Objective To interpret the major updates in the "2026 ACC/AHA Guideline on the Management of Dyslipidemia" and provide guidance for perioperative and long-term lipid management in patients undergoing cardiovascular surgery. Methods Based on the 2026 guideline and relevant cardiovascular outcome studies, this article summarized key aspects of lipid management across the entire life span, PREVENT-ASCVD risk assessment, low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) targets, lipoprotein(a) and apolipoprotein B testing, management of hypertriglyceridemia, and the use of non-statin therapies, while analyzing their clinical implications from the perspective of cardiovascular surgery. Results The 2026 guideline expanded the focus of lipid management from simple cholesterol control to comprehensive, lifelong lipid protein risk management across the entire spectrum. It recommended the PREVENT-ASCVD model, integrated risk-enhancing factors and coronary artery calcium scores to refine risk stratification, re-established LDL-C and non-HDL-C targets, strengthened management of lipoprotein(a), apolipoprotein B, and hypertriglyceridemia, and emphasized early combination lipid-lowering therapy. These updates helped identify residual cardiovascular risks in surgical patients, promoted postoperative lipid target achievement, and supported long-term secondary prevention. Conclusion The 2026 guideline advances lipid management toward precise risk stratification, goal-directed therapy, and longitudinal intervention. Standardized lipid assessment and lipid-lowering therapy should be integrated into perioperative and long-term postoperative management in cardiovascular surgery to improve long-term patient outcomes.

Objective To evaluate and compare the long-term efficacy of endoscopic radiofrequency ablation(RFA)and photodynamic therapy(PDT)combined with biliary stenting for the treatment of unresectable extrahepatic cholangiocarcinoma.Methods Clinical data of patients with cholangiocarcinoma who received endoscopic RFA or PDT treatment from February 2018 to February 2023 were retrospectively collected.The patients were divided into RFA group(n=30,received endoscopic RFA combined with biliary stent placement)and PDT group(n=20,received PDT combined with biliary stent placement).The frequency of treatment,stent patency time,overall survival time and adverse events incidence were counted.The factors affecting the survival time of patients were analyzed.Results The overall survival time was 14.0(95%CI:11.8～16.2)months in RFA group and 18.0(95%CI:15.4～20.6)months in PDT group,the median patency time of stent was 4.0(95%CI:2.7～5.3)months in RFA group and 3.5(95%CI:2.3～4.7)months in PDT group,the differences were not statistically significant(P>0.05).Multivariate Cox regression analysis showed that the H＾R of patients with≥2 endoscopic RFA or PDT treatments was 2.417,which was a protective factor affecting overall survival(P=0.018),while the H＾R of TNM stage Ⅲ to Ⅳ was 0.300,which was a risk factor affecting the overall survival period(P=0.002).No significant difference was found in clinical success rate(both 100.00%)and adverse events incidence between the two groups[28.13%(9/32)vs.23.81%(5/21)],the difference was not statistically significant(P>0.05).Conclusion The long-term efficacy of endoscopic RFA or PDT combined with biliary stenting in the treatment of unresectable extrahepatic cholangiocarcinoma is comparable,while the sequential treatment of endoscopic RFA or PDT≥2 times can effectively prolong the overall survival of patients.

Objective To evaluate and compare the long-term efficacy of endoscopic radiofrequency ablation(RFA)and photodynamic therapy(PDT)combined with biliary stenting for the treatment of unresectable extrahepatic cholangiocarcinoma.Methods Clinical data of patients with cholangiocarcinoma who received endoscopic RFA or PDT treatment from February 2018 to February 2023 were retrospectively collected.The patients were divided into RFA group(n=30,received endoscopic RFA combined with biliary stent placement)and PDT group(n=20,received PDT combined with biliary stent placement).The frequency of treatment,stent patency time,overall survival time and adverse events incidence were counted.The factors affecting the survival time of patients were analyzed.Results The overall survival time was 14.0(95%CI:11.8～16.2)months in RFA group and 18.0(95%CI:15.4～20.6)months in PDT group,the median patency time of stent was 4.0(95%CI:2.7～5.3)months in RFA group and 3.5(95%CI:2.3～4.7)months in PDT group,the differences were not statistically significant(P>0.05).Multivariate Cox regression analysis showed that the H＾R of patients with≥2 endoscopic RFA or PDT treatments was 2.417,which was a protective factor affecting overall survival(P=0.018),while the H＾R of TNM stage Ⅲ to Ⅳ was 0.300,which was a risk factor affecting the overall survival period(P=0.002).No significant difference was found in clinical success rate(both 100.00%)and adverse events incidence between the two groups[28.13%(9/32)vs.23.81%(5/21)],the difference was not statistically significant(P>0.05).Conclusion The long-term efficacy of endoscopic RFA or PDT combined with biliary stenting in the treatment of unresectable extrahepatic cholangiocarcinoma is comparable,while the sequential treatment of endoscopic RFA or PDT≥2 times can effectively prolong the overall survival of patients.

