Objective: To explore the mechanism of action of hepatic leukemia factor (HLF) in diabetes mellitus and to construct a conditional animal model of mice with islet β ⁃cell⁃specific HLF gene knockout. Methods: At the cellular level , the effects of HLF inhibition or overexpression on the proliferation of MIN6 cells was verified by the CCK⁃8 assay. The effects of HLF inhibition or overexpression were detected at the mRNA level and protein level by Cre + / - mice (C57BL/6J) to obtain offspring mice. The genotypes of the mice were identified by the PCR method.The differences in the expression levels of the HLF gene at the mRNA and protein levels in islet β ⁃cell knockout mice (HLFflox/flox Cre + / - ) and control mice (HLFflox/flox ) were detected by RT⁃qPCR technology and Western blot technology to verify the knockout effect. At the same time , the islet tissues of the mice in two groups were taken to make paraffin sections and analyzed by hematoxylin⁃eosin (HE) staining. Results: HLF gene inhibition or overex⁃pression had no significant effect on the proliferation of MIN6 cells. When the HLF gene was inhibited in MIN6 cells , the mRNA expression level decreased by 74% compared with the control group , and the protein expression level decreased by 60% compared with the control group. After overexpressing the HLF gene , the mRNA expres⁃sion level was 2. 13 times compared with that of the control group , and the protein expression level was 1. 8 times compared with that of the control group. The mRNA expression level of the HLF gene in the knockout mice de⁃creased by 89% compared with the control group , and the protein expression level decreased by 65% compared with the control group. The results of HE staining showed that there was no significant difference in the cell mor⁃phology in the islet tissues between the knockout mice and the control mice. Inhibiting HLF increased the glycogen content in MIN6 cells by approximately 20% . Conclusion The HLF gene knockout mice are successfully con⁃structed , providing an animal model for studying the role of HLF in the pathogenesis of diabetes mellitus.

Objective To share our experience of laparoscopic papillary ureterovesical replantation,so as to provide reference for the treatment of patients with lower ureteral lesions.Methods A retrospective analysis was conducted on 22 patients treated in our hospital during 2019 and 2024,including 12 cases of lower ureteral stenosis,3 cases of congenital macroureter,2 cases of terminal ureteral tumor,3 cases of bladder diverticulum,and 2 cases of ureterovaginal fistula.The operation time,intraoperative blood loss,drainage tube removal time,urinary catheter removal time,postoperative hospital stay,DJ tube removal time and occurrence of postoperative complications were statistically analyzed.Results All operations were successfully completed.The operation time(156.73±36.73)minutes,the intraoperative blood loss(35.64±11.47)mL,the drainage tube removal time(7.14±1.77)days,the catheter removal time(10.05±2.73)days,the postoperative hospital stay(13.04±3.79)days,and the DJ tube removal time(69.91±9.35)days.During the follow-up of 3 to 24 months,re-examinations such as B ultrasound and urography indicated no obvious ureterovesical anastomotic stenosis;cystography showed one patient had ureteral reflux.After long-term follow-up,no renal function impairment or ureteral reflux was observed.Conclusion The papillary ureterovesical replantation is safe,effective,simple and easy to operate in the treatment of lower ureteral lesions.It also has characteristics of short operation time and good anti-reflux effect,which is worthy of clinical recommendation.

Objective To develop a refined management model for operating rooms and assess its clinical impact on op-erational efficiency and cost control.Methods The study included 10,728 elective surgeries from January to June 2024 as the study group and 9 414 elective surgeries from January to June 2023 as the control group.The differences in operational metrics before and after implementing the refined management model were compared.The model was developed through comprehensive management by hospital leadership and multi-department collaboration,focusing on management structure,systems,processes,information technology,and resource allocation.Results In terms of efficiency,the on-time start rate of the first surgeries in the study group was significantly higher than in the control group(P＜0.05).The turnover time between surgeries was shorter in the study group(P＜0.01),and the rate of unexpected surgery cancellations was lower(P＜0.01).The average cost per surgery for consumables,excluding the impact of centralized procurement of consumables,was approximately 971 yuan,representing an 11% reduction compared to the previous year,despite a 14% increase in surgical volume.The average daily operating cost per operating room was about 12 303 yuan,a 7% reduction.Economic benefits increased by 8.43 million yuan,a 38% year-on-year increase.Conclusion Implementing a refined management model in operating rooms can significantly enhance efficiency,re-duce costs,and achieve dual improvements in social and economic benefits.

