Objective To explore the application value of microwave ablation under ultrasound-magnetic resonance imaging(US-MRI)in the treatment of small liver cancer.Methods A total of 94 patients with small liver cancer were selected and randomly divided into observation group and control group using a random number table method,with 47 patients in each group.The observation group underwent microwave ablation under US-MRI,while the control group received surgical resection.The tumor control rate,periopera-tive indicators,liver function indicators[total bilirubin(TBIL),albumin(ALB),aspartate aminotransferase(AST),and alanine amin-otransferase(ALT)],postoperative complications,and 6-month follow-up status were compared between the two groups.Results There was no significant difference in tumor control rate between the two groups(P>0.05).In the observation group,the proportion of patients with smaller intraoperative blood loss,shorter operative time and postoperative performance status(PS)score of 0-1 was higher than those in the control group(P<0.05).After treatment,the levels of TBIL,AST and ALT were lower and the level of ALB was higher,and the incidence of complications was lower in the observation group(P<0.05).There were no significant differences between the two groups in residual lesion and recurrence(P>0.05).Conclusion The short-term efficacy of microwave ablation under US-MRI in the treatment of small liver cancer is similar to that of surgical treatment,and the microwave ablation under US-MRI can also reduce liver function injury,reduce intraoperative blood loss and shorten operation time.

Objective To investigate the safety and feasibility of the domestic SA-1000 single-port single-arm robot-assisted laparoscopic system in total hysterectomy.Methods Data from 16 patients who underwent total hysterectomy using the SA-1000 system at the Department of Obstetrics and Gynecology,The Second Affiliated Hospital of Naval Medical University,between Mar.2023 and Jan.2024 were retrospectively collected.Surgical parameters were analyzed.Postoperative pain was assessed using the visual analogue scale(VAS)at 24 h after surgery and before discharge.Incision cosmesis was evaluated 3-5 weeks postoperatively using the body image questionnaire(BIQ,score range 3-24).Results All 16 procedures were successfully completed using the SA-1000 system without conversion to open surgery,achieving a 100.0%procedural success rate.The mean whole surgery time was(234.40±56.24)min.The median robotic arm setup time was 8.0(4.0,13.5)min,and the median console operating time was 128.0(100.0,151.0)min.The median intraoperative blood loss was 100.0(100.0,200.0)mL.No perioperative complications,such as hemorrhage,infection,injury to adjacent organs(ureters,bladder,bowel),poor wound healing,or incisional hernia,were observed.The mean wound pain score at 24 h postoperatively was 3.81±1.64,decreasing to a median of 3.0(2.0,4.0)before discharge.The BIQ score assessed at 3-5 weeks postoperatively was 21.88±1.15.Conclusion The application of the domestic SA-1000 single-port single-arm robot-assisted laparoscopic system for total hysterectomy is safe and feasible,demonstrating favorable surgical outcomes.It holds promise for broader implementation and promotion in domestic medical centers.

Objective To discuss the risk of complications occurring after CT-guided percutaneous puncture pulmonary nodule biopsy and to establish its prediction model.Methods The clinical data and imaging materials of 180 patients with small pulmonary nodules,who received CT-guided percutaneous puncture pulmonary nodule biopsy at the Affiliated Hongqi Hospital of Mudanjiang Medical University of China from September 2018 to September 2023,were collected.Logistic regression analysis was used to screen out the independent risk factors for the occurrence of complications after CT-guided percutaneous puncture pulmonary nodule biopsy.Based on the results of logistic regression analysis,a risk prediction model was constructed.Results Of the 180 patients with small pulmonary nodules,42(23.33％)developed postoperative complications(complication group),including pneumothorax(n=18,10.00％),hemorrhage(n=20,11.11％),pleural reaction(n=2,1.11％),and fever(n=2,1.11％).No complication occurred in the remaining 138 patients(76.67％,non-complication group).The differences in the coexisting chronic obstructive pulmonary disease(COPD),nodule diameter,number of needle-passing across the pleura,residence time of puncture needle,and distance between lesion and chest wall between the two groups were statistically significant(all P＜0.05).Multivariate logistic regression analysis showed that coexisting COPD(OR=6.558,95％CI:1.225-9.228,P=0.028),nodule diameter＜8 mm(OR=5.387,95％CI:1.773-16.367,P=0.003),number of puncture needle-passing across the pleura ≥3(OR=2.044,95％CI:1.275-3.278,P=0.003),residence time of puncture needle＞10 min(OR=12.620,95％CI:2.687-18.557,P=0.001)and distance between lesion and chest wall ≥30 mm(OR=1.992,95％CI:1.049-2.217,P=0.035)were the independent risk factors for the occurrence of complications after CT-guided percutaneous puncture pulmonary nodule biopsy.The above determined risk factors were used as the predictors to construct a prediction model.Receiver operating characteristic(ROC)curve analysis indicated that the critical value of this model to predict the occurrence of complications after CT-guided percutaneous puncture pulmonary nodule biopsy was 35.736,the area under ROC curve(AUC)was 0.831(95％CI:0.788-0.913),the sensitivity was 73.7％(95％CI:0.705-0.882),and the specificity was 90.6％(95％CI:0.811-0.985).Conclusion The predictive risk model,which is established based on the indicators of coexisting COPD,nodule diameter＜8 mm,number of puncture needle-passing across the pleura ≥3,residence time of puncture needle＞10 min and distance between lesion and chest wall ≥30 mm,can well predict the occurrence of complications after CT-guided percutaneous puncture pulmonary nodule biopsy,and this model carries high clinical application value.

