and 1 premature birth) after surgery.Conclusions The identification of SLN using 99mTc-labeled phytate could predict the pelvic lymph node status in early stage cervical cancer.Under the guidance of SLN detection,RAT is a feasible operative modality with well prognosis and low complications for young patients who desire to preserve reproductive function.