Objective To analyze the technical essentials of single-microport assisted micro-uni-port thoracoscopic surgery, and to investigate its surgical efficacy and promotional value. Methods Clinical data of patients who consecutively underwent radical upper lobectomy in the Department of Thoracic Surgery of Xi'an International Medical Center Hospital from March 2023 to June 2024 were retrospectively analyzed. According to the surgical approach, patients were divided into two groups: the single-microport assisted group (underwent upper lobectomy via single-microport assisted micro-uni-port thoracoscopy) and the traditional uniportal group (underwent traditional uniportal thoracoscopic lobectomy). Clinical outcomes were compared between the two groups. Results A total of 62 patients were enrolled. There were 30 patients in the single-microport assisted group, with a mean age of (57.4±10.8) years, and 32 patients in the traditional uniportal thoracoscopic group, with a mean age of (57.6±8.7) years. The baseline data were comparable between the two groups. All patients in both groups successfully underwent minimally invasive surgery without conversion to thoracotomy. The operative time in the single-microport assisted group was significantly shorter than that in the traditional uniportal group [(146.03±30.79) min vs. (171.41±36.41) min, P=0.004]. However, there were no statistically significant differences between the two groups in intraoperative blood loss, number of dissected lymph nodes, duration of chest tube drainage, postoperative pain score, postoperative hospital stay, hospitalization cost, or incidence of postoperative complications (all P>0.05). Conclusion Single-microport assisted micro-uni-port thoracoscopic surgery for upper lobectomy can maximally integrate the advantages of three-port and uni-port VATS while effectively avoiding their disadvantages. It significantly shortens the operative time without increasing postoperative pain or complications, and represents a more minimally invasive, safer, and more convenient surgical approach.

AIM To investigate the impact of varying dosages of Supplemented Wendan Decoction on the PI3K/Akt/FOXO1 glycolipid metabolic pathway in 3T3-L1 adipocytes.METHODS The CCK-8 assay was used to determine the concentration of Supplemented Wendan Decoction-medicated serum.The mature adipocytes differentiated from 3T3-L1 preadipocytes after induction were further divided into the blank control group,the model group,the rosiglitazone group(10 mg/L),and the Supplemented Wendan Decoction groups(5％,10％,and 20％),followed by the sample collections after 48 hours of treatment.Oil red O staining quantified lipid accumulation in 3T3-L1 adipocytes;extracellular glucose levels were measured using glucose oxidase(GOD)assay;RT-qPCR analyzed mRNA expressions of IRS-1,PI3K,Akt,GLUT4,IL-6,TNF-α and IL-1β;Western blot assessed protein expressions of INSR,IRS-1,PI3K-p85,Akt,FOXO1 and GLUT4.RESULTS No significant changes in cell viability(P＞0.05)were observed in 3T3-L1 preadipocytes exposed to serum containing supplemented Wendan Decoction at different concentrations for 24,48,or 72 hours.The 3T3-L1 preadipocytes held the capacity to differentiate into mature adipocytes within a 14-day induction period.Compared to the model group,all supplemented Wendan Decoction groups exhibited reduced lipid accumulation in adipocytes and downregulated mRNA expression of IRS-1,IL-6,TNF-α and IL-1β(P＜0.01);the low-dose group demonstrated increased mRNA expressions of PI3K and GLUT4(P＜0.05,P＜0.01),alongside elevated protein expressions of INSR,IRS-1,PI3K-p85,Akt and GLUT4(P＜0.05,P＜0.01);the medium-dose group showed enhanced GLUT4 mRNA expression,and upregulated protein expressions of INSR and FOXO1(P＜0.01).After 24 hours intervention,the high-dose Supplemented Wendan Decoction group exhibited increased glucose consumption in adipocytes(P＜0.01),and elevated protein expression of INSR,Akt and FOXO1(P＜0.05,P＜0.01).CONCLUSION Supplemented Wendan Decoction reduces lipid accumulation in adipocytes,regulates glucose and lipid metabolism,and promotes metabolic homeostasis through PI3K/Akt/FOXO1 signaling pathway.

