Objective:To explore the anal function and postoperative complications of 2-stage Turnbull-Cutait pull-through coloanal anastomosis (TCA) for low rectal cancer.Methods:Patients undergoing radical rectal cancer resection from Feb 2023 to Nov 2024 in the First Hospital of Jilin University were divided into the TCA surgery group and the low anterior resection combined with prophylactic stoma (LAR) surgery group.Results:Among the 102 patients, there were 50 cases in the TCA group and 52 cases in the LAR group. In the single-arm analysis of the TCA group, the overall complication rate was 44%. The incidence rates of severe LARS at 1 month, 3 months, and 6 months after surgery were 97%, 77%, and 64% respectively. There was no significant difference in the complication rate within 30 days after surgery between the two groups,(44% vs. 38%, χ2=0.135, P>0.05). There was no significant difference in the incidence rate of severe LARS between the TCA group and the LAR group (77% vs. 69%, χ2=0.202, P>0.05), and there was not significant difference in the incidence rate of severe LARS between the two groups at the 6th month after surgery,(64% vs. 48%, χ2=1.132, P>0.05). Conclusion:In patients who underwent TCA surgery, the LARS symptoms gradually decreased over time. Compared with patients undergoing low anterior resection and stoma reversal, there were no significant differences in complications within 30 days after surgery and LARS symptoms within half a year.

Low anterior resection syndrome (LARS) is a series of symptoms of intestinal dysfunction, and its research is mainly focused on patients with low rectal surgery. However, with the deepening understanding of postoperative LARS, surgeons found that LARS not only exists among patients who have undergone low anterior resection of rectum, but also plagues a considerable number of patients who have undergone non-rectal (mainly colon) surgeries. This article aims to elaborate on the incidence and treatment of LARS after colon surgery. Through a comprehensive analysis of relevant studies, it is found that the incidence of LARS after colon surgery is approximately 20%-30%, and the incidence is relatively higher in patients undergoing right hemicolectomy. Its pathogenesis is related to multiple factors, including surgical methods, resection range, changes in intestinal flora, patient age, gender, and underlying diseases. Treatment methods include conservative treatments such as dietary adjustment, drug therapy, transanal irrigation, and rehabilitation training. Single treatment methods have limited effect, while comprehensive treatment can effectively improve patients' symptoms and quality of life. The current LARS scoring system has not been effectively verified in the application after colon cancer surgery, and it is necessary to develop a more targeted scoring system.

Colorectal cancer is one of the most common malignant tumors in the digestive system, posing a serious threat to human health. In recent years, with the rapid development of medical technology, the treatment model for colorectal cancer has undergone profound changes, gradually shifting from traditional single-surgery treatment to multidisciplinary team (MDT) treat-ment. The concept of precision medicine has been deeply integrated into the entire process of colo-rectal cancer treatment, aiming not only to achieve radical tumor removal but also to focus on impro-ving postoperative quality of life of patients. In surgical treatment, accurate grasping of operative opportunity and precise preservation of anus have become key factors in enhancing the effectiveness of colorectal cancer treatment. Current research and trends are dedicated to addressing these issues. Tailored treatments based on individual patient conditions and highly personalized treatment plans aim to achieve optimal outcomes while minimizing adverse reactions. This philosophy is reflected in multiple aspects of colorectal cancer treatment, including precise judgment of surgical timing, accurate selection of sphincter-preserving surgery, and meticulous application of surgical techniques. After reviewing relevant literature both domestically and internationally, combined with practical experi-ence, the authors focus on the selection of surgical timing under neoadjuvant therapy, precise sphincter-preserving strategies, and the critical role of surgical techniques in sphincter preservation.

Low anterior resection syndrome (LARS) is a series of symptoms of intestinal dysfunction, and its research is mainly focused on patients with low rectal surgery. However, with the deepening understanding of postoperative LARS, surgeons found that LARS not only exists among patients who have undergone low anterior resection of rectum, but also plagues a considerable number of patients who have undergone non-rectal (mainly colon) surgeries. This article aims to elaborate on the incidence and treatment of LARS after colon surgery. Through a comprehensive analysis of relevant studies, it is found that the incidence of LARS after colon surgery is approximately 20%-30%, and the incidence is relatively higher in patients undergoing right hemicolectomy. Its pathogenesis is related to multiple factors, including surgical methods, resection range, changes in intestinal flora, patient age, gender, and underlying diseases. Treatment methods include conservative treatments such as dietary adjustment, drug therapy, transanal irrigation, and rehabilitation training. Single treatment methods have limited effect, while comprehensive treatment can effectively improve patients' symptoms and quality of life. The current LARS scoring system has not been effectively verified in the application after colon cancer surgery, and it is necessary to develop a more targeted scoring system.

