Objective:To evaluate the short-term outcomes of robotic double-flap technique following proximal gastrectomy in patients with carcinoma of esophagogastric junction(AEG).Methods:Clinical data of 5 AEG cases undergoing robotic double-flap technique following proximal gastrectomy were analyzed at the Department of Gastrointestinal Surgery, Peking University First Hospital from Dec 2023 to Aug 2024 .Results:All the 5 patients were of Siewert Ⅱ type AEG. Robot-assisted radical proximal gastrectomy and esophagogastric double-flap anastomosis were successfully completed. The operation time was (361±63) min, the installation time was (21±11) min, the anastomosis time was (90±21) min, and the median intraoperative blood loss was 100 (50,200) ml. The median number of intraoperative lymph nodes resected was 23 (14,32), the first postoperative exhaust time was (4.8±1.1) d, and postoperative hospital stay was (14.6±8.8) d. Postoperative abdominal distension occurred in 1 patient, and no significant anastomotic stenosis or anastomotic leakage was observed by upper gastroenterography. After conservative treatment, the patient recovered. None of them had Clavien-Dindo grade ≥Ⅲ complications. There were no anastomotic complications such as anastomotic leakage, anastomotic hemorrhage and anastomotic stenosis.Conclusion:Robotic double-flap technique following proximal gastrectomy is a safe and effective treatment for AEG.

Objective:To explore the effectiveness of the"full-chain"integrated medical and elderly care service model in addressing key issues in medical-nursing services such as weak medical support capacity and insufficient provision of community-and home-based medical-nursing services.Methods:The development pathway for the"full-chain"integrated medical-elderly care service standardization system,encompassing core components such as operational mechanisms,smart platforms,policy documents,and quality control systems was systematically outlined.Effectiveness based on dimensions including service coverage,quality improvement,talent development,and social benefits was evaluated.With standardization as the core driver,the'1234567'management model was innovatively implemented.Results:The model leveraged the downward allocation of high-quality resources from tertiary general hospitals to strengthen subdistrict community health service centers.By collaborating with subdistrict elderly-care service centers,it established"subdistrict medical-elderly care and wellness service centers".These centers enhanced the capabilities of"community-embedded elderly-care complexes",including community daytime care centers,established two-way referral channels between medical and elderly care services,aligned with healthcare demands to provide elderly individuals with reliable medical support.It reduced the burden on families and society,stimulated market vitality,boosted domestic demand,promoted the development of integrated medical-elderly care and wellness initiatives,thereby advancing the silver economy.With provincial government endorsement,the model had been applied to 203 communities across 37 counties by the end of 2024.Conclusion:The established"full-chain"integrated medical-elderly care service model facilitates regional high-quality development in integrated care by consolidating healthcare group resources and seamlessly connecting the service chain across hospitals,nursing homes,community institutions,and home-based settings,thereby creating a practical paradigm for comprehensive elderly care service delivery.

Objective To explore the application of evidence-based nursing based on mind mapping in patients undergoing knee arthroscopic surgery.Methods Ninety patients who underwent arthroscopic surgery in Dongzhimen Hospital,Beijing University of Chinese Medicine from June 2021 to January 2023 were selected for prospective study.They were randomly assigned to study group or control group according to the random number table,with 45 cases in each group.The control group was given routine nursing,and the study group was given evidence-based nursing based on mind mapping.The nursing care continued until one month after discharge.Psychological resilience score,pain degree[(visual analogue scale,VAS)score],hospitalization time,hospital knee score(HSS)score,postoperative complications and satisfaction degree at discharge were compared between the two groups.Results Repeated measures showed that there were significant differences in the time-point effect,intergroup effect and interaction effect of psychological resilience score and HSS score between the two groups(P<0.05),and the psychological resilience score and HSS score of the study group were higher than those of the control group(P<0.05).The VAS score at discharge and hospital stay of the study group were superior to those of the control group(P<0.05).The incidence of postoperative complications in the study group was lower than that in the control group(2.22%vs 17.78%,P<0.05).The degree of patients'satisfaction in the study group was higher than that in the control group(P<0.05).Conclusion Evidence-based nursing based on mind mapping can effectively improve psychological resilience,relieve postoperative pain,increase the range of motion of the knee,promote recovery,reduce postoperative complications and improve clinical satisfaction.

