Objective:To explore the treatment methods and clinical efficacy of penetrating high-voltage electric burns to thoracoabdominal wall.Methods:This study was a retrospective observational study. From March 2020 to March 2023, six male patients with penetrating high-voltage electric burns to thoracoabdominal wall who met the inclusion criteria were hospitalized at West China Hospital of Sichuan University, aged 42 to 57 years. Among them, one patient had thoracoabdominal wall defects with perforation and necrosis of the gastric wall and diaphragm, two patients had thoracoabdominal wall defects with perforation and necrosis of the gastric wall alone, and three patients had abdominal wall defects with perforation and necrosis of the small intestine. In the emergency department, aesthetic plastic and burn surgery, general surgery, and/or thoracic surgery doctors jointly formulated an emergency surgery plan for the patients. Three patients with perforation and necrosis of the gastric wall underwent subtotal gastrectomy and anastomosis. One of them, who also had diaphragmatic perforation and necrosis, underwent resection of the necrotic diaphragm and repair. The other three patients with perforation and necrosis of the small intestine underwent resection and anastomosis of the necrotic intestinal segment. After debriding the thoracoabdominal wall wounds conservatively in stage Ⅰ and repairing the abdominal wall defects with greater omentum coverage, the thoracoabdominal wall wounds were treated with vacuum sealing drainage (VSD). Seven days later, a stage Ⅱ thorough debridement of the thoracoabdominal wall wounds was performed, and bovine acellular dermal matrix was transplanted onto the surface of the greater omentum and the surrounding skin wounds without skin coverage, and the VSD treatment of the thoracoabdominal wall wounds was continued. After 7 days, the VSD treatment was stopped, and after the fresh granulation tissue well developed in the wounds, a stage Ⅲ transplantation of meshed split-thickness skin graft from the lateral femur was performed to close the thoracoabdominal wall wounds, followed by continuing VSD treatment for another 7 days. Data were recorded including the status of patients' enteral nutrition recovery and occurrence of complications such as abdominal infection after stage Ⅰ surgery, the time from starting moist dressing change to the wound being ready for skin grafting after stage Ⅱ surgery, the microbiological culture of wound exudate samples and conditions of wound surrounding areas from starting moist dressing change to wound healing after stage Ⅱ surgery, skin graft survival, and wound healing time. Follow-up was carried out to observe the occurrence of gastrointestinal symptoms, abdominal wall hernia, scars, and functional disorders, etc.Results:All six patients resumed enteral nutrition on day 2 to 4 after stage Ⅰ surgery, with no occurrence of intestinal obstruction, anastomotic leakage, or abdominal infection. The time from starting moist dressing change to the wound being ready for skin grafting after stage Ⅱ surgery was 8 (6, 12) days. During the period from starting moist dressing change to wound healing after stage Ⅱ surgery, microbiological culture of wound exudate sample showed Enterobacter cloacae in one patient and Pseudomonas aeruginosa in another patient, while the remaining four patients had negative cultures; no patient developed wound edge inflammation. All grafted skin survived, and the wound healing time was 38 (30, 46) days. During follow-up from 12 to 36 months after stage Ⅲ surgery, patients had no intractable constipation or intestinal obstruction symptoms, no obvious local tissue herniation requiring surgical treatment, no scar ulceration, and no functional disorders. Conclusions:For penetrating high-voltage electric burns to thoracoabdominal wall, a sequential three-stage surgical treatment plan under a multidisciplinary team collaboration model can effectively protect organ function and control wound infection. Long-term follow-up shows good gastrointestinal function and thoracoabdominal wall appearance. This method is highly reproducible and effective, which is suitable for clinical promotion and use.