Colorectal cancer is one of the most common malignant tumors in the digestive system, posing a serious threat to human health. In recent years, with the rapid development of medical technology, the treatment model for colorectal cancer has undergone profound changes, gradually shifting from traditional single-surgery treatment to multidisciplinary team (MDT) treat-ment. The concept of precision medicine has been deeply integrated into the entire process of colo-rectal cancer treatment, aiming not only to achieve radical tumor removal but also to focus on impro-ving postoperative quality of life of patients. In surgical treatment, accurate grasping of operative opportunity and precise preservation of anus have become key factors in enhancing the effectiveness of colorectal cancer treatment. Current research and trends are dedicated to addressing these issues. Tailored treatments based on individual patient conditions and highly personalized treatment plans aim to achieve optimal outcomes while minimizing adverse reactions. This philosophy is reflected in multiple aspects of colorectal cancer treatment, including precise judgment of surgical timing, accurate selection of sphincter-preserving surgery, and meticulous application of surgical techniques. After reviewing relevant literature both domestically and internationally, combined with practical experi-ence, the authors focus on the selection of surgical timing under neoadjuvant therapy, precise sphincter-preserving strategies, and the critical role of surgical techniques in sphincter preservation.

Objective:To explore the anal function and postoperative complications of 2-stage Turnbull-Cutait pull-through coloanal anastomosis (TCA) for low rectal cancer.Methods:Patients undergoing radical rectal cancer resection from Feb 2023 to Nov 2024 in the First Hospital of Jilin University were divided into the TCA surgery group and the low anterior resection combined with prophylactic stoma (LAR) surgery group.Results:Among the 102 patients, there were 50 cases in the TCA group and 52 cases in the LAR group. In the single-arm analysis of the TCA group, the overall complication rate was 44%. The incidence rates of severe LARS at 1 month, 3 months, and 6 months after surgery were 97%, 77%, and 64% respectively. There was no significant difference in the complication rate within 30 days after surgery between the two groups,(44% vs. 38%, χ2=0.135, P>0.05). There was no significant difference in the incidence rate of severe LARS between the TCA group and the LAR group (77% vs. 69%, χ2=0.202, P>0.05), and there was not significant difference in the incidence rate of severe LARS between the two groups at the 6th month after surgery,(64% vs. 48%, χ2=1.132, P>0.05). Conclusion:In patients who underwent TCA surgery, the LARS symptoms gradually decreased over time. Compared with patients undergoing low anterior resection and stoma reversal, there were no significant differences in complications within 30 days after surgery and LARS symptoms within half a year.