Objective:To analyze the status of hepatitis B virus (HBV) infection in pregnant women in Taizhou City in recent years and the effect of immunization management of hepatitis B vaccine project on the status.Methods:The pregnant women hospitalized in Taizhou People′s Hospital, Taizhou Second People′s Hospital, Taizhou Traditional Chinese Medicine Hospital and Taixing People′s Hospital from 2014 to 2017 were enrolled. According to the HBV serological results, the pregnant women were divided into non-immune population, successful immunization population, previous HBV infection population, HBV infection population and atypical manifestation population. The year of immunization management for the implementation of the hepatitis B vaccine plan was 1992. The HBV infection status of the pregnant women was analyzed based on the year of delivery and vaccination status, respectively. Chi-square test and trend chi-square test were used for statistical analysis.Results:A total of 31 449 cases were included in this study, of which 13 203 (41.98%) were non-immunized, 10 123 (32.19%) were successfully immunized, 6 409 (20.38%) were previous HBV infected, 1 566(4.98%) were HBV infected, and 148(0.47%) cases were atypical manifestation. The negative rate of all HBV serological markers of pregnant women born before 1992 and after 1992 (including 1992) were 42.07%(10 794/25 657) and 41.59%(2 409/5 792), respectively, with no statistically significant difference ( χ2=0.44, P=0.51). The hepatitis B surface antibody (anti-HBs) positive rate of pregnant women born before 1992 was 28.95%(7 428/25 657), which was lower than 46.53%(2 695/5 792) of pregnant women born after 1992 (including 1992). The difference was statistically significant ( χ2=668.94, P<0.01), and showed an upward trend year by year ( χ2=602.11, P<0.01). The hepatitis B core antibody (anti-HBc) positive rate of pregnant women born after 1992 (including 1992) was 8.81%(510/5 792), which was lower than 22.99%(5 899/25 657) of pregnant women born before 1992, the difference was statistically significant ( χ2=589.10, P<0.01), and the overall trend was declining year by year ( χ2=478.72, P<0.01). The hepatitis B surface antigen (HBsAg) positive rate of pregnant women born before 1992 was 5.46%(1 402/25 657), which was higher than 2.83%(164/5 792) of pregnant women born after 1992 (including 1992), the difference was statistically significant ( χ2 =69.23, P <0.01), and the overall trend was decreasing ( χ2=49.25, P<0.01). Among pregnant women infected with HBV, the negative rate of hepatitis B e antigen (HBeAg) was 78.16%(1 224/1 566). Conclusions:Pregnant women with HBV infection in Taizhou City are mainly HBeAg negative. Hepatitis B vaccine immunization management significantly reduces the HBsAg positive rate and anti-HBc positive rate of pregnant women, and increases the positive rate of anti-HBs, while the rate of all HBV serum marker negative is not significantly decreased. Horizontal transmission may still be a risk factor for HBV present and previous infections.

Objective To identify the main compositions of urinary calculi found in pediatric patients who had the history of exposing to infant formula milk powder contaminated with melamine and try to find out the urinary calculus formation mechanism in these patients.Methods Sixteen patients were studied.These infant patients with urinary calculi due to consumption of melamine tainted milk powder had been admitted to hospital from June,2008 to August,2008.The components of the urinary calculi were separated by liquid chromatograph,and identified by electrospray ionization mass spectrometry,electron bombard ionization mass spectrometry,Fourier transform infrared spectroscopy,and quantitatively determined by liquid chromatograph.Results The main chemical components of the urinary ealculi were melamine and uric acid.The molar ratio of uric acid tO melamine was 2:1.Conclusion The main urinary calculus formation mechanism in infant patients who exposed to the inrant formula milk powder contaminated with melamine is melamine and uric acid formed indissoluble complex.