The clinical application of binocular endoscope relies primarily on the visual system of physicians to create a three-dimensional effect, but it cannot provide accurate depth information. The utilization of 3D reconstruction technology in binocular endoscopy can facilitate the recovery of image depth information, and the application of deep learning-based 3D reconstruction technology can significantly improve the accuracy and real-time performance of reconstruction results, making it widely applicable in the realm of minimally invasive surgery. This paper aims to explore the key technologies and implementation methods of deep learning based 3D reconstruction for binocular endoscopic images, and seeks to outline strategies for enhancing the quality of 3D reconstruction in endoscopic images, providing guidance for sustainable development of binocular endoscopic image reconstruction technology in clinical settings. This will assist in the application of minimally invasive surgery and contribute to meeting the demands of precision medicine.
Deep Learning ; Imaging, Three-Dimensional/methods* ; Humans ; Endoscopy/methods* ; Image Processing, Computer-Assisted/methods* ; Minimally Invasive Surgical Procedures

This paper summarized the clinical experience of Professor LIU Shenlin in diagnosing and treating gastric cancer with the thinking of "prescription according to tendency". In this paper， the thinking of diagnosis and treatment for gastric cancer and medication skills were summarized into four dimensions： power， energy， chronology and situation. The diagnosis emphasizes the tendency of qi power， considering that the onset of gastric cancer primarily stems from the disorder of qi movement in zang-fu organs， and emphasizing the importance of regulating the liver and spleen qi to intercept the tendency of disease. It points out that dampness-phlegm-stasis-toxin is a crucial link leading to the metabolic imbalance of body energy， and Professor LIU adepts at using methods such as breaking up blood and expelling stasis， and clearing heat and resolving toxins to block the pathological chain reaction caused by energy imbalance and to restore the homeostasis of the organism. In the treatment process， according to the characteristics of gastric cancer staging and chronological evolution， we will explore the changes of the exuberance and weakness of healthy qi and pathogenic qi in the context of the chronologic tendency， and adjust the dosage of attacking and tonic medicines in different stages of the disease in order to balance and restore the body. The "situation" is in line with the state of consumptive disease in advanced gastric cancer， Professor LIU skillfully uses large doses of Huangqi （Astragalus mongholicus） with flexible combination of medicinals to replenish deficiencies， invigorate qi， and regulate blood vessels.

AIM: To investigate the pathogenic bacteria, drug resistance, therapy and prognosis of infectious endophthalmitis secondary to different ophthalmic surgeries.METHODS:A retrospective analysis was conducted on the clinical data of 37 patients(37 eyes)with infectious endophthalmitis secondary to different ophthalmic surgeries. All these patients were treated in the Ophthalmology Department of Hebei General Hospital between January 2009 and June 2023. The pathogenic bacteria, drug resistance and therapeutic effects of early intravitreal injection of antibiotics or vitrectomy combined with silicone oil filling were analyzed.RESULTS:There were 24 eyes following cataract phacoemulsification combined with intraocular lens implantation, 4 eyes following vitrectomy, 2 eyes following combination surgery for glaucoma and cataract, 2 eyes following anti-glaucoma surgery, 2 eyes following corneal transplantation, 2 eyes following anterior chamber puncture, and 1 eye following intravitreal injection among the 37 eyes with infectious endophthalmitis. Totally 37 samples of intraocular fluid were submitted for bacterial and fungal culture, and 20 strains of pathogenic bacteria were identified, including 17 Gram-positive bacteria, 2 Gram-negative bacteria, 1 fusarium, and 12 cases were staphylococcus epidermidis. According to the final therapy, 7 eyes only treated by intravitreal injection, 11 eyes treated by intravitreal injection and vitrectomy, and 19 eyes only treated by vitrectomy. At the last follow-up, the best corrected visual acuity(BCVA)was ≤0.05 in 15 eyes, 0.06-0.3 in 15 eyes, and 0.4-1.0 in 7 eyes. Compared to before treatment(no light perception - hand movement in 31 eyes, counting fingers -0.05 in 3 eyes, 0.06-0.3 in 3 eyes), the difference was statistically significant(P<0.001).CONCLUSION: For infectious endophthalmitis patients with relatively mild ocular manifestation and good initial visual acuity, intravitreal injection of antibiotics remains an economically viable and effective therapy option. Early vitrectomy may effectively prevent the progression of infectious endophthalmitis, reduce the number of surgeries, and significantly improve the vision outcomes.

