Pancreatic cancer is highly aggressive and often diagnosed at an advanced stage,leaving most patients ineligible for radical resection.This study retrospectively analyzed four patients with locally advanced or advanced pancreatic cancer to evaluate the clinical efficacy and safety of high-intensity focused ultrasound(HIFU)ablation combined with chemotherapy as a neoadjuvant and conversion therapy.All cases were reviewed and individualized treatment plans were formulated through a multidisciplinary team evaluation.All patients received HIFU plus gemcitabine and nab-paclitaxel chemotherapy,with assessments of tumor volume,vascular involvement,surgical conversion,symptom relief,and adverse events.Three patients achieved marked tumor shrinkage and reduction of vascular invasion,enabling successful R0 resection without recurrence during follow-up.The remaining patient achieved disease stability,significant pain relief,and maintained good quality of life under repeated HIFU therapy.All treatments were well tolerated,and no severe adverse reactions occurred.The combination of HIFU and chemotherapy demonstrated synergistic local and systemic effects,effectively achieving tumor downstaging,improving resectability,and alleviating symptoms.As a safe,noninvasive,and repeatable therapeutic approach,this strategy offers a promising option for patients with advanced pancreatic cancer.Further large-scale prospective studies are warranted to validate its long-term efficacy and elucidate underlying mechanisms.

Pancreatic cancer is highly aggressive and often diagnosed at an advanced stage,leaving most patients ineligible for radical resection.This study retrospectively analyzed four patients with locally advanced or advanced pancreatic cancer to evaluate the clinical efficacy and safety of high-intensity focused ultrasound(HIFU)ablation combined with chemotherapy as a neoadjuvant and conversion therapy.All cases were reviewed and individualized treatment plans were formulated through a multidisciplinary team evaluation.All patients received HIFU plus gemcitabine and nab-paclitaxel chemotherapy,with assessments of tumor volume,vascular involvement,surgical conversion,symptom relief,and adverse events.Three patients achieved marked tumor shrinkage and reduction of vascular invasion,enabling successful R0 resection without recurrence during follow-up.The remaining patient achieved disease stability,significant pain relief,and maintained good quality of life under repeated HIFU therapy.All treatments were well tolerated,and no severe adverse reactions occurred.The combination of HIFU and chemotherapy demonstrated synergistic local and systemic effects,effectively achieving tumor downstaging,improving resectability,and alleviating symptoms.As a safe,noninvasive,and repeatable therapeutic approach,this strategy offers a promising option for patients with advanced pancreatic cancer.Further large-scale prospective studies are warranted to validate its long-term efficacy and elucidate underlying mechanisms.

Objective:To investigate the effects of lactulose and oral rehydration salt powder (Ⅲ) on bowel preparation for colonoscopy and their impact on the detection rate of lesions.Methods:A retrospective study was conducted with 120 patients who underwent colonoscopy at The Second Affiliated Hospital of Wenzhou Medical University from January 2023 to April 2024. The patients were randomly divided into a control group and an experimental group, with 60 patients in each group. The control group received Hengkang Zhengqing and simethicone for bowel preparation, while the experimental group received lactulose, oral rehydration salt powder (Ⅲ), and simethicone for bowel preparation. The Boston Bowel Preparation Scale (referred to as the Boston scale) was used to assess bowel cleanliness, the Bubble scale was used to assess the presence of gas in the bowel, and a self-designed questionnaire was used to evaluate patient satisfaction after colonoscopy. The Boston scale scores, Bubble scale scores, patient satisfaction, lesion detection rates, and the incidence of adverse reactions were compared between the two groups. Results:The total score on the Boston scale in the experimental group was significantly higher than that of the control group [(7.23 ± 1.30) vs. (5.44 ± 1.17), t = 7.92, P < 0.001]. The Bubble scale score in the experimental group was significantly higher than that of the control group [(2.60 ± 0.15) vs. (2.21 ± 0.10), t = 16.75, P < 0.001]. The rates of acceptable taste and tolerance in the experimental group were 96.6% (58/60) and 95.0% (57/60), respectively, both of which were higher than those in the control group at 86.6% (52/60) and 81.6% (49/60) ( χ2 = 3.92, 5.17, P = 0.048, 0.023). The detection rate of colonic polyps in the experimental group was significantly higher than that in the control group [31.67% (19/60) vs. 15.00% (9/60), χ2 = 4.65, P = 0.031]. The incidence of adverse reactions in the experimental group was significantly lower than that in the control group [3.33% (2/60) vs. 13.33% (8/60), χ2 = 3.92, P = 0.048]. The patient satisfaction rate after examination in the experimental group was significantly higher than that in the control group [96.67% (58/60) vs. 85.00% (52/60), χ2 = 4.90, P = 0.027]. Conclusions:The intestinal preparation for colonoscopy using the lactulose and oral rehydration salt powder (Ⅲ) regimen can significantly improve the quality of bowel preparation and the detection rate of lesions. Additionally, it offers better taste, higher patient tolerance, and greater satisfaction, along with fewer adverse reactions compared with the Hengkang Zhengqing and simethicone regimen.

