Compared to traditional suturing, lung stapling using automatic staplers offers advantages such as smaller trauma, faster wound healing, ease of operation, and lower complication rates, making it widely used in clinical practice. However, there are significant differences in bronchial tissue thickness at different anatomical locations, and the market is flooded with various types of staplers. Currently, there is a lack of recommended stapling schemes for bronchial staplers at different anatomical locations. This article reviews the development and application of automatic staplers and summarizes some types of staplers that are currently used in clinical practice, with the aim of promoting the formation of individualized stapler selection protocols for minimally invasive thoracic surgery based on the Chinese population.

With the widespread adoption of low-dose CT screening and the extensive application of high-resolution CT, the detection rate of sub-centimeter lung nodules has significantly increased. How to scientifically manage these nodules while avoiding overtreatment and diagnostic delays has become an important clinical issue. Among them, lung nodules with a consolidation tumor ratio less than 0.25, dominated by ground-glass shadows, are particularly worthy of attention. The therapeutic challenge for this group is how to achieve precise and complete resection of nodules during surgery while maximizing the preservation of the patient's lung function. The "watershed topography map" is a new technology based on big data and artificial intelligence algorithms. This method uses Dicom data from conventional dose CT scans, combined with microscopic (22-24 levels) capillary network anatomical watershed features, to generate high-precision simulated natural segmentation planes of lung sub-segments through specific textures and forms. This technology forms fluorescent watershed boundaries on the lung surface, which highly fit the actual lung anatomical structure. By analyzing the adjacent relationship between the nodule and the watershed boundary, real-time, visually accurate positioning of the nodule can be achieved. This innovative technology provides a new solution for the intraoperative positioning and resection of lung nodules. This consensus was led by four major domestic societies, jointly with expert teams in related fields, oriented to clinical practical needs, referring to domestic and foreign guidelines and consensus, and finally formed after multiple rounds of consultation, discussion, and voting. The main content covers the theoretical basis of the "watershed topography map" technology, indications, operation procedures, surgical planning details, and postoperative evaluation standards, aiming to provide scientific guidance and exploration directions for clinical peers who are currently or plan to carry out lung nodule resection using the fluorescent microscope watershed analysis method.

Objective To analyze the correlation between inflammatory factors and bone mineral density(BMD)as well as β-C-terminal telopeptide of type I collagen(β-CTX)in postmenopausal patients with type 2 diabetes mellitus(T2DM),and to evaluate the diagnostic efficacy of the inflammatory factors in postmenopausal T2DM patients with osteoporosis(OP).Methods A total of 538 postmenopausal women with T2DM,hospitalized in the Department of Endocrinology at the Third People's Hospital of Yunnan Province from October 1,2023 to August 31,2024,were screened,and 181 were ultimately included in the study.Based on bone mineral density,they were divided into the osteopenia group(86 patients,-2.51,B>0),while BMI was an independent protective factor for the occurrence of OP(OR<1,B<0);(4)ROC curve analysis showed that CRP,IL-6,NLR,MLR,and SII all demonstrated diagnostic efficacy for postmenopausal T2DM patients with osteoporosis,among which the combined detection model of CRP,IL-6,and SII exhibited the highest diagnostic efficacy.Conclusion Inflammatory markers are correlated with bone mineral density and β-CTX levels,and may have predictive value for diagnosing osteoporosis in postmenopausal T2DM patients.

In order to understand the genetic variation and whole genome characteristics of goose as-trovirus(GoAstV)in Jiangxi Province,a strain of GoAstV was successfully isolated from a typical gosling gout case sample and the whole genome sequencing and genetic characteristics of the isola-ted strain were analyzed.The results showed that the JXNC1 strain could be stably passaged on LMH cells and could cause mild cytopathic effects in LMH cells.Sequencing and analysis showed that the full-length genome of the strain was 7 173 bp,and its genetic relationship was the closest to the GZ2301(PP966939)reference strain,belonging to the GoAstV-Ⅱ genotype.The complete genome of JXNC1 strain shared 98.1％-98.8％nucleotide similarity with 22 GoAstV-Ⅱ reference strains,and the amino acid similarity of ORF2 gene was 97.6％-99.6％.At the same time,the analysis results showed that the mutation of the strain mainly occurred in the ORF2 gene,and there were 13 amino acid site mutations,of which T630I was a unique mutation.Animal regression experiments showed that the inoculation of JXNC1 strain could cause urate deposition in the or-gans of goslings,congestion and dilatation of hepatic sinusoids,and small focal necrosis of some hepatocytes.Renal tissue tubular dilatation,renal interstitial connective tissue hyperplasia.The re-sults of this study laid a foundation for accurate prevention and control of the disease.