[Objective]To evaluate the effectiveness of Yinqiao Piwen Powder,an empirical formula,in the treatment of mild cases of corona virus disease 2019(COVID-19) infection.[Methods]A single-center retrospective cohort study was adopted. A total of 595 patients with mild COVID-19 infection who attended Zhejiang Provincial Hospital of Traditional Chinese Medicine from December 18 to 23,2022 were included in this study and then divided into western medicine group (WM),traditional Chinese medicine group (TCM) and integrated Chinese and western medicine group (TCM-WM) based on their medication,with 153 cases,144 cases and 298 cases in each respectively. The WM group received routine treatment of western medicine according to the Diagnosis and Treatment Protocol for COVID-19 Patients (Tentative 10th Edition),the TCM group received Yinqiao Piwen powder treatment,and the TCM-WM group received Yinqiao Piwen Powder treatment on the basis of the treatment of the WM group. After 14 days,the therapeutic effect of patients was evaluated. Specifically,the baseline characteristics,clinical symptoms and symptom relief time of the patients were collected,the TCM symptom scores were estimated,and the distribution of symptoms and efficacy distribution after treatment in each group were analyzed.[Results]The most common symptoms in patients with mild COVID-19 infection were fever,cough,sputum,fatigue,body aches,sore throat,nasal congestion and runny nose. On the efficacy distribution,the markedly effective rate of the TCM-WM group was significantly higher than that of the WM group,which were both significantly different(x2=14.022,P<0.001) After treatment,the total TCM symptom scores of all three groups were significantly decreased compared with pre-treatment,indicating a great relief in the clinical symptoms in all groups,with a statistically significant difference (P<0.001). Additionally,the median number of the rate of reduction of TCM symptom scores in the TCM-WM group was 100.00(93.21,100.00),higher than the TCM group[100.00(92.15,100.00)]and the WM group[100.00(78.95,100.00)],and showed statistical difference (P<0.05). The differences of TCM symptom scores of three groups between the pre-treatment and post-treatment were significant (P<0.05),and the TCM-WM group changed the most in the scores. Besides,after correction for age and pre-treatment symptom scores,the differences in post-treatment TCM symptom scores among the three groups were still statistically significant ( P<0.05). Moreover,the differences among the three groups in the symptom relief time of sore throat,cough,sputum and fatigue were statistically significant(P<0.05).[Conclusion]Compared with the western medicine treatment alone,the other two treatments achieved better clinical results in improving the efficacy,reducing the TCM symptom scores and shortening the symptom relief time. The results of our study can provide evidence-based medical proof for the benefits of TCM in the prevention and treatment of epidemics.

Objective:To evaluate the detection performance of left ventricular ejection fraction (LVEF) in patients with chronic renal failure (CRF) by an artificial intelligence (AI) model based on yolox framework integrating left ventricular segmentation and critical point detection.Methods:From January 2019 to June 2023, a total of 4 284 echocardiographic images of 2 000 adults aged 18-80 years without segmental wall motion abnormalities, structural heart disease, cardiac surgery or cardiomyopathy were collected in Henan Provincial People′s Hospital to delineate the endocardial membrane, as a training set, an AI model based on yolox framework integrating left ventricular segmentation and critical point detection was established. The images were divided into the training set( n=1 675) and the test set( n=325) in a ratio of about 5∶1. All 228 echocardiographic images of 100 normal adult volunteers who were treated in Henan Provincial Chest Hospital from May 2020 to May 2021 were collected as external test set validation. All 792 echocardiographic images of 204 patients treated in Henan Provincial People′s Hospital from April 2019 to June 2023 were continuously enrolled to evaluate the measurement efficiency of AI model. Spearman correlation statistical method was used to analyze the consistency of AI model measurement with manual measurement and TomTec software measurement methods of 3 senior echocardiographic professionals. Subjects were divided into clear image group, unclear image group, normal LVEF group and reduced LVEF group, the differences of general data between the two groups were compared. The correlation coefficient(ICC) within the group was calculated to analyze the consistency, so as to evaluate the model performance. Results:LVEF measured by AI model was significantly correlated with both manual measurement and TomTec model measurement ( rs=0.834, 0.826; all P<0.01). ICC values of the clear image group and the unclear image group were 0.96 and 0.97, respectively. ICC values for all subjects, normal LVEF group and reduced LVEF group were 0.96, 0.90 and 0.96, respectively. Conclusions:The AI model based on yolox framework integrating left ventricular segmentation and critical point detection has good diagnostic performance in the automatic measurement of LVEF in patients with CRF.

