Persistent left superior vena cava is a rare venous variant that is often combined with cardiovascular malformations. In thoracic surgery, especially mediastinal tumor resection, neglect of this variant may make the surgery difficult and risky, and careful preoperative imaging interpretation and adequate preoperative evaluation play an important role in the perioperative safety of the patient. In this paper, we reported a case of a 17-year-old female patient with a persistent left superior vena cava combined with mediastinal tumors. She was successfully discharged 5 days after thoracoscopic surgery, and after 3 years of postoperative follow-up, no tumor recurrence was observed.

ObjectiveTo investigate the possible mechanism of Shufeng Jiedu capsules （SFJD） in alleviating influenza A （H1N1） virus pneumonia and focus on its effect on Toll-like receptor （TLR） signaling pathway in respiratory epithelial cells. MethodsA mouse model of viral pneumonia was established via the A/PR/8/34 （PR8） strain of influenza A virus. Mice were randomly divided into a normal group， a PR8 infection （PR8） group， and an SFJD group （8.4 g·kg^-1）， with 10 mice in each group. The day of infection was designated as day 1. The SFJD group was administered intragastrically at a volume of 20 mL·kg^-1 daily， while the normal and PR8 groups were given an equal volume of deionized water. Micro-computed tomography （Micro-CT） was performed on day 5， and the mice were dissected to collect their lungs， after which the lung index was calculated to verify the therapeutic effect of SFJD. Single-cell sequencing was used to analyze the differentially expressed genes in respiratory epithelial cells. Multiplex fluorescence immunohistochemistry was employed to detect the expression of TLR， tumor necrosis factor receptor-associated factor 6 （TRAF6）， and myeloid differentiation factor 88 （MyD88） proteins in epithelial cell adhesion molecule （EpCAM）-positive cells， and the proportion of respiratory epithelial cells expressing TLR pathway proteins was calculated. Respiratory epithelial cells were then sorted by flow cytometry， and Western blot was used to detect the expression of TLR， MyD88， TRAF6， Toll-interleukin receptor domain-containing adaptor inducing interferon-β （TRIF）， inhibitor of κB kinase α （IKKα）， and nuclear factor-κB （NF-κB） in the sorted epithelial cells. Enzyme-linked immunosorbent assay （ELISA） was used to measure the levels of interleukin-1β （IL-1β） and tumor necrosis factor-α （TNF-α） in lung tissue. ResultsAt the transcriptional level， SFJD reversed the expression of TLR signaling pathway genes in respiratory epithelial cells， downregulating multiple TLR signaling pathway-related genes （P<0.01）. At the protein level， SFJD significantly reduced the proportion of respiratory epithelial cells expressing TLR3 （P<0.05）， the expression levels of TLR2， TLR3， TLR4， TRIF， TRAF6， IKKα， and NF-κB in epithelial cells（P<0.05， P<0.01）， as well as the levels of pro-inflammatory cytokines IL-1β and TNF-α in lung tissue （P<0.01）. ConclusionSFJD may alleviate viral pneumonia by suppressing the expression of TLR in respiratory epithelial cells and their subsequent signaling cascades.

BACKGROUND:Satellite cells are a specific population of adult stem cells contained in skeletal muscle that promote the regenerative reconstruction of injured skeletal muscle,but their specific mechanisms are not well established. OBJECTIVE:To review the regulatory role of satellite cells during skeletal muscle regeneration and the mechanism of interaction between satellite cells and their ecological niche signals,aiming to provide new research ideas and perspectives based on the summary of existing knowledge. METHODS:Web of Science,PubMed,CNKI,WanFang,and VIP databases were searched for literature published between January 2002 and June 2022.English search terms were"muscle,skeletal muscle,muscle injury,stem cells,satellite cells,muscle repair".Chinese search terms were"skeletal muscle,skeletal muscle regeneration,skeletal muscle reconstruction,satellite cells,ecological niche".The 66 included papers were organized and analyzed. RESULTS AND CONCLUSION:(1)Satellite cells exist in skeletal muscle and contribute to both the formation of new muscle fibers after injury and the effective growth of existing adult muscle fibers.(2)After the activation of quiescent satellite cells in satellite cells,the steps of satellite cell proliferation,differentiation and fusion to form muscle fibers during skeletal muscle regeneration are influenced by their intrinsic regulatory effects of different mechanisms.(3)Satellite cells can interact with myofibers,extracellular matrix,skeletal muscle junctions,fibroblast progenitor cells,immune cells and endothelial cells in the ecological niche signal to promote satellite cell activation,proliferation and differentiation to achieve effective skeletal muscle regeneration.(4)Possible breakthroughs in future research include:the division pattern of satellite cells in the body;the mechanisms regulating satellite cell transfer;the specific timing of satellite cell differentiation or self-renewal in vivo;and the interaction mechanisms between satellite cells and skeletal muscle junctions.(5)This review may provide some theoretical reference values for the field of injury reconstruction of skeletal muscle and its innovation.