Objective:To construct a nomogram model for differentiating gastric schwannoma (GS) from gastric stromal tumor (GST) (diameters 2 to 5 cm) based on CT imaging features before surgery.Methods:The clinical and imaging data of 49 patients with GS and 240 patients with GST in the Affiliated Hospital of Jining Medical University from July 2009 to April 2023 and Guangdong Provincial People′s Hospital from June 2017 to September 2022 were analyzed retrospectively. The independent factors for differentiating GS from GST were obtained by multivariate Logistic regression analysis. The nomogram model was constructed by R4.3.1 software. The efficacy of the nomogram model for differentiating GS from GST was evaluated by the receiver operating characteristics (ROC) curve, and calibration curve and decision curve analysis were used to evaluate the predictive efficacy and clinical application value of the nomogram model.Results:There were no statistical differences in the clinical symptom rate, calcification rate, ulcer rate, tumor vessel rate, ratio of long diameter to short diameter and CT value difference during the arterial and nonenhanced phases (CTV A-N) between GS patients and GST patients ( P>0.05). The proportion of female, incidence of lesions located in central or lower part of stomach, extraluminal or mixed growth rate, tumor-associated lymph node rate, strong enhancement rate, CT value difference during the portal and nonenhanced phases (CTV P-N), CT value difference during the delayed and nonenhanced phases (CTV D-N), CT value difference during the portal and arterial phases (CTV P-A) and CT value difference during the delayed and portal phases (CTV D-P) in GS patients were significantly higher than those in GST patients: 75.51% (37/49) vs. 58.33% (140/240), 85.71% (42/49) vs. 54.17% (130/240), 75.51% (37/49) vs. 45.00% (108/240), 44.90% (22/49) vs. 5.42% (13/240), 51.02% (25/49) vs. 27.08% (65/240), 32.0 (26.0, 43.5) HU vs. 29.0 (22.0, 37.7) HU, (44.59 ± 13.46) HU vs. (32.94 ± 12.47) HU, 20.0 (11.5, 25.0) HU vs. 10.0 (5.0, 17.0) HU and 9.0 (6.0, 12.0) HU vs. 4.0 (-2.7, 7.0) HU, the age, irregular shape rate, cystic degeneration rate and heterogeneous enhancement rate were significantly lower than those in GST patients: (58.12 ± 12.59) years old vs. (62.05 ± 11.22) years old, 16.33% (8/49) vs. 38.33% (92/240), 18.37% (9/49) vs. 51.25% (123/240) and 34.69% (17/49) vs. 56.25% (135/240), and there were statistical differences ( P<0.05 or<0.01). Multivariate Logistic regression analysis result showed that location, cystic degeneration, tumor-associated lymph node, CTV P-A and CTV D-P were the independent factors for differentiating GS from GST ( OR= 3.599, 0.201, 19.031, 1.124 and 1.160; 95% CI 1.184 to 10.938, 0.070 to 0.578, 6.159 to 58.809, 1.066 to 1.185 and 1.094 to 1.231; P<0.05 or<0.01). The nomogram model for differentiating GS from GST was constructed based on location, cystic degeneration, tumor-associated lymph node, CTV P-A and CTV D-P. The area under curve of the nomogram model for differentiating GS from GST was 0.924 (95% CI 0.887 to 0.951). The calibration curve analysis result showed that there was a good agreement between the predicted GS curve and the actual GS curve (the mean absolute error was 0.033). The result of the Hosmer-Lemeshow goodness-of-fit test indicated that the calibration of the nomogram model was appropriate ( χ2 = 2.52, P = 0.961). The clinical decision curve analysis result showed that when the threshold for the nomogram model for differentiating the two tumors was>0.03, the nomogram yielded more net benefits than the "all patients treated as GS" or "all patients treated as GST" scenarios. Conclusions:The nomogram model based on CT imaging features can be used to differentiate GS from GST before surgery.