Objective To study the effect of wall thickness on the accuracy(trueness and precision)of 3D printed models.Methods The 3D scanning data of the standard gypsum dental arch model was imported into Exocad software.And four sets of models were de-signed,including horseshoe shaped solid model and horseshoe shaped hollow models with different wall thicknesses(2 mm,3 mm,4 mm).On the first and seventh day after printing,the 3D scanning data of resin models were imported into Geomagic software.Deviation analysis were performed on 3D printed models for the root mean square(root mean square,RMS).Results The trueness range of the four groups of printed models on the first day was(34.63±4.17)μm to(45.26±6.50)μm,there was no statistical difference.The pre-cision range was(30.25±10.18)μm to(47.65±14.77)μm,and the precision of the solid group was lower than the other three groups(P＜0.05).The trueness range of the four groups of printing models on the 7th day was(49.00±9.11)μm to(69.25±9.70)μm.The trueness of the 2 mm wall thickness group was lower than that of the solid group and the 4 mum wall thickness group(P＜0.05).Con-clusion The accuracy of printing models with different wall thicknesses was within the clinical acceptance range.There was no statisti-cally significant difference in the trueness values of the four groups of printing models on the first day.The precision value of the solid group was the lowest.On the 7th day,the trueness of the wall thickness of 2 mm group was lower than that of the solid group and the 4 mum wall thickness group.

OBJECTIVE: Asthma imposes a significant global health burden. This study examines changes in the asthma-related disease burden from 1990 to 2021 and projects future burdens for 2050 under different scenarios. METHODS: Using data from the Global Burden of Disease 2021 study, we analyzed asthma incidence, prevalence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2021. We projected the disease burden for 2050 based on current trends and hypothetical scenarios in which all risk factors are controlled. Temporal trends in age-standardized incidence, prevalence, mortality, and DALY rates were explored using Annual Percent Change. RESULTS: In 2021, the age-standardized rates for asthma incidence, prevalence, mortality, and DALYs in China were 364.17 per 100,000 (95% uncertainty interval [ UI]: 283.22-494.10), 1,956.49 per 100,000 (95% UI: 1,566.68-2,491.87), 1.47 per 100,000 (95% UI: 1.15-1.79), and 103.76 per 100,000 (95% UI: 72.50-145.46), respectively. A higher disease burden was observed among Chinese men and individuals aged 70 years or older. Compared to the current trend, a combined scenario involving improvements in environmental factors, behavioral and metabolic health, child nutrition, and vaccination resulted in a greater reduction in the disease burden caused by asthma. CONCLUSION Addressing modifiable risk factors is essential for further reducing the asthma-related disease burden.
Humans ; Asthma/mortality* ; China/epidemiology* ; Male ; Female ; Adult ; Middle Aged ; Aged ; Child ; Adolescent ; Global Burden of Disease/trends* ; Child, Preschool ; Young Adult ; Infant ; Cost of Illness ; Disability-Adjusted Life Years ; Prevalence ; Incidence ; Infant, Newborn ; Aged, 80 and over ; Risk Factors

Objective To analyze the epidemiological characteristics and spatiotemporal clustering of varicella in Lu'an City from 2005 to 2023, and to provide a scientific basis for optimizing varicella prevention and control strategies. Methods Data on varicella cases were collected through the Chinese Center for Disease Control and Prevention Information System. Descriptive epidemiology, temporal trend analysis, seasonal analysis, spatiotemporal clustering analysis, and spatial autocorrelation analysis were conducted using QGIS, JoinPoint, SaTScan and GeoDa software. Results The average annual reported incidence rate of varicella in Lu'an City from 2005 to 2023 was 34.55/100,000, showing a trend of initial increase followed by a decrease. The peak incidence occurred from October to January of the following year (RR=1.97, LLR=1743.95, P=0.001). Students aged 0 to 19 was the primary affected group. Spatiotemporal scan analysis revealed four types of spatiotemporal clusters, with the cluster in Jin'an District from October 2017 to December 2023 being particularly prominent (RR=2.87，LLR=1734.15，P<0.001). Spatial autocorrelation analysis indicated significant clustering of varicella cases in the main urban area (Moran's I=0.216，Z=4.786，P=0.003). Conclusion The incidence of varicella in Lu'an City exhibits distinct seasonal and spatial clustering, and schools and kindergartens in the main urban area are the key to varicella prevention and control. It is necessary to enhance the monitoring of disease outbreaks during peak periods and in key areas, and to increase the two-dose vaccination rate for varicella in areas with case aggregation and among key populations.

