Magnetic surgery technology leverages the principle of "non-contact" magnetic force, demonstrating revolutionary potential in the field of digestive surgery. It has been widely applied in areas such as gastrointestinal anastomosis, esophageal atresia recanalization, and biliary stricture treatment. Magnetic surgery techniques can be categorized into the following six major types based on their application methods and principles: magnetic compression technology, magnetic navigation technology, magnetic anchoring technology, magnetic levitation technology, magnetic tracing technology, and magnetic drive technology. These innovative surgical techniques significantly simplify surgical operations, solve complex and difficult problems, and improve clinical treatment outcomes. Meanwhile, the deepening application of magnetic surgery technology requires further standardization of clinical operation and quality control standards, reinforcement of safety research, and acceleration of multidisciplinary integration and development. The authors review the develop-ment history of magnetic surgical technology and offer a perspective on its future, highlighting the core concept of surgical innovation. The authors also summarize the clinical applications of magnetic surgery in the treatment of digestive diseases, as well as its key theoretical and technological advance-ments. Looking forward, the authors anticipate that interdisciplinary collaboration and intelligent development, with the aim of further promoting the continuous innovation of surgical technology and enhancing clinical treatment value.

This paper reported the clinical manifestations, pathological features, immunophenotype and follow-up of two patients with superficial CD34-positive fibroblastic tumor (SCPFT), who were admitted to Shandong Provincial Hospital in 2022 and 2023, and discussed the relevant literatures. The two patients, aged 43 and 20 years old, were both male. Their tumors were located in the perineum and the back of left shoulder, respectively. Both presented as single slow-growing subcutaneous masses with a course typically measured in years, accompanied by mild tenderness but without pain or pruritus. Microscopically, spindled to epithelioid cells and pleomorphous nuclear cells arranged in cellular fascicles and solid sheets were the main findings. Immunophenotypically, positive expression of CD34 was found in both cases. Extended resection ensured negative marginal and basal margins for both cases. No recurrence was observed after 22 and 12 months of follow-up, respectively. Clinical features, pathology, and differential diagnosis were discussed and summarized through a review of relevant literature. SCPFT is a novel type of fibroblastic tumor categorized as a low-grade malignant soft tissue tumor with unique pathological and biological characteristics that is relatively rare clinically. Routine resection may lead to recurrence; therefore, long-term follow-up is necessary. The combination of morphological characteristics and immunohistochemistry is helpful to diagnosis. It is important to differentiate this disease from other tumors to avoid misdiagnosis or mistreatment.

Objective:To investigate the effects of hepatic fatty acid transporter 5 (FATP5) gene expression on the levels of free long-chain fatty acid (LCFA) in mice with metabolic associated fatty liver disease (MAFLD).Methods:From June to December 2022, a prospective study was conducted with three experimental groups: wild-type (WT) group, FATP5 gene expression negative (FATP5 -) group, and human FATP5 gene expression positive (hFATP5 +) group, with 10 mice in each group. Each group of mice was fed a high-fat diet for 16 weeks to establish a model of MAFLD. Hepatic tissue changes were observed using hematoxylin-eosin staining. The liver mass and liver coefficient of the mice were measured. Total cholesterol (TC), triglycerides (TG), aspartate aminotransferase (AST), alanine aminotransferase (ALT), uric acid (UA), and LCFA levels were determined using an automatic biochemical analyzer. Blood glucose (Glu) levels were measured using a blood glucose analyzer. The liver mass and liver coefficient, TC and TG levels, AST and ALT levels, Glu and UA levels, and LCFA levels were compared among the three groups. Results:In the WT group, there was significant inflammatory cell infiltration within the hepatocytes and a large amount of fat accumulation. In the FATP5 - group, the inflammatory cell infiltration in the hepatocytes was mild with slight fat accumulation. In the hFATP5 + group, the inflammatory cell infiltration in the hepatocytes was severe, with great fat accumulation. The liver mass [(1.27 ± 0.25) g], liver coefficient (2.38 ± 0.19), TC [(1.82 ± 0.26) mmol/L], TG [(0.93 ± 0.24) mmol/L], AST [(169.95 ± 37.73) U/L], ALT [(95.36 ± 21.49) U/L], Glu [(8.34 ± 1.52) mmol/L], and UA [(74.32 ± 15.52) μmol/L] in the FATP5 - group were all significantly lower than those in the WT group [(1.61 ± 0.23) g, (2.71 ± 0.20), (2.31 ± 0.28) mmol/L, (1.34 ± 0.21) mmol/L, (278.31 ± 43.24) U/L, (147.32 ± 28.81) U/L, (10.52 ± 1.24) mmol/L, (96.28 ± 17.43) μmol/L], while the LCFA level [(3.57 ± 0.48) mg/L] in the FATP5 - group was significantly higher than that in the WT group [(2.63 ± 0.56) mg/L] ( t = 3.17, 3.78, 4.06, 4.07, 5.97, 4.57, 3.51, 2.98, 4.03, all P < 0.05). In the hFATP5 + group, the liver mass [(1.92 ± 0.30) g], liver coefficient (2.95 ± 0.23), TC [(2.59 ± 0.24) mmol/L], TG [(1.76 ± 0.35) mmol/L], AST [(341.22 ± 48.98) U/L], ALT [(189.45 ± 17.97) U/L], Glu [(13.21 ± 1.98) mmol/L], and UA [(117.74 ± 18.38) μmol/L] were all significantly higher than those in the WT group, while the LCFA level [(3.57 ± 0.48) mg/L] in the FATP5 + group was significantly lower than that in the WT group ( t = 2.59, 2.49, 2.40, 3.25, 3.04, 3.92, 3.64, 2.68, 3.19, all P < 0.05). Conclusions:The absence of FATP5 in the liver can elevate blood levels of LCFA in mice with MAFLD, reduce food intake, and help alleviate the symptoms of MAFLD.