Objective To explore the effect of dexmedetomidine on the proliferation,invasion and cell cycle of gallbladder cancer cells by regulating the C-C chemokine ligand 2(CCL2)-C-C chemokine receptor 2(CCR2)pathway.Methods GBC-SD cells were devided into the control group,the low concentration dexmedetomidine group(2 μmol/L),the high concentration dexmedetomidine group(4 μmol/L)and the high concentration dexmedetomidine+CCL2 group(4 μmol/L dexmedetomidine and 10 μg/L CCL2 protein).The clone formation experiment and Edu experiment were performed to measure cell proliferation.Transwell experiment was performed to measure cell invasion and migration.Flow cytometry was performed to measure cell cycle and apoptosis.Western blot assay was used to measure the proliferating cell nuclear antigen(PCNA),Cyclin D1,matrix metalloproteinase(MMP)-2,MMP-9,Bcl-2 associated X protein(Bax),cysteine-dependent aspartate-specific protease-3(Caspase-3),CCL2 and CCR2 proteins.The nude mouse transplant tumor experiment was used to determine the growth of gallbladder cancer transplant tumors.Results After treatment with low and high concentrations of dexmedetomidine,the number of cell clone formed,the positive rate of Edu,the numbers of invasions and migrations,the expression levels of PCNA,CyclinD1,MMP-2,MMP-9,CCL2 and CCR2 proteins,the proportions of G2/M and S phase cells decreased,the proportion of G0/G1 phase cells,apoptosis rate and expression levels of Bax and Caspase-3 proteins increased,and the effect of high-concentration dexmedetomidine was more significant(P＜0.05).The inhibitory effects of dexmedetomidine on the proliferation,invasion,migration and cell cycle of gallbladder cancer cells,as well as its promoting effect on cell apoptosis could be reversed by CCL2 protein(P＜0.05).In vivo experiments showed that dexmedetomidine could reduce tumor mass,tumor volume of nude mice and expression levels of CCL2 and CCR2 proteins(P＜0.05).Conclusion Dexmedetomidine inhibits the proliferation and invasion of gallbladder cancer cells,and blocks the cell cycle in the G0/G1 phase by suppressing the CCL2-CCR2 pathway.

Objective To share our experience of laparoscopic papillary ureterovesical replantation,so as to provide reference for the treatment of patients with lower ureteral lesions.Methods A retrospective analysis was conducted on 22 patients treated in our hospital during 2019 and 2024,including 12 cases of lower ureteral stenosis,3 cases of congenital macroureter,2 cases of terminal ureteral tumor,3 cases of bladder diverticulum,and 2 cases of ureterovaginal fistula.The operation time,intraoperative blood loss,drainage tube removal time,urinary catheter removal time,postoperative hospital stay,DJ tube removal time and occurrence of postoperative complications were statistically analyzed.Results All operations were successfully completed.The operation time(156.73±36.73)minutes,the intraoperative blood loss(35.64±11.47)mL,the drainage tube removal time(7.14±1.77)days,the catheter removal time(10.05±2.73)days,the postoperative hospital stay(13.04±3.79)days,and the DJ tube removal time(69.91±9.35)days.During the follow-up of 3 to 24 months,re-examinations such as B ultrasound and urography indicated no obvious ureterovesical anastomotic stenosis;cystography showed one patient had ureteral reflux.After long-term follow-up,no renal function impairment or ureteral reflux was observed.Conclusion The papillary ureterovesical replantation is safe,effective,simple and easy to operate in the treatment of lower ureteral lesions.It also has characteristics of short operation time and good anti-reflux effect,which is worthy of clinical recommendation.