Objective:To investigate the correlation between CHA 2DS 2-VASC score and the recurrence risk of paroxysmal atrial fibrillation after radiofrequency ablation. Methods:It was a retrospective cohort study. A total of 150 patients who underwent radiofrequency ablation for paroxysmal atrial fibrillation in Xingtai People′s Hospital from January 2017 to January 2021 were consecutively included in the study. According to the preoperative CHA 2DS 2-VASC score, patients were divided into high score group (≥3 points, n=90) and low score group (<3 points, n=60). Baseline clinical data was collected. All patients underwent circumferential pulmonary vein isolation, and those with atrial flutter before ablation also underwent tricuspid isthmus isolation. Holter and electrocardiogram examinations were performed at 3, 6 months and 1 year after ablation to evaluate whether there was recurrence of atrial fibrillation. Univariate and multivariate Cox regression was used to analyze the risk factors for recurrence of atrial fibrillation after radiofrequency ablation. Results:Among 150 patients 90 were males and 60 were females with a mean age of (64.0±3.6) years. There were no significant differences in age, sex, and proportion of hypertension, diabetes, chronic heart failure and stroke or transient ischemic attack (TIA), medication of antiarrhythmic and anticoagulant drugs between the two groups (all P>0.05). The longest duration of atrial fibrillation in the high score group was significantly longer than that in the low score group (26.0±6.1) hours vs. (10.0±2.1) hours, P<0.05). There were no patients with cardiac tamponade, atrial esophageal fistula and severe vascular puncture complications in the two groups. During the follow-up period, the recurrence rate in the high score group was significantly higher than that in the low score group (16.7% (15/90) vs. 8.3% (5/60), P<0.05). Multivariate Cox regression analysis showed that CHA 2DS 2-VASC score≥3 was an independent risk factor for atrial fibrillation recurrence in patients with paroxysmal atrial fibrillation after radiofrequency ablation ( HR=3.84, 95% CI: 1.87-7.89, P=0.02). Conclusion:CHA 2DS 2-VASC score≥3 is an independent risk factor for atrial fibrillation recurrence in patients with paroxysmal atrial fibrillation after radiofrequency ablation.

Naked-eye 3D display technology has excellent 3D visual effects and does not require wearable devices assistance.It can present the depth,position and complex structure information of 3D medical images,allowing viewers to obtain information about tissues and organs from different points,reducing cognitive load,contributing to medical teaching and opening up innovative methods for planning and diagnosis.Naked-eye 3D augmented reality display can display medical images in real 3D space,achieving virtual and real vision.It helps a lot to medical research.The applications of naked-eye 3D display technology in three major aspects of medical diagnosis,clinical surgery and rehabilitation training is reviewed in the study.It provides the direction for the subsequent research in medical field,thus assisting medical research and improving medical practice.