This paper reported the clinical manifestations, pathological features, immunophenotype and follow-up of two patients with superficial CD34-positive fibroblastic tumor (SCPFT), who were admitted to Shandong Provincial Hospital in 2022 and 2023, and discussed the relevant literatures. The two patients, aged 43 and 20 years old, were both male. Their tumors were located in the perineum and the back of left shoulder, respectively. Both presented as single slow-growing subcutaneous masses with a course typically measured in years, accompanied by mild tenderness but without pain or pruritus. Microscopically, spindled to epithelioid cells and pleomorphous nuclear cells arranged in cellular fascicles and solid sheets were the main findings. Immunophenotypically, positive expression of CD34 was found in both cases. Extended resection ensured negative marginal and basal margins for both cases. No recurrence was observed after 22 and 12 months of follow-up, respectively. Clinical features, pathology, and differential diagnosis were discussed and summarized through a review of relevant literature. SCPFT is a novel type of fibroblastic tumor categorized as a low-grade malignant soft tissue tumor with unique pathological and biological characteristics that is relatively rare clinically. Routine resection may lead to recurrence; therefore, long-term follow-up is necessary. The combination of morphological characteristics and immunohistochemistry is helpful to diagnosis. It is important to differentiate this disease from other tumors to avoid misdiagnosis or mistreatment.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

Objective:To compare the effect of two hemostatic drugs, tranexamic acid and hemocoagulase, on postoperative bleeding in adult patients with Kashin-Beck disease undergoing total knee arthroplasty.Methods:A retrospective analysis was conducted to select 80 adult patients with Kashin-Beck disease who underwent unilateral primary total knee arthroplasty at Linyou County Hospital from January 2021 to March 2023. According to the inclusion and exclusion criteria, 19 cases with chronic anemia, long-term oral anticoagulants implanted with cardiac stents, and hematological diseases were excluded. Among the remaining 61 adult patients, 24 cases with preoperative intravenous application combined with intraoperative local application of tranexamic acid in articular cavity were selected as the experimental group, and 37 cases with preoperative intravenous application combined with intraoperative local application of hemocoagulase in articular cavity were selected as the control group. The preoperative general condition, postoperative drainage volume, total perioperative blood loss, occult blood loss, and hemoglobin levels at different time points before and after surgery were compared between the two groups of patients.Results:There was no statistically significant difference in age, gender distribution, body mass index, preoperative hemoglobin level, preoperative prothrombin time, and preoperative activated partial thromboplastin time between the two groups of patients ( P > 0.05). The total perioperative blood loss [(1 027.78 ± 472.71) ml], drainage volume 48 h after surgery [(336.67 ± 112.74) ml] in the experimental group were all lower than those in the control group [(1 390.39 ± 454.01), (498.65 ± 187.57) ml], and the differences were statistically significant ( P < 0.05). The hemoglobin levels on the second and fifth day after surgery were significantly higher than those in the control group, and the differences were statistically significant ( P < 0.05). Conclusion:For total knee arthroplasty for adult patients with Kashin-Beck disease, preoperative intravenous application combined with intraoperative local application of tranexamic acid in articular cavity is superior to hemocoagulase, which can effectively reduce total perioperative blood loss and postoperative drainage volume, and is worthy of clinical promotion.