Recent studies have shown that the physiological homeostasis of oral mucosal cells is regulated by the circadian clock.Dis-ruption or dysfunction of the circadian clock is closely associated with the development of oral squamous cell carcinoma(OSCC).Research based on the circadian clock offers a novel perspective on the pathogenesis and therapeutic strategies for OSCC.However,there is current-ly limited research on this topic,and people generally have insufficient understanding and recognition of the circadian clock.Given the complexity and challenges of circadian clock which is the fourth dimension of medical research,we organize relevant experts based on summarizing the current research results of circadian clock in the pathogenesis and precision diagnosis and treatment of OSCC,combining the scientific principles of the circadian clock's role and their long-term research experience,then summarizes and recommends the con-sensus opinions for the research of circadian clock in the pathogenesis mechanism and precision diagnosis and treatment of human OSCC,with the hope of providing guidance for the basic research and clinical application of circadian clock or circadian rhythm in the pathogene-sis mechanism and precision diagnosis and treatment of oral and maxillofacial squamous cell carcinoma.

Objective:This article explores the diagnosis and treatment of a special type of laryngeal foreign body with granuloma in children, providing a clinical reference for standardized diagnosis and treatment. Methods:This article retrospectively analyzes one case admitted to our department and five other cases reported in relevant literature involving a special type of laryngeal foreign body with granuloma in children. It summarizes the clinical characteristics of this disease and explores its diagnosis and treatment. Results:①A total of 6 cases were misdiagnosed and had a long course of illness. Five cases had no clear history of foreign body at the first visit. One case had foreign body history but no foreign body was found. ②The clinical symptoms were diverse, which could be hoarseness, cough, wheezing, dyspnea, or no symptoms. ③A total of 3 cases were diagnosed by laryngoscopy, and 3 cases were diagnosed by laryngoscopy and imaging examination. ④Foreign bodies that were not wrapped in granulomas, were removed first and then the granulomas were treated; foreign bodies wrapped in granulomas were removed after the removal of granulomas. Conclusion:A special type of laryngeal foreign body with granuloma may lack of accurate foreign body history, resulting in long-term retention of foreign bodies, leading to granuloma formation and misdiagnosis. Electronic laryngoscopy combined with CT examination contribute to early diagnosis. Low temperature plasma under endoscope and anesthetic laryngoscope is conducive to the exposure and precise removal of foreign bodies and avoids tracheotomy to a certain extent.
Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Foreign Bodies/surgery* ; Granuloma, Foreign-Body/therapy* ; Larynx/pathology* ; Retrospective Studies

Recent studies have shown that the physiological homeostasis of oral mucosal cells is regulated by the circadian clock.Dis-ruption or dysfunction of the circadian clock is closely associated with the development of oral squamous cell carcinoma(OSCC).Research based on the circadian clock offers a novel perspective on the pathogenesis and therapeutic strategies for OSCC.However,there is current-ly limited research on this topic,and people generally have insufficient understanding and recognition of the circadian clock.Given the complexity and challenges of circadian clock which is the fourth dimension of medical research,we organize relevant experts based on summarizing the current research results of circadian clock in the pathogenesis and precision diagnosis and treatment of OSCC,combining the scientific principles of the circadian clock's role and their long-term research experience,then summarizes and recommends the con-sensus opinions for the research of circadian clock in the pathogenesis mechanism and precision diagnosis and treatment of human OSCC,with the hope of providing guidance for the basic research and clinical application of circadian clock or circadian rhythm in the pathogene-sis mechanism and precision diagnosis and treatment of oral and maxillofacial squamous cell carcinoma.

In order to understand the genetic variation and whole genome characteristics of goose as-trovirus(GoAstV)in Jiangxi Province,a strain of GoAstV was successfully isolated from a typical gosling gout case sample and the whole genome sequencing and genetic characteristics of the isola-ted strain were analyzed.The results showed that the JXNC1 strain could be stably passaged on LMH cells and could cause mild cytopathic effects in LMH cells.Sequencing and analysis showed that the full-length genome of the strain was 7 173 bp,and its genetic relationship was the closest to the GZ2301(PP966939)reference strain,belonging to the GoAstV-Ⅱ genotype.The complete genome of JXNC1 strain shared 98.1％-98.8％nucleotide similarity with 22 GoAstV-Ⅱ reference strains,and the amino acid similarity of ORF2 gene was 97.6％-99.6％.At the same time,the analysis results showed that the mutation of the strain mainly occurred in the ORF2 gene,and there were 13 amino acid site mutations,of which T630I was a unique mutation.Animal regression experiments showed that the inoculation of JXNC1 strain could cause urate deposition in the or-gans of goslings,congestion and dilatation of hepatic sinusoids,and small focal necrosis of some hepatocytes.Renal tissue tubular dilatation,renal interstitial connective tissue hyperplasia.The re-sults of this study laid a foundation for accurate prevention and control of the disease.