OBJECTIVE To investigate the effect of Jianpi Yangzheng(JPYZ)formula regulating tumor-associated macrophage(TAM)exosomes on anoikis in gastric cancer and its mechanism.METHODS TAM model was established by inducing human mononuclear THP-1 cells in vitro;M0,TAM and TAM+JPYZ formula exosomes were extracted by ultracentrifugation and co-incuba-ted with gastric cancer cells.Flow cytometry was used to detect the effect of exosomes in each group on anoikis in gastric cancer cells.A BALB/c transplanted tumor mouse model was constructed,and the expression level of apoptotic proteins in transplanted tumors was detected by Western blot.Label-free mass spectrometry proteomics and bioinformatics were used to analyze the differential proteins in gastric cancer cells before and after intervention;Western blot and qPCR experiments were used to detect the expression level of dif-ferential protein isocitrate dehydrogenase 1(IDH1),and ubiquitination experiments were used to detect the ubiquitination level of IDH1;kits were used to detect the levels of α-ketoglutarate(α-KG),NADPH/NADP+,glutathione(GSH/GSSG)and reactive oxy-gen species(ROS)content.RESULTS The anoikis rate of gastric cancer cells was reduced after TAM exosomes intervention(P<0.05,P<0.01),while it was significantly increased after TAM+JPYZ exosomes intervention(P<0.05,P<0.01).In the in vivo mouse experiment,the ratio of Cleaved Caspase-3/Caspase-3 in the tumor of the TAM exosome group was reduced(P<0.05),while the ra-tio was significantly increased after TAM+JPYZ exosome intervention(P<0.05).Proteomic analysis showed that IDH1 was significant-ly different after intervention,and was related to tricarboxylic acid cycle metabolism.Compared with the M0 group,the IDH1 ubiquiti-nation level of gastric cancer cells in the TAM group with exosome intervention was increased,the levels of α-KG,NADPH/NADP+and GSH/GSSG were significantly increased,and the ROS content was reduced(P<0.05),while TAM+JPYZ exosomes could reverse the above phenomenon.CONCLUSION JPYZ Formula can regulate TAM exosomes to cause ubiquitin degradation of IDH1 in gas-tric cancer cells,reduce the level of tricarboxylic acid cycle metabolism in gastric cancer cells,promote ROS accumulation,induce anoikis in gastric cancer,and thus inhibit the development of gastric cancer.

Objective To compare the efficacy of endoscopic submucosal dissection(ESD)using the flexible auxiliary single-arm transluminal endoscopic robot(FASTER)with that of the traditional technique,and explore a safer and more efficient ESD operation method.Methods FASTER-assisted ESD and traditional ESD were used to operate in the isolated pig esophagus model.The differences of total procedure time,ESD time,the rate of direct-vision dissection,complete en bloc resection and complication rate between the two groups were compared and analyzed.Results The total procedure time[(19.2±2.9)and(28.9±8.2)min]and ESD time[(13.0±2.9)and(21.6±8.3)min]were significantly shorter in FASTER-assisted ESD group than those in traditional ESD group,the differences were statistically significant(P<0.01);The rate of direct-vision dissection was significantly higher than that of the traditional ESD(96.2%and 65.4%),the difference was statistically significant(P=0.014).Muscle layer injury rate was significantly lower than of the traditional group(19.2%and 69.2%),the difference was statistically significant(P<0.01).There was no significant difference in complete en bloc resection rate and perforation rate between the two groups(P>0.05).These advantages were more apparent in esophageal non-gravity lesions.Conclusion Esophageal ESD assisted by FASTER is safer and more efficient than traditional ESD.