Objective To investigate the effect of miR-217 on gefitinib resistance in non-small cell lung cancer(NSCLC),and to explore the downstream target genes and related pathways.Methods qRT-PCR was used to detect the expression of miR-217 in human lung normal epithelial cell lines BEAS-2B,NSCLC cell lines A549,HCC827,PC9,NCI-H1975 and gefitinib resistant strain PC9/GR.PC9/GR cells were selected and the cells of control group,NC-mimic group,miR-217 mimic group,miR-217 mimic+si-NC group,and miR-217 mimic+si-FOXO3 group were constructed using liposome transfection technique.CCK8 and clonal formation assay were used to detect changes in cell proliferation capacity,flow cytometry was used to detect changes in cell apoptosis capacity,and western blot was used to detect protein expression related to PI3K/AKT signaling pathway.The Targetscan bioinformatics website predicted the downstream target genes of miR-217,and the correlation between miR-217 and the target gene FOXO3 was detected by dual luciferase assay.Results Compared with BEAS-2B cells,the expression of miR-217 in A549,HCC827,PC9 and NCI-H1975 cells was significantly decreased(P＜0.05).With the increase of gefitinib concentration,the expression of miR-217 gene in PC9 cells was gradually decreased(P＜0.05),and the expression of miR-217 in PC9/GR cells was lower than that in PC9(P＜0.05).Compared with the control group and NC-mimic group,the cell proliferation capacity of miR-217 mimic group was significantly decreased(P＜0.05),the number of apoptosis was increased(P＜0.05),and the expression levels of p-PI3K and p-AKT were decreased(P＜0.05).Dual luciferase reporter gene assay proved that FOXO3 is the target of miR-217.Compared with miR-217 mimic group and miR-217 mimic+si-NC group,the cell drug resistance of miR-217 mimic+si-FOXO3 group was increased(P＜0.05),the proliferation ability was significantly increased(P＜0.05),and the number of apoptosis was decreased(P＜0.05).The expression levels of P-PI3K and P-AKT were increased(P＜0.05).Conclusion Overexpression of miR-217 reversed the resistance of PC9/GR to gefitinib in NSCLC cells and inhibited the proliferation and accelerated apoptosis of PC9/GR cells,which may be related to the regulation of PI3K/AKT signaling pathway by targeting FOXO3.

Objective To explore the potential mechanism of Babao Dan on primary liver cancer based on network pharmacology. Methods First, the diethylnitrosamine-induced hepatocellular carcinoma rat（HCC）model was used to observe the effects of Babao Dan. Then, the effective components in Babao Dan were detected by UPLC-MS, and the potential target sites of these effective components were predicted in the Swiss Target Prediction databases, etc. The corresponding target sites for HCC were screened using GeneCards, OMIM and Therapeutic Target Database, and the common target sites between Babao Dan and HCC were obtained after getting the intersection. The protein-protein interaction network was drawn by Cytoscape software and the STRING database, and the key molecules regulating HCC by Babao Dan were screened out. The effective target sites were subjected to GO analysis in the DAVID database and enrichment analysis in the Pathway’s KEGG. Finally, the clinical relevance of key molecules to liver cancer patients was verified by the TCGA database. Results Babao Dan could slow down the tumor development. 851 chemical components were detected in BaBao Dan by UPLC-MS , 9 major active components and 285 target sites were identified. 637 hepatocellular carcinoma-related targets were screened out, and 16 targets of Babao Dan regulating HCC were identified. GO enrichment analysis showed 802 biological processes, 11 cell compositions, and 43 molecular functions, while KEGG pathway enrichment analysis identified a total of 90 pathways. Correlation analysis of TCGA identified three key molecules associated with the survival of liver cancer patients. Conclusion In the primary rat liver cancer model, Babao Dan was found to significantly prolong the survival of cancer-induced rats and reduce tumor burden. The initial prediction of the mechanism by which Babao Dan regulating liver cancer was made through UPLC-MS analysis and network pharmacology methods, indicating that Babao Dan has the characteristics of multi-component, multi-pathway, and multi-target regulation of primary liver cancer, which could provide a reference for further relevant experimental research.