This paper aimed to explain the clinical thinking of using the method of unblocking the bowels and harmonizing viscera. Based on theory of "viscera-bowels extraordinary connection" of The Gateway to Medicine （《医学入门》）， combined with the theoretical research， clinical practice and individual experience of ancient physicians， modern scholars， it is believed that viscera qi disorder caused by bowels qi blocking is the basic mechanism of insomnia. In clinic， it is common that gallbladder phlegm-heat harassing the heart spirit， stagnant blood and qi in stomach blocking the pericardium， turbid heat in large intestine causing fire and affecting liver， dampness insmall intestine trapping the spleen， water retention in the bladder drying up lungs， and the inhibited original qi of sanjiao damaging the kidney， which could be treated with Wendan Decoction （温胆汤）， Taohe Chengqi Decoction （桃核承气汤）， Chengqi-series Decoction （承气汤类方）， Linggui Zhugan Decoction （苓桂术甘汤）， Wuling Powder （五苓散）， Xiaochaihu Decoction （小柴胡汤）， respectively.

AIM: To investigate the effect of a new type of rhinodacryocystostomy combined with fluticasone propionate on patients with chronic dacryocystitis.METHODS: A total of 100 patients(100 eyes)with chronic dacryocystitis who admitted to our hospital between January 2021 and December 2022 were enrolled in the prospective study. The patients in the study were divided into a control group(n=50)and an observation group(n=50)based on their admission order and number. Patients in the control group were treated with novel rhinodacryocystostomy, while patients in the observation group were treated with a new type of rhinodacryocystostomy combined with fluticasone propionate. The preoperative and postoperative best corrected visual acuity(BCVA), quality of life score, and recurrence of chronic dacryocystitis were compared between the two groups of patients.RESULTS: All patients completed the postoperative 6 mo follow-up, and the total effective rate of patients in the observation group was better than that of patients in the control group(98% vs 84%, P=0.001). There was no significant difference in preoperative and postoperative BCVA between the two groups(P>0.05). Preoperatively, there was no significant difference in the quality of life scores between the two groups of patients(P>0.05); At 6 mo postoperatively, the quality of life scores of patients in the control group, including physical function, psychological function, social function, and material life status, were lower than those in the observation group(all P<0.001). There were 9 recurrences in the control group(18%)and 1 in the observation group(2%), and there was statistical significance in the postoperative recurrence rate between the two groups(χ2=-2.739, P=0.001).CONCLUSION: The new type of rhinodacryocystostomy combined with fluticasone propionate treatment for chronic dacryocystitis patients has a good therapeutic effect, can improve the quality of life of patients, and reduce the probability of disease recurrence.

The online and offline hybrid teaching model of evidence-based medicine (EBM) is currently in the stage of development. Previous teaching focused on the teaching process in the classroom, and did not organically combine all the course contents before, during, and after class. The BOPPPS model can be used to establish coherence and integrity in the EBM teaching process. Considering the discipline characteristics and teaching objectives of EBM, this study initially explored and designed a BOPPPS-based online and offline hybrid teaching model. Taking the "diagnostic evidence" module as an example, the teaching implementation details were introduced. A pre-designed questionnaire was used to conduct baseline survey and follow-up survey on students before and after class to evaluate the teaching model and effect. The surveys showed that half of the students (77/154) preferred the new online and offline hybrid teaching model of EBM. The students found that all aspects of BOPPPS teaching were generally acceptable and satisfactory. Compared with before teaching, the students' proficiency in EBM was significantly improved after the teaching ( P<0.001), particularly in their ability to retrieve literature and evaluate the quality of evidence, which is of great significance for expanding their knowledge and clinical thinking.

