Objective To preliminarily investigate the safety and efficacy of donor pancreas needle biopsy in simultaneous pancreas-kidney transplantation. Methods Clinical data of 7 cases undergoing donor pancreas biopsy were collected retrospectively. All cases underwent donor pancreas biopsy before or during simultaneous pancreas-kidney transplantation. Frozen section or paraffin sectioning techniques were used for tissue preparation, and hematoxylin-eosin and Masson staining were performed to histologically evaluate the donor pancreas. The quality of donor pancreas was comprehensively assessed by combining histological findings with the donor's clinical data. Postoperative follow-up data of 5 simultaneous pancreas-kidney transplant recipients were collected to summarize the safety of donor pancreas biopsy and the prognosis of transplant recipients. Results The 7 pancreas donors were aged 28 to 62 years, with a body mass index ranging from 20.76 to 27.68 kg/m². Liver ultrasound indicated fatty liver in 3 cases, while pancreatic ultrasound did not reveal any significant abnormalities. Among them, biopsy was performed on 2 donors after completion of pancreatic procurement and processing, and the frozen section histology showed moderate acute pancreatitis changes (edema of acinar cells, necrosis and inflammatory cell infiltration). Combined with a serum amylase level elevated more than 3 times the upper limit of normal value, these two donor pancreases were finally discarded. The remaining 5 cases underwent biopsy immediately after pancreatic vascular anastomosis during simultaneous pancreas-kidney transplantation, and histological evaluation was performed on paraffin-embedded sections. No biopsy-related complications (such as bleeding, pancreatic fistula, etc.) occurred after transplantation. One recipient died of severe infection 2 months after transplantation, while the other 4 recipients were followed up for more than 5 years, with well-functioning transplant kidneys and pancreases. Conclusions Donor pancreas biopsy is relatively safe, and the risk of biopsy-related complications after transplantation is controllable. Comprehensive assessment of donor pancreas quality by combining histological evaluation with the donor's clinical indicators is conducive to improving the accuracy of donor pancreas selection and organ utilization.

Objective To evaluate the changes of bronchial mucosa observed by fiberoptic bronchoscopy after bronchial arterial embolization(BAE)treatment.Methods A total of 176 patients,who received BAE at the First Affiliated Hospital of Guangzhou Medical University of China from May 2019 to March 2024,were enrolled in this study.The pre-BAE and post-BAE bronchial mucosa was checked by fiberoptic bronchoscopy.Results Of the 176 patients,fiberoptic bronchoscopy showed no abnormal findings in 143 and showed abnormal findings in 33.All the abnormal findings were mucosal congestion and oedema,in some cases coexisting vascular bulge was seen,but no manifestations of ischemia or necrosis of the bronchial mucosa could be found.In 22 patients,the preoperative and postoperative 7-day fiberoptic bronchoscopy revealed that both preoperative and postoperative examinations showed no obvious abnormalities of the bronchial mucosa in 13 patients,preoperative examination had abnormalities of the bronchial mucosa in 9 patients,postoperative examination showed no obvious abnormalities of the bronchial mucosa in 3 patients,and in one patient the postoperative degree of bronchial mucosal congestion and oedema was significantly improved when compared with its preoperative degree.Conclusion BAE does not cause ischemic necrosis or shedding of bronchial mucosa,and BAE can reduce the degree of bronchial mucosal congestion in some patients.