Objective:To elucidate the correlation between phase angle and malnutrition and to determine the cut-off value for phase angle to predict malnutrition in pancreatic cancer patients.Methods:This prospective cross-sectional study enrolled patients with pancreatic cancer hospitalized in the Department of Hepato-pancreato biliary Surgery at Beijing Hospital between December 2021 and March 2024. Baseline data, diet survey results, and body composition of these patients were recorded. Phase angle was measured with the InBody 720(Biospace, Korea). The Global Leadership Initiative on Malnutrition (GLIM) criteria were used to diagnose malnutrition.Results:A total of 110 cases (75 males and 35 females) aged 29-87(63.00±12.37) years were included. The prevalence of malnutrition was 63.6% (70/111) among the patients. Patients were divided into malnutrition ( n=77) and non-malnutrition ( n=33) groups as per the GLIM criteria. Phase angle was significantly lower in the malnutrition group than in the non-malnutrition group ( t=-3.808, P<0.001). Positive correlations were found between phase angle and body mass index, appendicular skeletal muscle mass index, fat-free mass index , fat-free mass, total energy intake, total protein, albumin, and prealbumin (all P<0.05).After adjusting for sex and age, low phase Angle remained an independent risk factor for malnutrition ( OR=3.809, 95% CI: 1.150-12.612, P=0.029). The cut-off values of phase angle for predicting malnutrition were 4.43 for males (with a sensitivity of 0.955, specificity of 0.585, area under the curve of 0.636; 95% CI: 0.508-0.763, P=0.037) and 4.54 for females (with a sensitivity of 1.000, specificity of 0.708, area under the curve of 0.799; 95% CI: 0.653-0.946, P<0.001). Conclusion:Phase angle may serve as a valid and simple indicator of malnutrition in pancreatic cancer patients.

Objective:To elucidate the correlation between phase angle and malnutrition and to determine the cut-off value for phase angle to predict malnutrition in pancreatic cancer patients.Methods:This prospective cross-sectional study enrolled patients with pancreatic cancer hospitalized in the Department of Hepato-pancreato biliary Surgery at Beijing Hospital between December 2021 and March 2024. Baseline data, diet survey results, and body composition of these patients were recorded. Phase angle was measured with the InBody 720(Biospace, Korea). The Global Leadership Initiative on Malnutrition (GLIM) criteria were used to diagnose malnutrition.Results:A total of 110 cases (75 males and 35 females) aged 29-87(63.00±12.37) years were included. The prevalence of malnutrition was 63.6% (70/111) among the patients. Patients were divided into malnutrition ( n=77) and non-malnutrition ( n=33) groups as per the GLIM criteria. Phase angle was significantly lower in the malnutrition group than in the non-malnutrition group ( t=-3.808, P<0.001). Positive correlations were found between phase angle and body mass index, appendicular skeletal muscle mass index, fat-free mass index , fat-free mass, total energy intake, total protein, albumin, and prealbumin (all P<0.05).After adjusting for sex and age, low phase Angle remained an independent risk factor for malnutrition ( OR=3.809, 95% CI: 1.150-12.612, P=0.029). The cut-off values of phase angle for predicting malnutrition were 4.43 for males (with a sensitivity of 0.955, specificity of 0.585, area under the curve of 0.636; 95% CI: 0.508-0.763, P=0.037) and 4.54 for females (with a sensitivity of 1.000, specificity of 0.708, area under the curve of 0.799; 95% CI: 0.653-0.946, P<0.001). Conclusion:Phase angle may serve as a valid and simple indicator of malnutrition in pancreatic cancer patients.