Objective:To investigate the effects of lactulose and oral rehydration salt powder (Ⅲ) on bowel preparation for colonoscopy and their impact on the detection rate of lesions.Methods:A retrospective study was conducted with 120 patients who underwent colonoscopy at The Second Affiliated Hospital of Wenzhou Medical University from January 2023 to April 2024. The patients were randomly divided into a control group and an experimental group, with 60 patients in each group. The control group received Hengkang Zhengqing and simethicone for bowel preparation, while the experimental group received lactulose, oral rehydration salt powder (Ⅲ), and simethicone for bowel preparation. The Boston Bowel Preparation Scale (referred to as the Boston scale) was used to assess bowel cleanliness, the Bubble scale was used to assess the presence of gas in the bowel, and a self-designed questionnaire was used to evaluate patient satisfaction after colonoscopy. The Boston scale scores, Bubble scale scores, patient satisfaction, lesion detection rates, and the incidence of adverse reactions were compared between the two groups. Results:The total score on the Boston scale in the experimental group was significantly higher than that of the control group [(7.23 ± 1.30) vs. (5.44 ± 1.17), t = 7.92, P < 0.001]. The Bubble scale score in the experimental group was significantly higher than that of the control group [(2.60 ± 0.15) vs. (2.21 ± 0.10), t = 16.75, P < 0.001]. The rates of acceptable taste and tolerance in the experimental group were 96.6% (58/60) and 95.0% (57/60), respectively, both of which were higher than those in the control group at 86.6% (52/60) and 81.6% (49/60) ( χ2 = 3.92, 5.17, P = 0.048, 0.023). The detection rate of colonic polyps in the experimental group was significantly higher than that in the control group [31.67% (19/60) vs. 15.00% (9/60), χ2 = 4.65, P = 0.031]. The incidence of adverse reactions in the experimental group was significantly lower than that in the control group [3.33% (2/60) vs. 13.33% (8/60), χ2 = 3.92, P = 0.048]. The patient satisfaction rate after examination in the experimental group was significantly higher than that in the control group [96.67% (58/60) vs. 85.00% (52/60), χ2 = 4.90, P = 0.027]. Conclusions:The intestinal preparation for colonoscopy using the lactulose and oral rehydration salt powder (Ⅲ) regimen can significantly improve the quality of bowel preparation and the detection rate of lesions. Additionally, it offers better taste, higher patient tolerance, and greater satisfaction, along with fewer adverse reactions compared with the Hengkang Zhengqing and simethicone regimen.

It is believed that the endoscopic manifestations of interstitial cystitis/bladder pain syndrome （IC/BPS） such as extensive bleeding and Hunner's ulcers as well as its recurrent and prolonged condition are in line with the characteristics of sores and ulcers in traditional Chinese medicine （TCM）， and the treatment can be referred to TCM theory of sores and ulcers. The mechanism of IC/BPS is characterized by root deficiency and branch excess. The root cause is deficiency of the spleen and kidney qi， while the manifesting factors are dampness-heat and blood stasis. The treatment is based on the principles of promoting and supplementing， combining with resolving therapy， so that the symptoms could be relieved by promoting blood circulation and clearing heat， unblocking the collaterals and relieve pain. In clinical practice， modified Neituo Shengji Powder （内托生肌散） was commonly used to boost qi and invigorate blood， expel swollen sore and express toxin； combining with Sijunzi Decoction （四君子汤） or Suoquan Pill （缩泉丸） based on specific symptoms to strengthen the spleen and kidneys， thereby reinforcing healthy qi； according to concurrent symptoms like blood stasis， dampness heat， prescription with Sanleng （Cyperus rotundus）， Ezhu （Curcuma aromatica Salisb） to invigorate blood and dissolve stasis， or Yiyiren （Coix lacryma-jobi）， Zexie （Alisma plantago-aquatica） to clear heat and drain dampness.