Objective To develop a refined management model for operating rooms and assess its clinical impact on op-erational efficiency and cost control.Methods The study included 10,728 elective surgeries from January to June 2024 as the study group and 9 414 elective surgeries from January to June 2023 as the control group.The differences in operational metrics before and after implementing the refined management model were compared.The model was developed through comprehensive management by hospital leadership and multi-department collaboration,focusing on management structure,systems,processes,information technology,and resource allocation.Results In terms of efficiency,the on-time start rate of the first surgeries in the study group was significantly higher than in the control group(P＜0.05).The turnover time between surgeries was shorter in the study group(P＜0.01),and the rate of unexpected surgery cancellations was lower(P＜0.01).The average cost per surgery for consumables,excluding the impact of centralized procurement of consumables,was approximately 971 yuan,representing an 11% reduction compared to the previous year,despite a 14% increase in surgical volume.The average daily operating cost per operating room was about 12 303 yuan,a 7% reduction.Economic benefits increased by 8.43 million yuan,a 38% year-on-year increase.Conclusion Implementing a refined management model in operating rooms can significantly enhance efficiency,re-duce costs,and achieve dual improvements in social and economic benefits.

Objective To explore the effect of dexmedetomidine on the proliferation,invasion and cell cycle of gallbladder cancer cells by regulating the C-C chemokine ligand 2(CCL2)-C-C chemokine receptor 2(CCR2)pathway.Methods GBC-SD cells were devided into the control group,the low concentration dexmedetomidine group(2 μmol/L),the high concentration dexmedetomidine group(4 μmol/L)and the high concentration dexmedetomidine+CCL2 group(4 μmol/L dexmedetomidine and 10 μg/L CCL2 protein).The clone formation experiment and Edu experiment were performed to measure cell proliferation.Transwell experiment was performed to measure cell invasion and migration.Flow cytometry was performed to measure cell cycle and apoptosis.Western blot assay was used to measure the proliferating cell nuclear antigen(PCNA),Cyclin D1,matrix metalloproteinase(MMP)-2,MMP-9,Bcl-2 associated X protein(Bax),cysteine-dependent aspartate-specific protease-3(Caspase-3),CCL2 and CCR2 proteins.The nude mouse transplant tumor experiment was used to determine the growth of gallbladder cancer transplant tumors.Results After treatment with low and high concentrations of dexmedetomidine,the number of cell clone formed,the positive rate of Edu,the numbers of invasions and migrations,the expression levels of PCNA,CyclinD1,MMP-2,MMP-9,CCL2 and CCR2 proteins,the proportions of G2/M and S phase cells decreased,the proportion of G0/G1 phase cells,apoptosis rate and expression levels of Bax and Caspase-3 proteins increased,and the effect of high-concentration dexmedetomidine was more significant(P＜0.05).The inhibitory effects of dexmedetomidine on the proliferation,invasion,migration and cell cycle of gallbladder cancer cells,as well as its promoting effect on cell apoptosis could be reversed by CCL2 protein(P＜0.05).In vivo experiments showed that dexmedetomidine could reduce tumor mass,tumor volume of nude mice and expression levels of CCL2 and CCR2 proteins(P＜0.05).Conclusion Dexmedetomidine inhibits the proliferation and invasion of gallbladder cancer cells,and blocks the cell cycle in the G0/G1 phase by suppressing the CCL2-CCR2 pathway.