Objective:To compare the short-term efficacy of robotic-assisted sacrocolpopexy(RASC)and lap-aroscopic sacrocolpopexy(LSC)in overweight/obese patients with pelvic organ prolapse(POP),and to evaluate the advantages of RASC.Methods:We retrospectively collected the clinical data of overweight/obese(body mass index≥24 kg/m2)patients over 50 years old with POP who underwent sacrocolpopexy in the Department of Gynecology of the First Affiliated Hospital of Zhengzhou University from November 2014 to June 2023.According to the surgical method,they were divided into robotic group(68 cases)and laparoscopic group(110 cases).The intraoperative,postoperative and short-term follow-up outcomes of the two groups were compared.Pelvic Floor Distress Inventory-short form 20(PFDI-20),Pelvic Floor Impact Questionnaire-short form 7(PFIQ-7)and the Patient Global Impression of Improvement(PGI-Ⅰ)were used to evaluate surgical outcomes.Results:①No intra-operative conversion to laparotomy was found in both groups.Compared with the laparoscopic group,the robotic group had shorter operation time,less intraoperative blood loss,shorter postoperative anal exhaust time,and shor-ter postoperative hospital stay.The difference was statistically significant(P＜0.05).②There were no intraopera-tive complications in the robot group.While in the laparoscopic group,there was 1 case of bladder injury.③Within the two groups,the PFDI-20 and PFIQ-7 scores at 3 and 12 months after surgery were lower than those before surgery,and the difference was statistically significant(P＜0.05).PGI-Ⅰ scores were both"significantly im-proved".Subjective and objective cure rate were 100％.④The POP-Q indicator points(Aa,Ba,C,Ap,Bp,gh,pb,TVL)of both groups at 3 and 12 months after surgery were better than those before surgery(P＜0.05),achie-ving satisfactory anatomical reduction.Conclusions:RASC is safe and feasible in the treatment of overweight and obese patients with POP.Compared to LSC,RASC has significantly shorter operation time,less blood loss,faster postoperative intestinal function recovery,shorter postoperative hospital stay,and stable short-term effect.Therefore,RASC can provide a new choice for overweight/obese patients with POP.

Objective:To compare the short-term efficacy of robotic-assisted sacrocolpopexy(RASC)and lap-aroscopic sacrocolpopexy(LSC)in overweight/obese patients with pelvic organ prolapse(POP),and to evaluate the advantages of RASC.Methods:We retrospectively collected the clinical data of overweight/obese(body mass index≥24 kg/m2)patients over 50 years old with POP who underwent sacrocolpopexy in the Department of Gynecology of the First Affiliated Hospital of Zhengzhou University from November 2014 to June 2023.According to the surgical method,they were divided into robotic group(68 cases)and laparoscopic group(110 cases).The intraoperative,postoperative and short-term follow-up outcomes of the two groups were compared.Pelvic Floor Distress Inventory-short form 20(PFDI-20),Pelvic Floor Impact Questionnaire-short form 7(PFIQ-7)and the Patient Global Impression of Improvement(PGI-Ⅰ)were used to evaluate surgical outcomes.Results:①No intra-operative conversion to laparotomy was found in both groups.Compared with the laparoscopic group,the robotic group had shorter operation time,less intraoperative blood loss,shorter postoperative anal exhaust time,and shor-ter postoperative hospital stay.The difference was statistically significant(P＜0.05).②There were no intraopera-tive complications in the robot group.While in the laparoscopic group,there was 1 case of bladder injury.③Within the two groups,the PFDI-20 and PFIQ-7 scores at 3 and 12 months after surgery were lower than those before surgery,and the difference was statistically significant(P＜0.05).PGI-Ⅰ scores were both"significantly im-proved".Subjective and objective cure rate were 100％.④The POP-Q indicator points(Aa,Ba,C,Ap,Bp,gh,pb,TVL)of both groups at 3 and 12 months after surgery were better than those before surgery(P＜0.05),achie-ving satisfactory anatomical reduction.Conclusions:RASC is safe and feasible in the treatment of overweight and obese patients with POP.Compared to LSC,RASC has significantly shorter operation time,less blood loss,faster postoperative intestinal function recovery,shorter postoperative hospital stay,and stable short-term effect.Therefore,RASC can provide a new choice for overweight/obese patients with POP.