Objective: To investigate the trends in cerebrovascular disease mortality among residents in Hangzhou City from 2006 to 2020, so as to provide insights into the development of cerebrovascular disease control strategy. Methods: The cerebrovascular disease mortality data were collected from residents in Hangzhou City through household registered death cards recorded in county- and city-level hospitals, township-level health centers and community health service centers in Hangzhou City and standardized by the national population census data in China in 2010. The changes in the crude and standardized mortality of cerebrovascular diseases were estimated using annual percent change (APC) in Hangzhou City from 2006 to 2020. Results: A total of 109 891 deaths were reported due to cerebrovascular diseases among residents in Hangzhou City from 2006 to 2020, accounting for 17.72% of all deaths in Hangzhou City during the 15-year period, and the crude and standardized mortality rates were 105.83/105 and 65.15/105, which both appeared a tendency towards a decline (crude mortality: APC=-0.80%, t=-3.832, P=0.002; standardized mortality: APC=-4.69%, t=-24.084, P<0.001). The crude mortality of hemorrhagic stroke showed a tendency towards a decline among residents in Hangzhou City from 2006 to 2020 (APC=-7.97%, t=-30.704, P<0.001), and the crude mortality of both ischemic stroke (APC=5.76%, t=6.106, P<0.001) and sequelae of cerebrovascular disease (APC=13.20%, t=18.103, P<0.001) appeared a tendency towards a rise. The crude mortality of cerebrovascular diseases was significantly higher in men than in women (110.15/105 vs. 101.51/105; χ2=183.078, P<0.001), which both appeared a tendency towards a decline among residents in Hangzhou City from 2006 to 2020 (men: APC=-0.90%, t=-4.669, P<0.001; women: APC=-0.70%, t=-2.658, P=0.020). The crude mortality of cerebrovascular diseases was 101.95/105 and appeared a tendency towards a decline among urban residents in Hangzhou City from 2006 to 2020 (APC=-1.19%, t=-3.655, P=0.003), and was 112.46/105 and showed no remarkable changes among rural residents in Hangzhou City from 2006 to 2020 (t=-0.719, P=0.485). In addition, the crude mortality of cerebrovascular diseases appeared a tendency towards a rise with age among residents in Hangzhou City from 2006 to 2020 (χ2trend=502 711.682, P<0.001), and the crude mortality of cerebrovascular diseases appeared a tendency towards a decline among residents at ages of 35 years and above in Hangzhou City from 2006 to 2020 (P<0.05). Conclusions The cerebrovascular disease mortality appeared a tendency towards a decline among residents in Hangzhou City from 2006 to 2020, and a high mortality rate of cerebrovascular diseases was seen among rural residents, men and the elderly.

Objective : To learn the association between dietary patterns and thyroid cancer in Hangzhou residents, and to provide evidence for thyroid cancer prevention. Methods: The newly diagnosed patients with thyroid cancer in Zhejiang Cancer Hospital were selected as the case group, while the healthy population matched (1∶1) by gender, age and residence were selected from community as the control group. A questionnaire survey was conducted to obtain demographic characteristics, disease history, dietary intake, lifestyle and other information. The dietary patterns were established by factor analysis. The multivariate conditional logistic regression model was conducted to explore the relationship between different dietary patterns and thyroid cancer. Results: A total of 258 pairs of cases and controls were recruited. Five dietary patterns were obtained, including vegetarian pattern, high-protein food pattern, salted vegetables and algae pattern, seafood and cereal pattern, as well as alcohol and tea pattern. The multivariate conditional logistic regression analysis suggested seafood and cereal pattern might reduce the risk of thyroid cancer (OR=0.286, 95%CI: 0.146-0.561). Conclusion More consumption of seafood and cereal may decrease the incidence of thyroid cancer.

Objective : To learn the incidence trend of gestational diabetes mellitus (GDM) among women of childbearing age in Hangzhou from 2009 to 2018, providing evidence for GDM prevention and control. Methods: The information of GDM cases aged 15 to 49 years in Hangzhou from 2009 to 2018 was extracted from Zhejiang non-communicable diseases surveillance system. The crude and age-standardized (by national standard population in 2000) incidence rate of GDM were calculated, the annual change percentage (APC) and the average APC (AAPC) of GDM incidence rate were calculated to understand the trend of incidence in different age groups and areas. Results: A total of 45 519 cases of GDM were reported in Hangzhou from 2009 to 2018. The crude and age-standardized incidence rates were 248.04/100 000 and 158.52/100 000, respectively, both showed upward trends with 59.7% and 56.4% in AAPC (both P<0.05). The APCs of crude and age-standardized incidence rates of GDM were 139.76% and 134.60% from 2009 to 2012, 30.35% and 27.65% from 2012 to 2018, which all had increasing trends (all P<0.05). There were upward trends in GDM incidence in each age groups of 15-24, 25-29, 30-34, 35-39 and 40-49 years old (all P<0.05). The AAPC of GDM incidence in 40-49 year-old women was 65.3% and ranked the first among all the age groups. The age-standardized incidence rate of GDM increased more in rural areas (AAPC=66.0%) than in urban areas (AAPC=53.4%). Conclusion A rising trend in GDM incidence among women aged 15-49 years in Hangzhou has been found in recent ten years, especially in women aged 40-49 years and lived in rural areas.