Background: Overactive bladder (OAB) is a prevalent condition that substantially degrades patient quality of life. Acupuncture is recognized as an effective therapeutic approach for various urological diseases. However, there is limited evidence validating the effectiveness and safety of acupuncture for OABs. Objective: To assess the therapeutic efficacy of acupuncture for OAB and to investigate the potential mechanisms by analyzing its effects on relevant urinary biomarkers. Methods: This is a randomized, participants and outcome assessors blinded, sham acupuncture controlled trial. A total of 110 patients with OABs will be randomly divided in a 1:1 ratio between the acupuncture and sham acupuncture groups. Participants in the acupuncture group will undergo 30-min authentic acupuncture, while their counterparts in the sham acupuncture group will undergo sham acupuncture needling non-acupoints superficially three times weekly for a duration of 8 weeks. The two co-primary outcomes will be the change in the mean number of micturitions per 24 h from baseline to the end of the 8-week treatment and 20-week follow-up. The secondary outcomes will encompass the change in Overactive Bladder Symptom Score, Overactive Bladder Questionnaire Short Form, and average 24 h values of urgency, daytime micturition, nocturia, and mean volume voided per micturition from baseline to weeks 8 and 20. Urinary nerve growth factor, brain-derived neurotrophic factor, and monocyte chemoattractant protein-1 levels will be measured at baseline and week 8. Adverse events will also be documented. Discussion The results of this trial will provide evidence for the effectiveness and safety of acupuncture in the management of OAB.

Objective:To investigate the prevalence of abnormal chromosomal karyotype in amniotic fluid cells from penatal fetuses in the Huaibei Region and to analyze the detection rates of abnormal chromosomal karyotype across different populations based on indications for prenatal diagnosis.Methods:This study is a retrospective analysis. A total of 883 pregnant women who visited the Prenatal Diagnosis Center at Huaibei Maternal and Child Health Care Hospital between January 2018 and December 2022 were included in this study. All participants had indications for prenatal diagnosis and underwent sterile amniocentesis under ultrasound guidance. Amniotic fluid was collected for dual culture of amniotic fluid cells and chromosomal karyotype analysis.Results:The success rate of amniotic fluid specimen culture was 99.55% (879/883). The detection rate of abnormal karyotypes was 9.22% (81/879), with numerical abnormalities accounting for 76.54% (62/81), structural abnormalities for 17.28% (14/81), and chimerism for 6.17% (5/81). The detection rates of abnormal karyotypes based on various prenatal diagnostic indications are summarized below: 2.56% (8/313) in the high-risk group for Down syndrome screening, 36.57% (49/134) in the high-risk group for non-invasive prenatal testing, 4.23% (9/213) in the group with abnormal B-ultrasound findings, 6.90% (10/145) in the advanced age group (≥ 35 years), 25.00% (4/16) in the group with chromosomal abnormalities in either the mother or her partner, and 1.72% (1/58) in the group with adverse pregnancy outcomes.Conclusion:Prenatal diagnosis is of great significance for detecting chromosomal abnormalities in fetuses. In the Huaibei Region, numerical abnormalities account for the highest proportion of detected prenatal fetal chromosomal abnormalities. The detection rates vary among different prenatal diagnostic indication groups, with non-invasive prenatal testing demonstrating the highest sensitivity.