Objective:To compare the short-term efficacy of robotic-assisted sacrocolpopexy(RASC)and lap-aroscopic sacrocolpopexy(LSC)in overweight/obese patients with pelvic organ prolapse(POP),and to evaluate the advantages of RASC.Methods:We retrospectively collected the clinical data of overweight/obese(body mass index≥24 kg/m2)patients over 50 years old with POP who underwent sacrocolpopexy in the Department of Gynecology of the First Affiliated Hospital of Zhengzhou University from November 2014 to June 2023.According to the surgical method,they were divided into robotic group(68 cases)and laparoscopic group(110 cases).The intraoperative,postoperative and short-term follow-up outcomes of the two groups were compared.Pelvic Floor Distress Inventory-short form 20(PFDI-20),Pelvic Floor Impact Questionnaire-short form 7(PFIQ-7)and the Patient Global Impression of Improvement(PGI-Ⅰ)were used to evaluate surgical outcomes.Results:①No intra-operative conversion to laparotomy was found in both groups.Compared with the laparoscopic group,the robotic group had shorter operation time,less intraoperative blood loss,shorter postoperative anal exhaust time,and shor-ter postoperative hospital stay.The difference was statistically significant(P＜0.05).②There were no intraopera-tive complications in the robot group.While in the laparoscopic group,there was 1 case of bladder injury.③Within the two groups,the PFDI-20 and PFIQ-7 scores at 3 and 12 months after surgery were lower than those before surgery,and the difference was statistically significant(P＜0.05).PGI-Ⅰ scores were both"significantly im-proved".Subjective and objective cure rate were 100％.④The POP-Q indicator points(Aa,Ba,C,Ap,Bp,gh,pb,TVL)of both groups at 3 and 12 months after surgery were better than those before surgery(P＜0.05),achie-ving satisfactory anatomical reduction.Conclusions:RASC is safe and feasible in the treatment of overweight and obese patients with POP.Compared to LSC,RASC has significantly shorter operation time,less blood loss,faster postoperative intestinal function recovery,shorter postoperative hospital stay,and stable short-term effect.Therefore,RASC can provide a new choice for overweight/obese patients with POP.

Objective:To compare the short-term efficacy of robotic-assisted sacrocolpopexy(RASC)and lap-aroscopic sacrocolpopexy(LSC)in overweight/obese patients with pelvic organ prolapse(POP),and to evaluate the advantages of RASC.Methods:We retrospectively collected the clinical data of overweight/obese(body mass index≥24 kg/m2)patients over 50 years old with POP who underwent sacrocolpopexy in the Department of Gynecology of the First Affiliated Hospital of Zhengzhou University from November 2014 to June 2023.According to the surgical method,they were divided into robotic group(68 cases)and laparoscopic group(110 cases).The intraoperative,postoperative and short-term follow-up outcomes of the two groups were compared.Pelvic Floor Distress Inventory-short form 20(PFDI-20),Pelvic Floor Impact Questionnaire-short form 7(PFIQ-7)and the Patient Global Impression of Improvement(PGI-Ⅰ)were used to evaluate surgical outcomes.Results:①No intra-operative conversion to laparotomy was found in both groups.Compared with the laparoscopic group,the robotic group had shorter operation time,less intraoperative blood loss,shorter postoperative anal exhaust time,and shor-ter postoperative hospital stay.The difference was statistically significant(P＜0.05).②There were no intraopera-tive complications in the robot group.While in the laparoscopic group,there was 1 case of bladder injury.③Within the two groups,the PFDI-20 and PFIQ-7 scores at 3 and 12 months after surgery were lower than those before surgery,and the difference was statistically significant(P＜0.05).PGI-Ⅰ scores were both"significantly im-proved".Subjective and objective cure rate were 100％.④The POP-Q indicator points(Aa,Ba,C,Ap,Bp,gh,pb,TVL)of both groups at 3 and 12 months after surgery were better than those before surgery(P＜0.05),achie-ving satisfactory anatomical reduction.Conclusions:RASC is safe and feasible in the treatment of overweight and obese patients with POP.Compared to LSC,RASC has significantly shorter operation time,less blood loss,faster postoperative intestinal function recovery,shorter postoperative hospital stay,and stable short-term effect.Therefore,RASC can provide a new choice for overweight/obese patients with POP.