[Objective]To evaluate the effectiveness of Yinqiao Piwen Powder,an empirical formula,in the treatment of mild cases of corona virus disease 2019(COVID-19) infection.[Methods]A single-center retrospective cohort study was adopted. A total of 595 patients with mild COVID-19 infection who attended Zhejiang Provincial Hospital of Traditional Chinese Medicine from December 18 to 23,2022 were included in this study and then divided into western medicine group (WM),traditional Chinese medicine group (TCM) and integrated Chinese and western medicine group (TCM-WM) based on their medication,with 153 cases,144 cases and 298 cases in each respectively. The WM group received routine treatment of western medicine according to the Diagnosis and Treatment Protocol for COVID-19 Patients (Tentative 10th Edition),the TCM group received Yinqiao Piwen powder treatment,and the TCM-WM group received Yinqiao Piwen Powder treatment on the basis of the treatment of the WM group. After 14 days,the therapeutic effect of patients was evaluated. Specifically,the baseline characteristics,clinical symptoms and symptom relief time of the patients were collected,the TCM symptom scores were estimated,and the distribution of symptoms and efficacy distribution after treatment in each group were analyzed.[Results]The most common symptoms in patients with mild COVID-19 infection were fever,cough,sputum,fatigue,body aches,sore throat,nasal congestion and runny nose. On the efficacy distribution,the markedly effective rate of the TCM-WM group was significantly higher than that of the WM group,which were both significantly different(x2=14.022,P<0.001) After treatment,the total TCM symptom scores of all three groups were significantly decreased compared with pre-treatment,indicating a great relief in the clinical symptoms in all groups,with a statistically significant difference (P<0.001). Additionally,the median number of the rate of reduction of TCM symptom scores in the TCM-WM group was 100.00(93.21,100.00),higher than the TCM group[100.00(92.15,100.00)]and the WM group[100.00(78.95,100.00)],and showed statistical difference (P<0.05). The differences of TCM symptom scores of three groups between the pre-treatment and post-treatment were significant (P<0.05),and the TCM-WM group changed the most in the scores. Besides,after correction for age and pre-treatment symptom scores,the differences in post-treatment TCM symptom scores among the three groups were still statistically significant ( P<0.05). Moreover,the differences among the three groups in the symptom relief time of sore throat,cough,sputum and fatigue were statistically significant(P<0.05).[Conclusion]Compared with the western medicine treatment alone,the other two treatments achieved better clinical results in improving the efficacy,reducing the TCM symptom scores and shortening the symptom relief time. The results of our study can provide evidence-based medical proof for the benefits of TCM in the prevention and treatment of epidemics.

Objective:To explore the applicability of the distance between facial marks classification in evaluating the severity of androgenic alopecia in men.Methods:From June to December 2019, the male Chinese with diagnosis of androgenic alopecia were evaluated in the specific clinic of alopecia of Hangzhou First People’s Hospital according to the distance between facial marks and BASP(basic and specific) classification. The classification based on the distance between facial marks measures the distance from the facial marks of the anterior hairline to the horizontal line of the eyebrow and the longest radius of hair loss in the hair rotation center, the hair recession of the patient’s forehead (F), temporal (M) and vertex (V) parts. The hair loss in each region is rated as 0-3 grade from light to heavy, and the final hair loss grading is expressed as FnMnVn, such as F1M2V0. The highest grade of hair loss in F, M and V is the overall grade of hair loss. SPSS 25.0 software was used to statistically analyze the general data of patients, and Kappa test was used to evaluate the consistency between the results of the distance classification and BASP classification. The repeatability of the distance classification was tested by the repetition rate of three hair loss specialists. When two or more specialists gave the same evaluation among the three hair loss specialists, the result was regarded as the standard result. The ease of use of the distance between facial marks classification was tested by the consistency rate between the grading results of two temporary trained general doctors and the standard results.Results:A total of 150 male patients, aged (32.8±7.9) years (19-58 years), were included, of which 99 patients were 24-35 years old, accounting for 66.00%. It can be observed that the onset age was earlier. As assessed in this classification, the patients who participated in the study were graded as mild in 65 cases(43.33%), severe in 58 cases(38.67%), and moderate, which was consistency with the results obtained by BASP classification ( κ=0.573, P<0.001). Three experienced alopecia specialists evaluated 150 patients through the distance between facial marks. The results showed that the repetition rates of frontal, temporal and parietal classification results were 98.00%(147/150), 97.33%(146/150) and 96.00%(144/150), respectively. The repetition rate of the final alopecia classification was 92.00%(138/150), and the repetition rate of the overall alopecia classification was 98.00%(147/150). The consistency rate between the overall alopecia classification results of two temporary trained general doctors and the standard results was 95.92%(141/147) and 96.60%(142/147), respectively, and the consistency rate of the other results was higher than 90.00% except for one general doctor who was 89.86%(124/138) in the final classification. Conclusion:The distance between facial marks classification is a comparatively accurate and easy-to-learn grading method designed for Chinese male androgenic hair loss patients based on objective measurement data.