Objective To analyze the relationship between frailty and acute kidney injury(AKI)after hip fracture surgery in the elderly.Methods A total of 405 elderly patients who underwent hip fracture surgery in Jieyang People's Hospital from August 2021 to January 2023 were retrospectively analysed.According to the modified frailty index(mFI),they were divided into frail group(mFI≥0.27,n=112)and non-frail group(mFI<0.27,n=293).Postoperative AKI was defined according to the Kidney Disease:Improving Global Outcomes(KDIGO)criteria.After 1:1 propensity score matching(PSM),100 cases in each group were successfully matched.Univariable and multivariable logistic regression models,propensity score adjustment,PSM,inverse probability of treatment weighting(IPTW),standardized mortality ratio weighting(SMRW),pairwise algorithm(PA)weighting,and overlap weighting(OW)methods were used to analyze the relationship between frailty and postoperative AKI.Stratified analyses were performed according to age(≥80 or<80 years),gender,whether angiotensin-converting enzyme inhibitors(ACEI)/angiotensin Ⅱreceptor antagonists(ARB)were used,and whether intraoperative hypotension occurred.Results After PSM,there were no significant differences between the two groups in age,sex,surgical type,ACEI/ARB,blood urea nitrogen,serum creatinine,intraoperative blood loss,and intraoperative hypotension[standardized mean difference(SMD)<0.1].In both the original cohort and the matched cohort,the incidence of AKI was higher in frail group than in non-frail group(25.9%vs.8.9%,P<0.001;28.0%vs.11.0%,P=0.002).Analysis of the risk of postoperative AKI in elderly hip fracture patients in frail group found that compared with the non-frail group,in the univariate logistic regression model the odds ratio(OR)and a 95%confidence interval(CI)for the frail group was 3.59(2.00-6.43),P<0.001,and in the multivariable logistic regression model,the OR(95%CI)for frail group was 3.04(1.55-5.95),P=0.001.After adjustment for propensity score,the OR(95%CI)for frail group was 2.85(1.52-5.34),P=0.001,and the OR(95%CI)for frail group after PSM was 3.15(1.47-6.75),P=0.003.After IPTW,SMRW,PA weighting,and OW,the OR(95%CI)for frail group were 2.48(1.37-4.50),2.43(1.41-4.19),2.63(1.25-5.54),and 2.69(1.07-6.78),respectively,with P<0.05.The interaction tests were not statistically significant for age,sex,use of ACEI/ARB,and intraoperative hypotension(P>0.05).Conclusion In elderly patients with hip fractures,preoperative frailty may be a risk factor for postoperative AKI.

Objective To explore the anatomical landmarks and segmentation method for the intraoperative identification of the cervical segment of the internal carotid artery by studying cadaveric dissections with an endoscopic transoral medial pterygomandibular fold approach and to investigate its clinical significance.Methods The head specimens of five fresh frozen cadavers were dissected in the anatomical laboratory of the Surgical Treatment Technology Innovation Unit of Nasal Skull Base Tumor in Eye&ENT Hospital of Fudan University.The parapharyngeal space was dissected layer by layer through the endoscopic transoral medial pterygomandibular fold approach,and the location marks of parapharyngeal internal carotid artery(ppICA)and adjacent structures of ppICA were anatomically studied.The anatomical landmarks associated with ppICA were observed and characterized,and the ppICA was segmented anatomically according to its adjacent structures.Then,the length of each ppICA segment was measured.Results Muscle structures were essential anatomical landmarks for an endoscopic transoral pterygoid medial approach that identifies mandibular folds.The first layer of muscles included the superior pharyngeal constrictor,tensor veli palatini,and medial pterygoid muscles.The second layer includes the stylopharyngeus,styloglossus,longus capitis,and levator veli palatini muscles.The stylopharyngeal and levator veli palatini muscles were close to the ppICA and were reliable landmarks for locating the ppICA.Furthermore,the ppICA was divided into three segments according to their positional relationship with the ppICA.The first segment of ppICA(P1 ICA)was located between the greater horn plane of the hyoid bone and the intersection plane between the upper margin of stylopharyngeal muscle and ppICA.The second segment of ppICA(P2 ICA)was between the plane where the upper edge of the stylopharyngeal muscle intersected with the ppICA and the plane where the projection of inferior edge of the levator veli palatini muscle intersected with the ppICA.The third segment of ppICA(P3 ICA)was between the intersection of the lower margin projection of the levator veli palatini muscle and ppICA and the external orifice of the carotid canal.The P2 ICA was within an anatomical region bounded by the levator veli palatini muscle,longus capitis muscle,and stylopharyngeus muscle.This region was termed"ICA window"in this paper measured under the cadaver head specimen,the lengths of P1 ICA,P2 ICA,and P3 ICA were(36.5±7.3)mm,(15.5±1.6)mm,(7.4±1.7)mm respectively.Conclusion The muscular structure refers to the relatively constant anatomical reference landmarks within the endoscopic transoral medial pterygomandibular fold.The stylopharyngeus and levator veli palatini muscles are reliable landmarks for precisely locating and segmenting the ppICA,thus having essential clinical implications.

