Objective Investigate the expression level and clinical significance of microRNA-223-3p(miR-223-3p)in the serum of pregnant women with preterm premature rupture of membranes(PPROM).Methods A total of 91 pregnant women who underwent cesarean delivery at the Xuzhou Maternal and Child Health Hospital affiliated with Xuzhou Medical University between April and September 2023 were selected for the study.This included 60 cases of PPROM and 31 cases of term normal pregnant women as the research subjects.The study group was divided based on the pathological results of the membranes into:PPROM group without histological chorioamnionitis(HCA)(PPROM group,n = 37),and PPROM group with HCA(PPROM+HCA group,n = 23).Serum samples from pregnant women were collected before hospital treatment,and the expression level of miR-223-3p in the serum was detected by quantitative real-time PCR(qRT-PCR).The levels of inflammatory factors such as IL-1β,IL-6,IL-8,and TNF-α in the serum were measured by enzyme-linked immunosorbent assay(ELISA).Results The expression level of miR-223-3p in the serum of the PPROM+HCA group was significantly higher than that of the PPROM group and the normal group(P＜0.05).The expression levels of IL-1β,IL-6,IL-8,and TNF-α in the serum of the PPROM+HCA group were also significantly higher than those of the PPROM group and the normal group(P＜0.05).There was a positive correlation between the expression level of miR-223-3p in the serum of the PPROM+HCA group and the expression levels of IL-1β,IL-6,IL-8,and TNF-α(r = 0.553,0.505,0438,0.656,P＜0.05).Conclusion The upregulation of miR-223-3p in the serum of pregnant women with PPROM+HCA is associated with the severity of inflammation in PPROM.

Objective:To explore the relationship between the hypertensive snowbirds′ length of migratory stay and their blood pressure control and blood pressure levels.Methods:This study was a cross-sectional study. A population of snowbirds with hypertension was recruited between October and November 2022, and a structured questionnaire was used to collect their self-measured blood pressure and length of stay in Hainan Province. The blood pressure control status is determined based on self-measured blood pressure. According to the self-measured blood pressure to determine whether the blood pressure was well controlled. The associations between snowbirds′ length of stay and their blood pressure control as well as their self-measured blood pressure were analyzed using restricted cubic splines.Results:A total of 362 research subjects were included, 169(46.7%) of whom were male, and their age was (69.7±7.0) years old. The participants′ self-measured systolic blood pressure and diastolic blood pressure were (129.1±16.2) mmHg (1 mmHg=0.133 kPa) and (78.9±10.1) mmHg, respectively. Overall, 174 (48.1%) participants attained adequate blood pressure control. The median length of stay in Wuzhishan City was 7(6, 7) months. There was an inverted U-shaped association between snowbirds′ length of stay and blood pressure control (overall: P=0.023; nonlinearity: P=0.014), where participants with a length of stay of 7 months had the highest rate of blood pressure control. There is a U-shaped curve relationship between length of stay and systolic blood pressure (overall: P=0.001; nonlinearity: P=0.033), and a linear negative correlation with diastolic blood pressure ( β=-1.19, P=0.003). Conclusions:Compared with hypertensive snowbirds with too long or too short lengths of stay, snowbirds who stayed in Wuzhishan City for seven months have better blood pressure control, and systolic blood pressure is also lower.

Five new saponins, including three steroid saponins, paristenoids A-C (1-3), and two triterpenoid saponins, paristenoids D-E (4-5), along with four known ones (6-9) were isolated from the rhizomes of Paris polyphylla var. stenophylla. The structures of the isolated compounds were identified mainly by detailed spectroscopic analysis, including extensive 1D and 2D NMR, MS, as well as chemical methods. Compound 3 is a new cyclocholestanol-type steroidal saponin with a rare 6/6/6/5/5 fused-rings cholestanol skeleton, and this skeleton has been first found from the genus Paris. The cytotoxicities of the isolated compounds against three human three glioma cell lines (U87MG, U251MG and SHG44) were evaluated, and compound 7 displayed certain inhibitory effect with IC₅₀ values of 15.22 ± 1.73, 18.87 ± 1.81 and 17.64 ± 1.69 μmol·L^-1, respectively.
Humans ; Rhizome/chemistry* ; Steroids/chemistry* ; Liliaceae/chemistry* ; Saponins/chemistry* ; Triterpenes/analysis*