Objective:To explore the differential diagnostic value of abdominal diffusion-weighted imaging (DWI) combined with serum alpha fetoprotein (AFP), des-gamma-carboxyprothrombin (DCP), and the ratio of γ-glutamyl transpeptidase to alanine transaminase (GTP/ALT) in the diagnosis of benign and malignant liver tumors.Methods:Ninety liver tumor patients admitted to the Chenzhou First People′s Hospital from February 2020 to May 2022 were selected, including 48 malignant tumors and 42 benign tumors, and were divided into malignant group and benign group. The imaging findings of routine magnetic resonance imaging (MRI) and DWI examination were analyzed for two groups of patients. We compared the apparent diffusion coefficient (ADC) values, serum AFP, DCP levels, and GTP/ALT between two groups of patients. The diagnostic value of DWI, individual and combined detection of various serological indicators for malignant tumors was analyzed using receiver operating characteristic (ROC) curves.Results:There were significant differences in MRI and DWI imaging manifestations between the malignant and benign groups of patients. The ADC values and ADC index of patients in the malignant group at different b values of 50, 400, and 800 s/mm 2 were lower than those in the benign group, and the differences were statistically significant (all P<0.05). The serum AFP, DCP, and GTP/ALT of patients in the malignant group were higher than those in the benign group, and the differences were statistically significant (all P<0.05). The ROC curve analysis results showed that the sensitivity and specificity of DWI combined with serum AFP, DCP, and GTP/ALT in diagnosing liver malignant tumors were higher than those of DWI alone and each serological indicator alone. Conclusions:The combination of DWI, serum AFP, DCP, and GTP/ALT has high sensitivity and specificity in diagnosing liver malignant tumors, and has certain clinical value in distinguishing between benign and malignant liver tumors.

Objective To investigate the role and mechanism of urate in chronic kidney disease complicated with renal interstitial fibrosis(CKD-RIF).Methods Mice were continuously fed with a diet containing 0.2％adenine for a duration of 9 weeks to establish mice models with CKD-RIF.By the end of the 9-week experimental periods,collected blood samples from the posterior orbital venous plexus of mice to measure renal functions and serum urate concentrations prior to euthanizing the mice.Hematoxylin-eosin(HE)staining and periodic acid-Schiff staining(PAS)were used to investigate the pathological alternations in kidney tissues.Masson's trichrome staining was used to observe the extent of renal fibrosis.Urate staining was used to detect urate deposition in renal tissues.Western blot and immunohistochemistry were used to detect the expression of target molecules.Scratch tests were used to ex-amine the migration abilities of cells treated with different concentrations of uric acid.Results The kidney function analysis showed that a significant increase in the levels of serum urea nitrogen(P=0.006 4),creatinine(P=0.008 0)and urate(P=0.000 7)in the CKD-RIF mice compared with the normal control group.The results of HE staining and PAS staining showed a significance of renal tubule injury and infiltration of inflammatory cells in the model group.Masson's trichrome staining showed that a marked increase in collagen deposition in the model group.The results of urate staining showed a significant presence of urate crystals in kidney tissue of the model group when compared to the control group.Animal tissue immunoblotting and immunohistochemistry analysis showed a significant increase in the expression levels of vimentin,α-SMA and TGF-β1 in the model group in comparison to the control group.Conversely,in the model group,E-cadherin levels exhibited a dramatic reduction compared to the control group.The findings from the scratching tests showed that uric acid significantly enhanced cell migration.Western blot analysis showed a dramatic increase in the expression levels of vimentin and α-SMA,while E-cadherin exhibited significant decrease in the cells subjected to uric acid treatment.Conclusion Urate stimulates the secre-tion of TGF-β1 by renal tubule epithelial cells and induces epithelial-mesenchymal transdifferentiation,thereby ex-acerbating renal interstitial fibrosis in CKD.