Objective To explore the application value of microwave ablation under ultrasound-magnetic resonance imaging(US-MRI)in the treatment of small liver cancer.Methods A total of 94 patients with small liver cancer were selected and randomly divided into observation group and control group using a random number table method,with 47 patients in each group.The observation group underwent microwave ablation under US-MRI,while the control group received surgical resection.The tumor control rate,periopera-tive indicators,liver function indicators[total bilirubin(TBIL),albumin(ALB),aspartate aminotransferase(AST),and alanine amin-otransferase(ALT)],postoperative complications,and 6-month follow-up status were compared between the two groups.Results There was no significant difference in tumor control rate between the two groups(P>0.05).In the observation group,the proportion of patients with smaller intraoperative blood loss,shorter operative time and postoperative performance status(PS)score of 0-1 was higher than those in the control group(P<0.05).After treatment,the levels of TBIL,AST and ALT were lower and the level of ALB was higher,and the incidence of complications was lower in the observation group(P<0.05).There were no significant differences between the two groups in residual lesion and recurrence(P>0.05).Conclusion The short-term efficacy of microwave ablation under US-MRI in the treatment of small liver cancer is similar to that of surgical treatment,and the microwave ablation under US-MRI can also reduce liver function injury,reduce intraoperative blood loss and shorten operation time.

Objective:To analyze the correlation between nutritional status and frailty and sarcopenia in geriatric inpatients (GIPs) planning to receive major hepatopancreatobiliary (HPB) surgery.Methods:From December, 2020 to September, 2022, GIPs who were planning to receive major HPB surgery were recruited. Nutritional assessment was performed using nutritional risk screening 2002 (NRS-2002) and Global Leadership Initiative on Malnutrition (GLIM) criteria. Frailty and sarcopenia assessment were performed using Fried frailty phenotype (FFP) and Asian Working Group for Sarcopenia (AWGS) 2019 consensus on sarcopenia diagnosis and treatment. The prevalence and concurrence of malnutrition, frailty and sarcopenia were investigated, and the correlation between nutritional status and frailty and sarcopenia was analyzed.Results:A total of 144 participants at the mean age of (70.10±7.44) years were included. The prevalence of nutritional risk, malnutrition, and severe malnutrition were 73.6% ( n ?=?106), 68.1% ( n ?=?98), and 34.7% ( n ?=?50) respectively. The prevalence of frailty was 20.8% ( n ?=?30) and that of sarcopenia was 35.4% ( n ?=?51). The prevalence of severe malnutrition increased significantly in older participants and the prevalence of nutritional risk, malnutrition and severe malnutrition decreased significantly with higher BMI. The prevalence was 35.4% (51/144) for concurrent sarcopenia and malnutrition, 19.4% (28/144) for frailty and malnutrition, 14.6% (21/144) for sarcopenia and weakness, and 14.6% (21/144) for sarcopenia, malnutrition, and weakness. There was a positive correlation between nutritional risk and frailty ( r = 0.603, P < 0.001). The risk of pre-frailty and frailty in the nutritional risk group was higher than that in the non-nutritional risk group ( χ 2 = 31.830, P < 0.001). The risk of pre-frailty and frailty in the malnutrition group was higher than that in the normal nutrition group ( χ 2 = 36.727, P < 0.001). Logistic regression analysis showed that the risk of frailty in patients with severe malnutrition was 12.303 times higher than that in patients with normal nutrition status (95% CI: 2.592 to 58.409, P = 0.002). The risk of sarcopenia in the nutritional risk group was higher than that in the non-nutritional risk group ( χ 2 = 13.982, P < 0.001). The risk of sarcopenia in the malnutrition group was higher than that in the normal nutrition group ( χ 2 = 37.066, P < 0.001). Conclusions:The prevalence and concurrence rate of malnutrition, frailty, and sarcopenia are high in GIPs undergoing major HPB surgery. GIPs with malnutrition are susceptible to frailty.

Abdomen/diagnostic imaging* ; Artificial Intelligence ; Body Composition ; Magnetic Resonance Imaging ; Practice Guidelines as Topic