Objective:A method was first established for determination simultaneously of 12 elements including B,Al,Si,As,Cd,Hg,Pb,Co,Ni,V,Cu and Sb in phloroglucinol injection,and investigate the elemental impuri-ty content of commercially available phloroglucinol injection.Methods:Samples were digested with microwave-as-sisted acid and determined by inductively coupled plasma chromatography(ICP-MS).Results:This method has a good linear relationship.The average recovery rate was range from 88.9％-100.4％.The repeatability RSD were range from 0.6％-5.8％,and the precision RSD were between 0.4％-8.1％.The methodological validation meets the requirements.B,Al,Si,As,Cd,Co,Ni,V,Cu were detected to varying degrees in 9 batches of sam-ples,and there were significant differences in content among different enterprises.The sources of elemental impuri-ties were deeply explored in combination with the production process,medicinal property and pharmaceutical packa-ging material.Conclusion:The new established method has strong specificity,high accuracy,reliable results,and can be used as a quality evaluation method for elemental impurities in phloroglucinol injection.

Objective To study the effect of wall thickness on the accuracy(trueness and precision)of 3D printed models.Methods The 3D scanning data of the standard gypsum dental arch model was imported into Exocad software.And four sets of models were de-signed,including horseshoe shaped solid model and horseshoe shaped hollow models with different wall thicknesses(2 mm,3 mm,4 mm).On the first and seventh day after printing,the 3D scanning data of resin models were imported into Geomagic software.Deviation analysis were performed on 3D printed models for the root mean square(root mean square,RMS).Results The trueness range of the four groups of printed models on the first day was(34.63±4.17)μm to(45.26±6.50)μm,there was no statistical difference.The pre-cision range was(30.25±10.18)μm to(47.65±14.77)μm,and the precision of the solid group was lower than the other three groups(P＜0.05).The trueness range of the four groups of printing models on the 7th day was(49.00±9.11)μm to(69.25±9.70)μm.The trueness of the 2 mm wall thickness group was lower than that of the solid group and the 4 mum wall thickness group(P＜0.05).Con-clusion The accuracy of printing models with different wall thicknesses was within the clinical acceptance range.There was no statisti-cally significant difference in the trueness values of the four groups of printing models on the first day.The precision value of the solid group was the lowest.On the 7th day,the trueness of the wall thickness of 2 mm group was lower than that of the solid group and the 4 mum wall thickness group.

Objective:To observe any effect of combining repeated transcranial magnetic stimulation (rTMS) with electro-acupuncture in treating post-stroke cognitive impairment (PISC).Methods:Three groups of PISC patients were formed through random selection: an rTMS group, an electro-acupuncture group, and a combined group. In addition to routine medication and conventional rehabilitation training, the rTMS and electro-acupuncture groups received rTMS and electro-acupuncture treatment, while the combined group underwent both for six weeks. Before the treatment, immediately afterward and 3, 6, and 12 months later, everyone′s cognitive functioning was assessed using the Montreal Cognitive Assessment (MoCA). The modified Barthel Index (MBI), the 17-item Hamilton Depression Rating Scale (HAMD-17), and the National Institutes of Health Stroke Scale (NIHSS) were also applied. Transcranial Doppler ultrasound (TCD) was employed to measure the mean cerebral blood flow velocity (Vm), pulsatility index (PI), and breath-holding index (BHI) in the subjects′ bilateral middle cerebral arteries (MCAs). The total effectiveness rates and the incidence of adverse reactions were compared among the three groups.Results:The MoCA scores, MBI scores, HAMD-17 scores, NIHSS scores, and Vm of the MCA had improved significantly in all three groups right after the treatment. There was further significant improvement in the average MoCA scores 12 months later. The combined group showed significantly higher MoCA scores than the other two groups at each time point after the treatment. That group also had superior MBI, HAMD-17 and NIHSS scores and a better BHI compared to the other 2 groups, on average. Its total effectiveness rate was significantly higher too. There was no significant difference in the incidence of adverse reactions among the groups.Conclusions:Combining rTMS with electro-acupuncture significantly improves cognition, ADL ability, depression and neurological functioning after a stroke. The combined treatment is worthy of wider clinical application.