Objective To discuss the application of 3D printing technology in the adjuvant treatment of complex Stanford type B aortic dissection(SBAD)and abdominal aortic aneurysm.Methods The clinical data of 64 patients with complex SBAD and 64 patients with abdominal aortic aneurysm,who were admitted to the Mianyang No.404 Hospital of China from January 2022 to January 2024,were retrospectively analyzed.Of the 64 patients with complex SBAD,33 received preoperative 3D printing adjuvant treatment(observation group Ⅰ)and 31 received preoperative routine examination(control group Ⅰ).Of the 64 patients with abdominal aortic aneurysm,32 received preoperative 3D printing adjuvant treatment(observation group Ⅱ)and 32 received preoperative routine examination(control group Ⅱ).The changes in left-right diameter(LR)and anterior-posterior diameter(AP)of anatomical structure in observation group Ⅰ and observation group Ⅱ were analyzed.The perioperative situations were compared between observation group Ⅰ and control group Ⅰ,as well as between observation groupⅡ and control group Ⅱ.Results In patients with complex SBAD,LR of descending aorta diaphragm in S2(STL model)was significantly higher than that in S1(CTA image)and S3(plastic model,P＜0.05),and AP of descending aorta diaphragm in S2 was higher than that in S3(P＜0.05).LR of brachiocephalic trunk in S3 was significantly lower than that in S1 and S2(P＜0.05),AP of brachiocephalic trunk in S3 stage was significantly higher than that in S1 and S2(P＜0.05),and AP of brachiocephalic trunk in S2 was higher than that in S1(P＜0.05).LR of left common carotid artery in S3 was significantly higher than that in S1 and S2(P＜0.05),LR of left common carotid artery in S2 was higher than that in S1(P＜0.05),and AP of left common carotid artery in S3 was lower than that in S1(P＜0.05).LR and AP of left subclavian artery in S3 were significantly higher than those in S1 and S2(P＜0.05).In patients with abdominal aortic aneurysm,LR and AP of tumor neck in S3 were significantly higher than those in S1(P＜0.05),and AP of aneurysm neck in S3 was significantly higher than that in S2(P＜0.05).LR and AP of aneurysm in S3 and S2 were significantly higher than those in S1(P＜0.05),and LR and AP of aneurysm in S3 were significantly higher than those in S2(P＜0.05).LR of abdominal aortic bifurcation in S3 and S2 was significantly higher than that in S1(P＜0.05),LR of abdominal aortic bifurcation in S3 was significantly higher than that in S2(P＜0.05),and AP of abdominal aortic bifurcation in S3 was significantly lower than that in S1(P＜0.05).AP of left common iliac artery in S3 was significantly lower than that in S1(P＜0.05).In the observation group Ⅰ,the operation time,endovascular operation time and length of hospital stay were significantly shorter than those in the control group Ⅰ(P＜0.05),and the intraoperative blood loss and used dosage of contrast agent were lower than those in the control group Ⅰ(P＜0.05).In observation group Ⅱ,the operation time,endovascular operation time and length of hospital stay were significantly shorter than those in the control group Ⅱ(P＜0.05),and the intraoperative blood loss and used dosage of contrast agent were lower than those in the control group Ⅱ(P＜0.05).In patients with complex SBAD or abdominal aortic aneurysm,there was no internal leakage or stent displacement at 6 months after surgery.Conclusion Adjuvant treatment with 3D printing technology is helpful for improving anatomical structure measurement of lesion sites in patients with complex SBAD and abdominal aortic aneurysm.Preoperative 3D plastic model preview surgery is helpful for shortening the operation time and length of hospital stay and reducing the used dosage of contrast agent without affecting surgical treatment effect.