Magnetic surgery technology leverages the principle of "non-contact" magnetic force, demonstrating revolutionary potential in the field of digestive surgery. It has been widely applied in areas such as gastrointestinal anastomosis, esophageal atresia recanalization, and biliary stricture treatment. Magnetic surgery techniques can be categorized into the following six major types based on their application methods and principles: magnetic compression technology, magnetic navigation technology, magnetic anchoring technology, magnetic levitation technology, magnetic tracing technology, and magnetic drive technology. These innovative surgical techniques significantly simplify surgical operations, solve complex and difficult problems, and improve clinical treatment outcomes. Meanwhile, the deepening application of magnetic surgery technology requires further standardization of clinical operation and quality control standards, reinforcement of safety research, and acceleration of multidisciplinary integration and development. The authors review the develop-ment history of magnetic surgical technology and offer a perspective on its future, highlighting the core concept of surgical innovation. The authors also summarize the clinical applications of magnetic surgery in the treatment of digestive diseases, as well as its key theoretical and technological advance-ments. Looking forward, the authors anticipate that interdisciplinary collaboration and intelligent development, with the aim of further promoting the continuous innovation of surgical technology and enhancing clinical treatment value.

Objective:To investigate the effects of hepatic fatty acid transporter 5 (FATP5) gene expression on the levels of free long-chain fatty acid (LCFA) in mice with metabolic associated fatty liver disease (MAFLD).Methods:From June to December 2022, a prospective study was conducted with three experimental groups: wild-type (WT) group, FATP5 gene expression negative (FATP5 -) group, and human FATP5 gene expression positive (hFATP5 +) group, with 10 mice in each group. Each group of mice was fed a high-fat diet for 16 weeks to establish a model of MAFLD. Hepatic tissue changes were observed using hematoxylin-eosin staining. The liver mass and liver coefficient of the mice were measured. Total cholesterol (TC), triglycerides (TG), aspartate aminotransferase (AST), alanine aminotransferase (ALT), uric acid (UA), and LCFA levels were determined using an automatic biochemical analyzer. Blood glucose (Glu) levels were measured using a blood glucose analyzer. The liver mass and liver coefficient, TC and TG levels, AST and ALT levels, Glu and UA levels, and LCFA levels were compared among the three groups. Results:In the WT group, there was significant inflammatory cell infiltration within the hepatocytes and a large amount of fat accumulation. In the FATP5 - group, the inflammatory cell infiltration in the hepatocytes was mild with slight fat accumulation. In the hFATP5 + group, the inflammatory cell infiltration in the hepatocytes was severe, with great fat accumulation. The liver mass [(1.27 ± 0.25) g], liver coefficient (2.38 ± 0.19), TC [(1.82 ± 0.26) mmol/L], TG [(0.93 ± 0.24) mmol/L], AST [(169.95 ± 37.73) U/L], ALT [(95.36 ± 21.49) U/L], Glu [(8.34 ± 1.52) mmol/L], and UA [(74.32 ± 15.52) μmol/L] in the FATP5 - group were all significantly lower than those in the WT group [(1.61 ± 0.23) g, (2.71 ± 0.20), (2.31 ± 0.28) mmol/L, (1.34 ± 0.21) mmol/L, (278.31 ± 43.24) U/L, (147.32 ± 28.81) U/L, (10.52 ± 1.24) mmol/L, (96.28 ± 17.43) μmol/L], while the LCFA level [(3.57 ± 0.48) mg/L] in the FATP5 - group was significantly higher than that in the WT group [(2.63 ± 0.56) mg/L] ( t = 3.17, 3.78, 4.06, 4.07, 5.97, 4.57, 3.51, 2.98, 4.03, all P < 0.05). In the hFATP5 + group, the liver mass [(1.92 ± 0.30) g], liver coefficient (2.95 ± 0.23), TC [(2.59 ± 0.24) mmol/L], TG [(1.76 ± 0.35) mmol/L], AST [(341.22 ± 48.98) U/L], ALT [(189.45 ± 17.97) U/L], Glu [(13.21 ± 1.98) mmol/L], and UA [(117.74 ± 18.38) μmol/L] were all significantly higher than those in the WT group, while the LCFA level [(3.57 ± 0.48) mg/L] in the FATP5 + group was significantly lower than that in the WT group ( t = 2.59, 2.49, 2.40, 3.25, 3.04, 3.92, 3.64, 2.68, 3.19, all P < 0.05). Conclusions:The absence of FATP5 in the liver can elevate blood levels of LCFA in mice with MAFLD, reduce food intake, and help alleviate the symptoms of MAFLD.