Objectives:To analyze the clinical features and prognosis of patients with medullary thyroid carcinoma combined with papillary thyroid carcinoma (combined carcinoma).Methods:The clinical data of 24 patients admitted to Tianjin Medical University Cancer Hospital from Nov 2012 to Dec 2019 were retrospectively analyzed. The treatment methods, pathological results, and prognosis of all patients were examined.Results:The results showed that combined carcinoma accounted for 10.0% (24/241) of all medullary thyroid carcinoma cases. In the combined cancer group, 45.8% (11/24) patients had lymph node metastasis, and the type of metastasis matched the largest lesion. There were no significant differences in gendex ratio ( χ2=0.164, P>0.05), age at onset ( t=1.381, P>0.05), maximum diameter of lesion ( Z=-1.733, P>0.05), multifocality ( χ2=2.695, P>0.05), and lymph node metastasis in the central ( χ2=1.625, P>0.05) and lateral neck regions ( χ2=1.537, P>0.05) between combined cancer patients and those with MTC alone. The median follow-up time for the 24 patients was 77.6 months. Local recurrence was observed in 2 cases, while no distant metastasis was found. There were no significant differences in disease-free survival, disease-specific survival, and overall survival between combined cancer and pure MTC groups (all P>0.05). Conclusion:The pathological characteristics and prognosis of medullary thyroid carcinoma combined with papillary thyroid carcinoma are similar to those of pure MTC. Therefore, clinical treatment decisions can be similar to pure MTC.

Thoracic trauma has the characteristics of complexity, specificity, urgency and severity. Therefore, the treatment is particularly important. Thoracic Traumatology Group, Trauma Medicine Branch of Zhejiang Medical Association organized the writing of the thoracic trauma and further optimization consensus of Zhejiang thoracic surgery industry Treatment and diagnosis of rib and sternum trauma: A consensus statement by Zhejiang Association for Thoracic Surgery (version 2021), compiled the popular science book Emergency Treatment and Risk Avoidance Strategy of Thoracic Trauma and Illustration of Real Scene Treatment of Trauma, actively prepared to build the trauma database of Zhejiang Province, and participated in the construction of trauma group in the Yangtze River Delta. Although Zhejiang Province has carried out many related works in the diagnosis and treatment of chest trauma, it is still inconsistent with the development requirements of the times. Standardization of chest trauma treatment, popularization of relevant knowledge, management of trauma big data, grass-roots radiation promotion tour and further optimization of industry consensus are the requirements and objectives of this era.

The application of robots in thoracic surgery is mainly based on the da Vinci general surgery robot. With the popularization of artificial intelligence (AI) application scenarios, the combination of AI and robots is more closely, and there is a strong clinical demand and huge application space for the development of specialized disease-specific robotic systems for thoracic surgery. This article aims to systematically describe the history of the rise of specialized surgical robots and the status of the localization of surgical robots in China, propose the concept of applying AI to the research and development of integrated specialized disease-specific robots in thoracic surgery, and clarify the ethics and prospects that intelligent specialized disease-specific surgical robots will face.

Hypertension is an important risk factor for the morbidity and mortality of cardiovascular and cerebrovascular diseases. Improving compliance is the key to the prevention and control of hypertension in community. This paper summarizes the improvement of compliance of patients with hypertension， analyzes the ideas and feasibility of assisting hypertension community prevention and control from three aspects： improving medication compliance， improving behavior compliance and digital intelligent management， and puts forward corresponding suggestions to improve the compliance of patients with hypertension.