Objective To investigate the status of population dynamics and distribution changes of Aedes aegypti in Guangdong Province.Methods Continuous monitoring was conducted from May 2018 to July 2024 in Wushi Town and Qishui Town,Leizhou City,Zhanjiang City,Guangdong Province.Additionally,a survey of the distribution of Ae.aegypti along the Leizhou Peninsula coast was carried out.Results The density of Ae.aegypti in Zhanjiang showed a gradual decline from 2018 to 2024.The last detection of adult Ae.aegypti in Wushi Town was in September 2021,and the last larva was found in October 2023.No Ae.aegypti was detected in Qishui Town during surveys from 2021 to 2024.A survey of 18 coastal villages in the Leizhou Peninsula revealed no detections of Ae.aegypti.Conclusions This study provides a basis for understanding the distribution and population density fluctuations of Ae.aegypti,assessing its invasion risk,and scientifically conducting relevant prevention and control efforts.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To analyze the short-term efficacy and safety of robot-assisted laparoscopic partial nephrectomy（RAPN）for non-metastatic pathological stage T 3a renal cell carcinoma. Methods:The clinical and pathological data of 45 patients with pathologically confirmed non-metastatic T 3a renal cell carcinoma who underwent RAPN at Sun Yat-sen University Cancer Center between January 2016 and December 2023 were retrospectively reviewed. There were 30 males and 15 females. The average age of the cohort was（54.3±10.7）years，and the average clinical tumor diameter was（4.9±1.8）cm. Of all the patients，35（77.8%）were asymptomatic，7（15.6%）presented with hematuria，and 3（6.7%）presented with lumbar pain. Preoperative imaging assessed 34 patients（75.6%）as having clinical stage T 3a，all suspected of involving the collecting system or perirenal fat invasion；the remaining 11 patients（24.4%）were assessed as having stage T 1-2 disease. The median R.E.N.A.L. nephrectomy score was 8.0（7.0，10.0）. A history of hypertension，diabetes，or chronic kidney disease was present in 18 patients（40.0%）. The primary endpoint was progression-free survival，and the secondary endpoints included postoperative complications and short-term renal function outcomes. Survival curve was estimated using the Kaplan-Meier method，and renal function comparisons were made using the paired t-test. Results:The RAPN was performed through a transabdominal approach in 32 patients（71.1%），with a median estimated blood loss of 150.0（50.0，300.0）ml. Seven（15.6%）patients required intraoperative blood transfusion. The median length of postoperative hospital stay was 4.0（4.0，6.0）days. Postoperative complications occurred in 6 patients（13.3%），including 5（11.1%）with mild complications and 1（2.2%）with a severe complication. Renal function returned to baseline in 24 of 39 evaluable patients（61.5%），while 3 patients（7.7%）developed surgery-related chronic kidney disease 3 to 12 months postoperatively，but none required dialysis. The median follow-up time was 31.8（22.7，50.9）months，12（26.7%）patients received programmed cell death protein 1 inhibitor adjuvant therapy postoperatively. During follow-up，3 patients experienced tumor recurrence，the 3-year progression-free survival rate of the entire cohort was 95.4%.Conclusions:For some carefully selected patients with T 3a renal cell carcinoma，RAPN performed by experienced surgeons is a feasible and safe option，providing excellent short-term oncological outcomes，complication control，and renal function recovery. The long-term efficacy remains to be seen.

Objective:To analyze the variation trends in the levels of apolipoprotein B (ApoB), the ratio of apolipoprotein B to low-density lipoprotein cholesterol (ApoB/LDL-C), and non-high density lipoprotein cholesterol (non-HDL-C) among patients and individuals undergoing physical examinations at Zhongshan Hospital, Fudan University from 2014 to 2024.Methods:Data on ApoB, LDL-C, and nonHDL-C levels were collected from individuals (the overall population) who visited or underwent physical examinations at our hospital from January 1, 2014 to December 31, 2024, as well as from individuals (the fixed population) who were tested annually over the 11-year period. The Mann-Kendall test combined with Sen slope estimation was used to analyze the trends. The abnormal rates of ApoB and non-HDL-C in both the overall and fixed populations, as well as the changes in the first and last test results over the 11 years in the fixed population, were also analyzed.Results:The overall