Fibrosis is a pathological condition characterized by the excessive deposition of extracellular matrix due to the imbalance between injury and repair.It can affect multiple organs,including the heart,lungs,liver,kidneys,and pancreas.The progression of fibrosis is usually slow and difficult to reverse,and it can severely impair organ functions.In industrialized countries,deaths caused by fibrosis account for up to 45％,resulting in a tremendous disease burden.Thus,there is an urgent need for drugs that can reverse or delay the progression of fibrosis.In recent years,remarkable progress has been made in the research on the pathogenesis of fibrosis in different organs,and relevant drugs targeting fibrosis are also under active development.This article briefly summarizes the drugs currently marketed and drugs at the clinical trial stage for treating fibrosis.

Neutralizing antibodies have been designed to specifically target and bind to the receptor binding domain (RBD) of spike (S) protein to block severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus from attaching to angiotensin converting enzyme 2 (ACE2). This study reports a distinctive nanobody, designated as VHH21, that directly catalyzes the S-trimer into an irreversible transition state through postfusion conformational changes. Derived from camels immunized with multiple antigens, a set of nanobodies with high affinity for the S1 protein displays abilities to neutralize pseudovirion infections with a broad resistance to variants of concern of SARS-CoV-2, including SARS-CoV and BatRaTG13. Importantly, a super-resolution screening and analysis platform based on visual fluorescence probes was designed and applied to monitor single proteins and protein subunits. A spontaneously occurring dimeric form of VHH21 was obtained to rapidly destroy the S-trimer. Structural analysis via cryogenic electron microscopy revealed that VHH21 targets specific conserved epitopes on the S protein, distinct from the ACE2 binding site on the RBD, which destabilizes the fusion process. This research highlights the potential of VHH21 as an abzyme-like nanobody (nanoabzyme) possessing broad-spectrum binding capabilities and highly effective anti-viral properties and offers a promising strategy for combating coronavirus outbreaks.
Single-Domain Antibodies/immunology* ; Spike Glycoprotein, Coronavirus/metabolism* ; SARS-CoV-2/immunology* ; Animals ; Humans ; Antibodies, Neutralizing/immunology* ; Camelus ; COVID-19/immunology* ; Antibodies, Viral/immunology* ; Angiotensin-Converting Enzyme 2

Objective:To explore the effectiveness of the"full-chain"integrated medical and elderly care service model in addressing key issues in medical-nursing services such as weak medical support capacity and insufficient provision of community-and home-based medical-nursing services.Methods:The development pathway for the"full-chain"integrated medical-elderly care service standardization system,encompassing core components such as operational mechanisms,smart platforms,policy documents,and quality control systems was systematically outlined.Effectiveness based on dimensions including service coverage,quality improvement,talent development,and social benefits was evaluated.With standardization as the core driver,the'1234567'management model was innovatively implemented.Results:The model leveraged the downward allocation of high-quality resources from tertiary general hospitals to strengthen subdistrict community health service centers.By collaborating with subdistrict elderly-care service centers,it established"subdistrict medical-elderly care and wellness service centers".These centers enhanced the capabilities of"community-embedded elderly-care complexes",including community daytime care centers,established two-way referral channels between medical and elderly care services,aligned with healthcare demands to provide elderly individuals with reliable medical support.It reduced the burden on families and society,stimulated market vitality,boosted domestic demand,promoted the development of integrated medical-elderly care and wellness initiatives,thereby advancing the silver economy.With provincial government endorsement,the model had been applied to 203 communities across 37 counties by the end of 2024.Conclusion:The established"full-chain"integrated medical-elderly care service model facilitates regional high-quality development in integrated care by consolidating healthcare group resources and seamlessly connecting the service chain across hospitals,nursing homes,community institutions,and home-based settings,thereby creating a practical paradigm for comprehensive elderly care service delivery.

Comprehensive performance appraisal,continuous optimization of performance appraisal indicators,reform of internal performance appraisal methods,and linking the appraisal results to salary allocation are important measures for the high-quality development of public hospitals.It is based on the performance allocation mechanism improvement in case hospital under the requirements of high-quality development.The implementation of performance reform practice based on incremental assessment has achieved the social benefits improvement,income structure optimization,performance distribution equity improvement,and more refined management of disciplines and other management objectives,with a view to providing lessons and references for medical colleagues to follow up to deepen the performance reform and improve the performance distribution.