Objective To investigate the effect of sufentanil(ST)on lipopolysaccharide-induced acute lung injury(ALI)in rats by regulating the cyclic guanosine monophosphate-adenosine monophosphate synthase(cGAS)/stimulator of interferon gene(STING)signaling pathway.Methods Male SD rats were induced by lipopolysaccharide to construct an ALI model.The successfully modeled rats were randomly separated into ALI group,L-ST group,H-ST group,and H-ST+DMXAA group,with 6 rats in each group.Among them,the L-ST group and H-ST group were intraperitoneally injected with 2.5 μg/ml and 5 μg/ml ST after successful modeling immediately.The H-ST+DMXAA group was given 25 mg/kg DMXAA by gavage on the basis of intraperitoneal injection of 5 μg/ml ST.Six healthy and normal temperature rats were randomly selected as the control group,and an equal amount of physiological saline was injected intraperitoneally.The reagent kit was used to detect the SOD enzyme activity and MDA content in serum;ELISA was used to detect the levels of inflammatory factors such as interleukin-10(IL-10),tumor necrosis factor-α(TNF-α),and IL-6 in bronchoalveolar lavage fluid(BALF);cell staining was used to detect the total number of cells and neutrophils in BALF;the wet to dry mass ratio of lung tissue was calculated;HE staining was used to observe pathological changes in lung tissue,while Western blot was applied to detect the expression of cGAS and STING proteins in lung tissue.Results After L-ST and H-ST treatment,the SOD enzyme activity and IL-10 level increased sequentially,the MDA,TNF-α,IL-6,W/D value,total number of cells and neutrophils,cGAS,and STING protein expression decreased sequentially(P<0.05),while lung tissue injury was effectively alleviated.DMXAA reversed the influence of H-ST on the above indexes(P<0.05).Conclusion ST may inhibit the cGAS-STING pathway,reduce inflammation and oxidative stress responses,and thereby alleviates lipopolysaccharide induced ALI in rats.

Objective To investigate the effect of sufentanil(ST)on lipopolysaccharide-induced acute lung injury(ALI)in rats by regulating the cyclic guanosine monophosphate-adenosine monophosphate synthase(cGAS)/stimulator of interferon gene(STING)signaling pathway.Methods Male SD rats were induced by lipopolysaccharide to construct an ALI model.The successfully modeled rats were randomly separated into ALI group,L-ST group,H-ST group,and H-ST+DMXAA group,with 6 rats in each group.Among them,the L-ST group and H-ST group were intraperitoneally injected with 2.5 μg/ml and 5 μg/ml ST after successful modeling immediately.The H-ST+DMXAA group was given 25 mg/kg DMXAA by gavage on the basis of intraperitoneal injection of 5 μg/ml ST.Six healthy and normal temperature rats were randomly selected as the control group,and an equal amount of physiological saline was injected intraperitoneally.The reagent kit was used to detect the SOD enzyme activity and MDA content in serum;ELISA was used to detect the levels of inflammatory factors such as interleukin-10(IL-10),tumor necrosis factor-α(TNF-α),and IL-6 in bronchoalveolar lavage fluid(BALF);cell staining was used to detect the total number of cells and neutrophils in BALF;the wet to dry mass ratio of lung tissue was calculated;HE staining was used to observe pathological changes in lung tissue,while Western blot was applied to detect the expression of cGAS and STING proteins in lung tissue.Results After L-ST and H-ST treatment,the SOD enzyme activity and IL-10 level increased sequentially,the MDA,TNF-α,IL-6,W/D value,total number of cells and neutrophils,cGAS,and STING protein expression decreased sequentially(P<0.05),while lung tissue injury was effectively alleviated.DMXAA reversed the influence of H-ST on the above indexes(P<0.05).Conclusion ST may inhibit the cGAS-STING pathway,reduce inflammation and oxidative stress responses,and thereby alleviates lipopolysaccharide induced ALI in rats.

With rapid global growth of the older population, it has been increasingly important for screening, early diagnosis, treatment and daily monitoring of cognitive function in the elderly population. Given the limited effects of pharmacological treatments, cognitive rehabilitation has the potential to improve meaningful outcomes for older people and thus comes into sight. Traditional cognitive assessment and rehabilitation require face-to-face interview, while patients with cognitive impairment are mostly elderly with difficulties in access to medical care, usually needed to be accompanied by caregivers and having other co-morbidities with limited mobility. This contradiction is especially prominent in the context of COVID-19 pandemic, which may even exacerbate cognitive decline of patients. Therefore, remote cognitive assessment and rehabilitation based on information and communication technologies have become new options. This paper introduces the widely used and validated means of remote assessment and its guiding use in cognitive rehabilitation, which can be implemented through the Internet, applications, video and telephone. The advantages of being fast, convenient and geographically agnostic lead to a wider use in large community and safeguard the health of patients with cognitive impairment.