population totaled 1 679 440 cases, aged 57 (45, 67) years, and 718 738 cases (42.8%) were female, of which 1 250 234 cases (74.4%) were in the patient population and 429 206 cases (25.6%) were in the health check population. The fixed population of 1 560 cases was 56 (45, 65) years old and 655 cases (42.0%) were female, of which 1 044 cases (66.9%) were in the patient population and 516 cases (33.1%) in the health check population. Between 2014 and 2024, the overall population ApoB decreased from 0.842 g/L to 0.822 g/L (Sen slope -0.001 g·L -1·year -1, P=0.01), the abnormality rate decreased from 24.70% to 22.03% (Sen slope -0.50%/year, P=0.06), and 69.4% of the fixed population showed no change in the subgroups of initial and final tests. ApoB/LDL-C increased from 0.824 to 0.868 (Sen slope -0.003/year, P=0.72). Non-HDL-C decreased from 3.46 mmol/L to 3.32 mmol/L (Sen slope 0.018 mmol·L -1·year -1, P=0.35), with a statistically significant upward trend since 2019 (Sen slope 0.037 mmol·L -1·year -1, P=0.008), and the anomaly rate decreased from 24.3% to 22.7% (Sen slope 0.55%/year, P=0.64), with a statistically significant upward trend since 2019 (Sen slope 1.53%/year, P=0.014), and no change in the grouping of the first and last tests in 75.0% of the fixed population. The trends in the above items were consistent between the overall population and the fixed population. 20-<40 year olds had the most significant upward trend in non-HDL-C along with the least significant downward trend in ApoB/LDL-C and ApoB. Conclusion:ApoB in the overall and fixed populations from 2014-2024 in a Shanghai hospital showed a decreasing trend, and non-HDL-C and abnormality rates showed an increasing trend from 2019 onwards.

Objective:To analyze the trend of lipid changes in patients and individuals undergoing physical examination at Zhongshan Hospital of Fudan University from 2014 to 2024, providing evidence for the formulation of cardiovascular disease prevention and control strategies.Methods:A total of 2 657 835 individuals (general population) who underwent lipid testing during medical visits or physical examinations at Zhongshan Hospital of Fudan University from January 1, 2014, to December 31, 2024, were selected. Among them, 6 234 individuals who were tested consecutively for 11 years were considered as the fixed population. Lipid levels were analyzed across different genders and age groups. Total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were analyzed. The trends in lipid changes and the abnormal rates of TC (≥5.18 mmol/L) and LDL-C (≥3.40 mmol/L) in both the general and fixed populations were statistically analyzed.Results:The median age of the general population was 53 (41, 63) years, with 1 498 533 males (56.4%); 1 149 662 individuals (43.3%) were from the physical examination group. The median age of the fixed population was 52 (39, 62) years, with 3 262 males (52.3%); 2 955 individuals (47.4%) were from the physical examination group. Over an 11-year period, the logarithmically transformed TG (lnTG) in the general population slightly increased from 1.35 mmol/L to 1.36 mmol/L (Sen slope=0.007 mmol·L -1·year -1; S=27, P=0.043). Although there were fluctuations in TC, LDL-C, and HDL-C, the trends were not statistically significant ( P>0.05). However, in the subset of the population undergoing regular health check-ups, TC showed a steady increase over time ( S=27, P=0.043). Within a fixed population over the same 11-year period, there were no statistically significant changes in lipid profiles ( P>0.05). Nevertheless, in the fixed subset undergoing regular health check-ups, both TC and lnTG exhibited an upward trend (TC: S=27, P=0.043; lnTG: S=31, P=0.020), while in the fixed subset seeking medical attention, TC and LDL-C demonstrated a downward trend (TC: S=-31, P=0.020; LDL-C: S=-27, P=0.043). Trends in lipid profiles varied among different genders and age groups. Specifically, both men and women aged 20-<40 years old showed an increase in TC, abnormal TC rates, and abnormal LDL-C rates ( P<0.05). Conversely, in the fixed population, women over 60 years old exhibited a decrease in TC, abnormal TC rates, and abnormal LDL-C rates ( P<0.05). Conclusion:During the period from 2014 to 2024, there were slight fluctuations in the average lipid levels of both the general and fixed populations. Notably, TC, abnormal TC rates, and abnormal LDL-C rates increased among men and women aged 20-<40 years old, while these parameters decreased among women over 60 years old in the fixed population.