Objective To observe the body surface calorific value characteristics of Governor Vessel and Conception Vessel,triple energizer,and zang-fu organs chronic insomnia patients with heart-spleen deficiency syndrome through infrared thermal imaging technology.Methods Totally 150 patients with chronic insomnia with heart-spleen deficiency syndrome who were treated in the outpatient department of Shenzhen Hospital of Beijing University of Chinese Medicine(Longgang)from December 2021 to December 2022 were selected as the observation group.Another 50 healthy subjects were recruited as the normal control group.Infrared thermal imaging technology was used to collect and measure the temperature of surface areas of Governor Vessel and Conception Vessel,triple energizer,and zang-fu organs,and the calorific values were analyzed and compared.Results Compared with healthy subjects,chronic insomnia patients with heart-spleen deficiency syndrome had a statistically significant decrease in the temperature of the Governor Vessel(P<0.05);there were statistically significant decreased in the temperature of upper energizer and middle energizer(P<0.05);there were statistically significant decreased in the temperature of chest,apex,right chest,epigastric region,big abdomen,and the temperature of left and right flank increased(P<0.05).Conclusion There were significant differences in infrared thermography distribution characteristics of Governor Vessel and Conception Vessel,triple energizer,and zang-fu organs between patients with chronic insomnia with heart-spleen deficiency syndrome and healthy subjects,which can provide some reference for the clinical diagnosis and syndrome differentiation of chronic insomnia with heart-spleen deficiency syndrome.

Objective To develop the'E-Bone',a comprehensive one-stop preoperative planning system for reverse total shoulder arthroplasty with improved accuracy and efficiency.Methods The nnU-net deep neural network was utilized for scapula segmentation to obtain precise scapula segmentation results.Based on the 3 key factors,namely bone density,upward and downward angle and nail length,the base was automatically positioned.The quantitative parameters required for surgical planning were calculated.A personalized guide plate was generated by combining glenoid morphology and base positioning information.The system interface was developed to modularize various functions for easy use,providing interactive operation and real-time display.Results Compared with the Mimics system,the'E-bone'preoperative planning system reduced complex manual adjustments during the planning process.The average planned nail length was longer than that of the Mimics system,and the planning time was reduced by 86%.The scapula segmentation accuracy of this system reached 99.93%,better than that of Mimics to achieve a higher precision.Conclusion The"E-bone"system provides a one-stop,efficient,and accurate preoperative planning system for reverse shoulder replacement and potentially broader clinical applications.

Non-alcoholic fatty liver disease(NAFLD)is a series of diseases characterized by hepatic steatosis and is also a metabolism-associated disease and an important factor for liver fibrosis,liver cirrhosis,and hepatocellular carcinoma.Endoplasmic reticulum is a core organelle for the regulation of lipid metabolism,and unfolded protein response is an important process of endoplasmic reticulum stress(ERS).Based on the important stress role of endoplasmic reticulum in metabolism-associated diseases,this article explores the influencing mechanism between ERS and NAFLD and reviews the research advances in lipid metabolism,inflammatory response,hepatocyte death,fibrosis,and ERS-targeted therapies in the pathological development of NAFLD.

Objective To develop the'E-Bone',a comprehensive one-stop preoperative planning system for reverse total shoulder arthroplasty with improved accuracy and efficiency.Methods The nnU-net deep neural network was utilized for scapula segmentation to obtain precise scapula segmentation results.Based on the 3 key factors,namely bone density,upward and downward angle and nail length,the base was automatically positioned.The quantitative parameters required for surgical planning were calculated.A personalized guide plate was generated by combining glenoid morphology and base positioning information.The system interface was developed to modularize various functions for easy use,providing interactive operation and real-time display.Results Compared with the Mimics system,the'E-bone'preoperative planning system reduced complex manual adjustments during the planning process.The average planned nail length was longer than that of the Mimics system,and the planning time was reduced by 86%.The scapula segmentation accuracy of this system reached 99.93%,better than that of Mimics to achieve a higher precision.Conclusion The"E-bone"system provides a one-stop,efficient,and accurate preoperative planning system for reverse shoulder replacement and potentially broader clinical applications.