Objective To analyze the clinical characteristics,treatment,and prognosis of immune checkpoint inhibitor-related diabetes mellitus(ICI-DM).Methods The clinical characteristics,laboratory examinations,treatment regimens,and follow-up outcomes of 10 ICI-DM patients who were diagnosed and treated in the First Medical Center of Chinese PLA General Hospital between July 2019 and December 2024 were retrospectively analyzed.Relevant literatures were retrieved from domestic and foreign databases such as PubMed,CNKI,and VIP.The clinical characteristics of ICI-DM were summarized based on the literature results.Results All 10 patients were PD-1 inhibitor users,including 5 males and 5 females,with a median age of 54.5(51.3,64.0)years and a body mass index(BMI)of(22.0±2.15)kg/m2.Among them,9 cases(90.0%)were fulminant type 1 diabetes mellitus(FT1DM);9 cases(90.0%)had a severity of adverse events reaching grade 3-4 according to the Common Terminology Criteria for adverse events(CTCAE).The median time from PD-1 inhibitor treatment to the occurrence of the classic diabetes symptoms referred to as"three more and one less"(polyuria,polydipsia,polyphagia,and weight loss)in all patients was 145.5(110.5,204.8)days,and the medication duration was 6.0(4.3,7.8)cycles.The average blood glucose level of the 10 patients at the time of consultation was 25.3(10.0-41.4)mmol/L,and the glycated hemoglobin(HbA1c)level was 8.0%(6.6%-10.9%).Eight patients had fasting and 2-hour C-peptide levels<0.1 ng/ml(fasting C-peptide from<0.010 to 0.067 ng/ml,2-hour C-peptide from<0.010 to 0.077 ng/ml).Nine of the 10 patients were negative for diabetes autoantibodies,while 1 was not tested.All 10 patients were successfully treated with insulin and other therapies.During the follow-up after discharge,all patients still relied on insulin treatment,and no significant recovery of pancreatic islet β cell function was observed compared with that at discharge.Literature review revealed that ICI-DM was more common in PD-1 inhibitor users,with clinical mainly manifested as diabetic ketoacidosis(DKA)(65.4%)and diabetic ketosis(13.1%).Patients had severely impaired pancreatic islet function and required long-term insulin treatment,and some cases were complicated by thyroid or pituitary dysfunction.Conclusions ICI-DM typically presents as FT1DM,often manifesting with DKA or diabetic ketosis at onset.It is characterized by severe and irreversible loss of pancreatic islet function,necessitating lifelong insulin therapy.To enable early detection and prompt treatment,close monitoring of blood glucose is essential during ICI treatment.

Objective:To explore the impact of plant and animal dietary behaviors on type 2 diabetes mellitus (T2DM) in older adults aged ≥65 in 18 longevity areas of China.Methods:The subjects were 5 223 older adults over 65 years old from the Healthy Ageing and Biomarkers Cohort Study (HABCS) in 18 longevity areas in China. Through a questionnaire survey and physical examination, information about their demographic characteristics, lifestyles, daily activities, self-health status, current diseases, and fasting venous blood were collected. Food Frequency and Questionnaire (FFQ) was used to collect data on food intake frequency. Based on the prior method, the plant-based diet index (PDI) and animal-based diet index (ADI) of 5 223 older adults were calculated. Subjects were divided into three groups (low-level group: PDI<39 or ADI<31, middle-level group: 39≤PDI≤42 or 31≤ADI≤34, high-level group: PDI>42 or ADI>34) by tertiles of PDI and ADI. Multivariate logistic regression was used to analyze the association between PDI and ADI and the risk of T2DM.Results:The average age of 5 223 subjects was (84.8±11.5) years, with the median ( Q1, Q3) of PDI about 41(38, 43) and the median ( Q1, Q3) of ADI about 33 (30, 35). The prevalence rate of T2DM was 16.41% (857/5 223). After adjusting for covariates, multivariate logistic regression showed that PDI was negatively associated with T2DM. Compared with the low-level group, the OR (95% CI) for T2DM in the high-level group was 0.83 (0.69-0.99). ADI was positively associated with T2DM, and compared with the low-level group, the OR (95% CI) for T2DM in the high-level group was 1.28 (1.06-1.55). For every one-point increase in PDI and ADI, the risk of T2DM decreased by 2% and increased by 3%, respectively, with the OR (95% CI) of 0.98 (0.96-1.00) and 1.03 (1.01-1.06), respectively. Conclusion:In Chinese older adults ≥65 years in 18 longevity areas, higher adherence to the plant-based behavior may be negatively associated with the risk of T2DM, while higher adherence to the animal-based behavior may be positively associated with the risk of T2DM.