Comprehensive performance appraisal,continuous optimization of performance appraisal indicators,reform of internal performance appraisal methods,and linking the appraisal results to salary allocation are important measures for the high-quality development of public hospitals.It is based on the performance allocation mechanism improvement in case hospital under the requirements of high-quality development.The implementation of performance reform practice based on incremental assessment has achieved the social benefits improvement,income structure optimization,performance distribution equity improvement,and more refined management of disciplines and other management objectives,with a view to providing lessons and references for medical colleagues to follow up to deepen the performance reform and improve the performance distribution.

Objective:To investigate the clinical efficacy of fixation with a modified double-pulley anchor suture in the treatment of Rockwood type Ⅱ patella fractures.Methods:A retrospective study was conducted to analyze the 60 patients with Rockwood type Ⅱ patellar fracture who had been admitted to Department of Joint Surgery, The Hospital Affiliated to Qingdao University between November 2021 and November 2023. The cohort included 31 males and 29 females, with an age of (53.5±10.4) years. According to the treatment methods, the patients were divided into a study group (28 cases) which was treated by traction reinforcement of the terminal anchor suture in addition to fixation with a double-pulley anchor suture, and a control group (32 cases) which was treated by the traditional Kirschner wire tension band technique. The operation time, intraoperative blood loss, incision length, reoperation rate, complication rate, fracture healing, and visual analog scale (VAS) pain scores and Bostman scores at postoperative 1 month, 3 months, and 6 months and at the last follow-up were compared between the 2 groups.Results:No statistically significant differences were observed in the preoperative general data between the 2 groups, indicating that the 2 groups were comparable ( P>0.05). All patients were followed up for (12.8±1.4) months postoperatively. The study group demonstrated significantly lower intraoperative blood loss [(25.9±6.8) mL] than the control group [(40.5±11.6) mL], and a significantly lower reoperation rate (0) than the control group [53.1% (17/32)] ( P<0.05). There was no statistically significant difference between the 2 groups in operation time, incision length, incidence of complications, as well as in VAS pain scores or Bostman scores at postoperative 1 month, 3 months, or 6 months or at the last follow-up (all P>0.05). Fractures healed in both groups at 6 months postoperatively. Conclusions:For patients with Rockwood type Ⅱ patellar fracture, fixation with modified double-pulley suture anchor can achieve good clinical efficacy. Compared to the traditional Kirschner wire tension band technique, the modified mothed significantly reduces intraoperative blood loss and avoids secondary trauma caused by a second surgery for implant removal.

Objective:To investigate the clinical efficacy of fixation with a modified double-pulley anchor suture in the treatment of Rockwood type Ⅱ patella fractures.Methods:A retrospective study was conducted to analyze the 60 patients with Rockwood type Ⅱ patellar fracture who had been admitted to Department of Joint Surgery, The Hospital Affiliated to Qingdao University between November 2021 and November 2023. The cohort included 31 males and 29 females, with an age of (53.5±10.4) years. According to the treatment methods, the patients were divided into a study group (28 cases) which was treated by traction reinforcement of the terminal anchor suture in addition to fixation with a double-pulley anchor suture, and a control group (32 cases) which was treated by the traditional Kirschner wire tension band technique. The operation time, intraoperative blood loss, incision length, reoperation rate, complication rate, fracture healing, and visual analog scale (VAS) pain scores and Bostman scores at postoperative 1 month, 3 months, and 6 months and at the last follow-up were compared between the 2 groups.Results:No statistically significant differences were observed in the preoperative general data between the 2 groups, indicating that the 2 groups were comparable ( P>0.05). All patients were followed up for (12.8±1.4) months postoperatively. The study group demonstrated significantly lower intraoperative blood loss [(25.9±6.8) mL] than the control group [(40.5±11.6) mL], and a significantly lower reoperation rate (0) than the control group [53.1% (17/32)] ( P<0.05). There was no statistically significant difference between the 2 groups in operation time, incision length, incidence of complications, as well as in VAS pain scores or Bostman scores at postoperative 1 month, 3 months, or 6 months or at the last follow-up (all P>0.05). Fractures healed in both groups at 6 months postoperatively. Conclusions:For patients with Rockwood type Ⅱ patellar fracture, fixation with modified double-pulley suture anchor can achieve good clinical efficacy. Compared to the traditional Kirschner wire tension band technique, the modified mothed significantly reduces intraoperative blood loss and avoids secondary trauma caused by a second surgery for implant removal.