Objective To propose two novel methods based on deep learning for computer-aided tongue diagnosis, including tongue image segmentation and tongue color classification, improving their diagnostic accuracy. Methods LabelMe was used to label the tongue mask and Snake model to optimize the labeling results. A new dataset was constructed for tongue image segmentation. Tongue color was marked to build a classified dataset for network training. In this research, the Inception + Atrous Spatial Pyramid Pooling (ASPP) + UNet (IAUNet) method was proposed for tongue image segmentation, based on the existing UNet, Inception, and atrous convolution. Moreover, the Tongue Color Classification Net (TCCNet) was constructed with reference to ResNet, Inception, and Triple-Loss. Several important measurement indexes were selected to evaluate and compare the effects of the novel and existing methods for tongue segmentation and tongue color classification. IAUNet was compared with existing mainstream methods such as UNet and DeepLabV3+ for tongue segmentation. TCCNet for tongue color classification was compared with VGG16 and GoogLeNet. Results IAUNet can accurately segment the tongue from original images. The results showed that the Mean Intersection over Union (MIoU) of IAUNet reached 96.30%, and its Mean Pixel Accuracy (MPA), mean Average Precision (mAP), F1-Score, G-Score, and Area Under Curve (AUC) reached 97.86%, 99.18%, 96.71%, 96.82%, and 99.71%, respectively, suggesting IAUNet produced better segmentation than other methods, with fewer parameters. Triplet-Loss was applied in the proposed TCCNet to separate different embedded colors. The experiment yielded ideal results, with F1-Score and mAP of the TCCNet reached 88.86% and 93.49%, respectively. Conclusion IAUNet based on deep learning for tongue segmentation is better than traditional ones. IAUNet can not only produce ideal tongue segmentation, but have better effects than those of PSPNet, SegNet, UNet, and DeepLabV3+, the traditional networks. As for tongue color classification, the proposed network, TCCNet, had better F1-Score and mAP values as compared with other neural networks such as VGG16 and GoogLeNet.

Metastatic castration-resistant prostate cancer (mCRPC) is the inevitable form of most prostate cancers after endocrine therapy, and conventional drugs are not effective at this time.In this case, an elderly mCRPC patient with cardiopulmonary diseases admitted to the First Hospital of Shanxi Medical University in August 2020 was selected. After the failure of traditional endocrine therapy, enzalumide+ ADT regimen was adopted, and the patient's blood PSA was significantly reduced without cardiopulmonary adverse events.

Objective:To investigate the long-term effects of porcine small intestinal submucosa (SIS) biologic mesh in open Lichtenstein tension-free hernia repair.Methods:The prospective randomized controlled study was conducted. The clinical data of 76 patients with unilateral inguinal hernia who underwent open Lichtenstein tension-free hernia repair in 2 medical centers (52 cases in Tianjin People′s Hospital and 24 cases in China-Japan Friendship Hospital) from August 2013 to March 2014 were selected. Based on random number method, patients were allocated into two groups. Patients undergoing Lichtenstein tension-free hernia repair using Biodesign Surgisis mesh were allocated into control group, and patients undergoing Lichtenstein tension-free hernia repair using SIS biologic mesh were allocated into experiment group. Observa-tion indicators: (1) grouping situations of the enrolled patients; (2) postoperative long-term effects. Follow-up was conducted using telephone interview, text message or mail to detect hernia recurrence or death due to other reasons as the end-point event of patients up to December 2019. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented by M (range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Results:(1) Grouping situations of the enrolled patients: a total of 76 patients were selected for eligibility. There were 38 cases in the control group and the experiment group, respectively. The number of males and females, age, body mass index, cases with intraspinal anesthesia or local anesthesia (anesthesia method), cases with inguinal hernia on the left side or on the right side, cases classified as type Ⅰ, Ⅱ, Ⅲ, Ⅳ or Ⅴ of Gilbert classification, operation time of the control group were 35, 3, (56±15)years, (23.0±2.0)kg/m 2, 22, 16, 16, 22, 9, 16, 0, 11, 2 and (49±15)minutes, respectively. The above indicators of the experiment group were 34, 4, (54±13)years, (22.9±2.2)kg/m 2, 17, 21, 14, 24, 9, 21, 1, 7, 0, and (53±21)minutes, respectively. There was no significant difference in the above indicators between the two groups ( χ2=0.157, t=0.532, 0.367, χ2=1.317, 0.220, Z=-0.315, t=-0.765, P>0.05). (2) Post-operative long-term effects: 35 patients of the control group were followed up for (68.8±2.7)months, 4 cases of which died due to other reasons, 1 case had hernia recurrence, 1 case had chronic pain and no foreign body sensation and postoperative infection occurred. Thirty-one patients of the experiment group were followed up for (68.8±2.7)months, with no death or above complications. There was no significant difference in hernia recurrence or chronic pain between the two groups ( P>0.05). Conclusion:The long-term effects of biological mesh in open Lichtenstein tension-free hernia repair is satisfactory and there is no difference in the long-term effects between the domestic SIS biological mesh and Biodesign Surgisis mesh.