OBJECTIVE： To investigate the analgesic and anti-inflammatory effects of ethanol extract from Arenga pinnata in mice/rats after intragastric administration. METHODS： The mice were randomly divided into A. pinnata ethanol extract group  and solvent control group （distilled water）， with 20 mice in each group. Maximal dosage method was used to observe the acute toxicity of ethanol extract from A. pinnata with intragastric administration. The mice were randomly divided into A. pinnata ethanol extract high-dose， medium-dose and low-dose groups [6.5， 3.25， 1.625 g/kg （by ethanol extract， similarly here in after）， i.g.]， positive control group （0.005 g/kg morphine， i.p.） and blank control group （distilled water， i.g.）. The analgesic effect was evaluated by hot plate method， and the licking latency was compared 30， 60 and 90 minutes after administration. The mice were randomly divided into A. pinnata ethanol extract high-dose， medium-dose and low-dose groups （6.5， 3.25， 1.625 g/kg， i.g.）， positive control group （loxoprofen sodium 0.023 g/kg， i.g.） and model control group （distilled water， i.g.）. The analgesic effect was evaluated by acetic acid writhing method. The writhing times within 20 minutes were compared and the writhing inhibition rate was calculated. The mice were randomly divided into A. pinnata ethanol extract high-dose， medium-dose and low-dose groups （6.5， 3.25， 1.625 g/kg， i.g.）， positive control group （morphine 0.005 g/kg， i.p.）， model control group （distilled water， i.g.）. The analgesic effect was evaluated by formalin-induced pain method. The total licking time was compared between 0-5 min and 10-40 min after formalin administration； the inhibition rate of licking was calculated. The mice were grouped according to acetic acid writhing test. The mice were given relevant medicine once a day for consecutive 3 days. The mice were given xylene to induce inflammation model， and the degree of ear swelling was compared. Rats were randomly divided into A. pinnata ethanol extract high-dose， medium-dose and low-dose groups （4.5， 2.25， 1.125 g/kg， i.g.）， positive control group （losoprofen sodium 0.016 g/kg， i.g.）， model control group （distilled water， i.g.） and blank control group （distilled water， i.g.）， once a day， for consecutive 3 days. The rats were given Freund’s complete adjuvant to induce inflammation model and then given relevant medicine for consecutive 7 d. The degree of paw swelling was compared before inflammation and within 7 days after inflammation. The number of mice/rats in each group was 8 to 14 in the analgesic and anti-inflammatory tests. RESULTS： Compared with solvent control group， the body weight of mice had no significant increase in A. pinnata ethanol extract group； no drug-induced toxicity was found. Compared with blank control group， licking latency in mice was significantly prolonged in A. pinnata ethanol extract high-dose group 30 and 60 minutes after medication （P＜0.01）. Compared with model control group， the times of writhing， total licking time and the degree of ear swelling of mice were decreased significantly in A. pinnata ethanol extract high-dose， medium-dose and low-dose groups （P＜0.05 or P＜0.01）. Compared with model control group， the degree of paw swelling began decrease significantly in A. pinnata ethanol extract high-dose group 4 h after inducing inflammation， and the effect lacted until the 7th day （P＜0.01）. CONCLUSIONS： A. pinnata ethanol extract has no significant acute oral toxicity， and possesses significant analgesic and anti-inflammatory effects.

OBJECTIVE： To optimize and improve the quality standard for Citrus reticulata formula granules. METHODS： Totally 13 batches of C. Reticulata formula granules from 4 different manufacturers were used as trial samples， and qualitative identification of hesperidin and nobiletin in the samples were carried out by TLC according to the method of 2015 edition of Chinese Pharmacopoeia （part Ⅳ）. The quantitative analysis of naringin， hesperidin， hesperetin， nobiletin and tangeretin in C. reticulatae formula granules were conducted by UPLC[The determination was performed on Waters Acquity UPLC BEH C18 column with mobile phase consisted of acetonitrile-0.2％ phosphoric acid aqueous solution （gradient elution）. The detection wavelength was set at 283 nm， and sample size was 3 μL]. RESULTS： The results of TLC showed that in the chromatograms of samples， same color spots were shown in the corresponding positions of the chromatogram of reference substance. The results of UPLC showed， that the linear range of naringin， hesperidin， hesperetin， nobiletin and tangeretin were 0.64-6.44， 15.78-157.80， 0.17-1.66， 2.08-20.85 and 2.04-20.43 μg/mL， respectively （all r≥0.999 2）； the limits of detection were 0.03， 0.33， 0.10， 0.20 and 0.06       μg/mL； the limits of quantitation were 0.07， 1.34， 0.20， 0.60 and 0.22 μg/mL. The average recoveries were 99.4％， 99.6％， 99.7％， 99.7％ and 99.7％ （n＝9）； RSDs of precision （n＝6）， stability （n＝7） and reproducibility （n＝6） tests were all≤2.03％； naringin was detected in only 3 batches of samples from one manufacturer （the content ranged from 0.067 3 to 0.069.6    mg/g）， while the other 4 components were detected in 13 batches of samples （the contents of them ranged 0.646 5-1.728 0，   0.102 6-0.290 5， 0.023 1-0.689 8， 0.018 2-0.270 7 mg/g）. CONCLUSIONS： In this study， the quality standard of C. reticulata formula granules was improved by qualitative and quantitative methods， and the contents of hesperidin， hesperetin， nobiletin and tangeretin were not less than 0.60， 0.10， 0.02 and 0.01 mg/g， respectively.