Objective:To compare the short-term efficacy of robotic-assisted sacrocolpopexy(RASC)and lap-aroscopic sacrocolpopexy(LSC)in overweight/obese patients with pelvic organ prolapse(POP),and to evaluate the advantages of RASC.Methods:We retrospectively collected the clinical data of overweight/obese(body mass index≥24 kg/m2)patients over 50 years old with POP who underwent sacrocolpopexy in the Department of Gynecology of the First Affiliated Hospital of Zhengzhou University from November 2014 to June 2023.According to the surgical method,they were divided into robotic group(68 cases)and laparoscopic group(110 cases).The intraoperative,postoperative and short-term follow-up outcomes of the two groups were compared.Pelvic Floor Distress Inventory-short form 20(PFDI-20),Pelvic Floor Impact Questionnaire-short form 7(PFIQ-7)and the Patient Global Impression of Improvement(PGI-Ⅰ)were used to evaluate surgical outcomes.Results:①No intra-operative conversion to laparotomy was found in both groups.Compared with the laparoscopic group,the robotic group had shorter operation time,less intraoperative blood loss,shorter postoperative anal exhaust time,and shor-ter postoperative hospital stay.The difference was statistically significant(P＜0.05).②There were no intraopera-tive complications in the robot group.While in the laparoscopic group,there was 1 case of bladder injury.③Within the two groups,the PFDI-20 and PFIQ-7 scores at 3 and 12 months after surgery were lower than those before surgery,and the difference was statistically significant(P＜0.05).PGI-Ⅰ scores were both"significantly im-proved".Subjective and objective cure rate were 100％.④The POP-Q indicator points(Aa,Ba,C,Ap,Bp,gh,pb,TVL)of both groups at 3 and 12 months after surgery were better than those before surgery(P＜0.05),achie-ving satisfactory anatomical reduction.Conclusions:RASC is safe and feasible in the treatment of overweight and obese patients with POP.Compared to LSC,RASC has significantly shorter operation time,less blood loss,faster postoperative intestinal function recovery,shorter postoperative hospital stay,and stable short-term effect.Therefore,RASC can provide a new choice for overweight/obese patients with POP.

Objective:To compare the short-term efficacy of robotic-assisted sacrocolpopexy(RASC)and lap-aroscopic sacrocolpopexy(LSC)in overweight/obese patients with pelvic organ prolapse(POP),and to evaluate the advantages of RASC.Methods:We retrospectively collected the clinical data of overweight/obese(body mass index≥24 kg/m2)patients over 50 years old with POP who underwent sacrocolpopexy in the Department of Gynecology of the First Affiliated Hospital of Zhengzhou University from November 2014 to June 2023.According to the surgical method,they were divided into robotic group(68 cases)and laparoscopic group(110 cases).The intraoperative,postoperative and short-term follow-up outcomes of the two groups were compared.Pelvic Floor Distress Inventory-short form 20(PFDI-20),Pelvic Floor Impact Questionnaire-short form 7(PFIQ-7)and the Patient Global Impression of Improvement(PGI-Ⅰ)were used to evaluate surgical outcomes.Results:①No intra-operative conversion to laparotomy was found in both groups.Compared with the laparoscopic group,the robotic group had shorter operation time,less intraoperative blood loss,shorter postoperative anal exhaust time,and shor-ter postoperative hospital stay.The difference was statistically significant(P＜0.05).②There were no intraopera-tive complications in the robot group.While in the laparoscopic group,there was 1 case of bladder injury.③Within the two groups,the PFDI-20 and PFIQ-7 scores at 3 and 12 months after surgery were lower than those before surgery,and the difference was statistically significant(P＜0.05).PGI-Ⅰ scores were both"significantly im-proved".Subjective and objective cure rate were 100％.④The POP-Q indicator points(Aa,Ba,C,Ap,Bp,gh,pb,TVL)of both groups at 3 and 12 months after surgery were better than those before surgery(P＜0.05),achie-ving satisfactory anatomical reduction.Conclusions:RASC is safe and feasible in the treatment of overweight and obese patients with POP.Compared to LSC,RASC has significantly shorter operation time,less blood loss,faster postoperative intestinal function recovery,shorter postoperative hospital stay,and stable short-term effect.Therefore,RASC can provide a new choice for overweight/obese patients with POP.