Objective:To investigate the prevalence of abnormal chromosomal karyotype in amniotic fluid cells from penatal fetuses in the Huaibei Region and to analyze the detection rates of abnormal chromosomal karyotype across different populations based on indications for prenatal diagnosis.Methods:This study is a retrospective analysis. A total of 883 pregnant women who visited the Prenatal Diagnosis Center at Huaibei Maternal and Child Health Care Hospital between January 2018 and December 2022 were included in this study. All participants had indications for prenatal diagnosis and underwent sterile amniocentesis under ultrasound guidance. Amniotic fluid was collected for dual culture of amniotic fluid cells and chromosomal karyotype analysis.Results:The success rate of amniotic fluid specimen culture was 99.55% (879/883). The detection rate of abnormal karyotypes was 9.22% (81/879), with numerical abnormalities accounting for 76.54% (62/81), structural abnormalities for 17.28% (14/81), and chimerism for 6.17% (5/81). The detection rates of abnormal karyotypes based on various prenatal diagnostic indications are summarized below: 2.56% (8/313) in the high-risk group for Down syndrome screening, 36.57% (49/134) in the high-risk group for non-invasive prenatal testing, 4.23% (9/213) in the group with abnormal B-ultrasound findings, 6.90% (10/145) in the advanced age group (≥ 35 years), 25.00% (4/16) in the group with chromosomal abnormalities in either the mother or her partner, and 1.72% (1/58) in the group with adverse pregnancy outcomes.Conclusion:Prenatal diagnosis is of great significance for detecting chromosomal abnormalities in fetuses. In the Huaibei Region, numerical abnormalities account for the highest proportion of detected prenatal fetal chromosomal abnormalities. The detection rates vary among different prenatal diagnostic indication groups, with non-invasive prenatal testing demonstrating the highest sensitivity.

Objective: To observe the effects of electroacupuncture (EA) at Neiguan (PC6) on arrhythmia during acute myocardial ischemia-reperfusion and the expression of connexin 43 (Cx43) in rats. Methods: A total of 40 Sprague-Dawley male rats were used. Ten rats were randomly selected as the blank group, and the remaining 30 rats were randomly divided into a model group and an EA group, with 15 rats in each group. Before modeling, rats in the EA group received one session of EA intervention at bilateral Neiguan (PC6) for 30 min; the other groups were treated with the same grasping and anesthesia for 30 min without intervention. PowerLab physiological recorder was used to record electrocardiograph within 30 min of infarction. After the experiment, cardiac tissue and serum were collected from rats. Hematoxylin-eosin (HE) staining was used to observe the morphological changes of myocardial tissue in the ventricular infarction area of rats in each group. The expression of Cx43 protein in the myocardium of each group was detected by Western blotting (WB). Enzyme-linked immunosorbent assay (ELISA) was used to determine the activity of Na+-K+-ATPase in myocardial tissue and the serum content of endogenous digitalis-like factor (EDLF) in rats. Results: There was no statistical difference in arrhythmia score between the EA group and the model group, but the total duration and average duration of arrhythmia in the EA group were decreased (P<0.01). HE staining showed that compared with the blank group, myocardial cells in the model group were disorganized and seriously damaged. The pathological changes in the EA group were similar to those in the model group, but the damage was relatively minor. The results of WB showed that compared with the blank group, the Cx43 expression in myocardial tissue of the model group was decreased (P<0.01); compared with the model group, the Cx43 expression in the EA group was increased (P<0.01); compared with the blank group, the Na+-K+-ATPase activity in myocardial tissue of the model group was significantly decreased (P<0.01); compared with the model group, the Na+-K+-ATPase activity in the EA group was increased (P<0.01). ELISA results showed that compared with the blank group, the serum EDLF content in the model group was significantly increased (P<0.01); compared with the model group, the EDLF content in the EA group was decreased (P<0.01). Conclusion: EA at Neiguan (PC6) can delay and reduce the onset of arrhythmia during myocardial infarction in the rat model of myocardial ischemia-reperfusion. Its mechanism of action may be related to the regulation of the Cx43 expression in myocardial tissue, improvement of the activity of Na+-K+-ATPase in myocardial tissue, and increase in the content of serum EDLF.

Objective To explore the impact of predictive nursing intervention under the guidance of the"5S"management model on the rehabilitation effect and pulmonary infection rate of hypertensive intracerebral hemorrhage patients.Methods A total of 120 patients with hypertensive intracerebral hemorrhage who were treated at the Second Affiliated Hospital of Wenzhou Medical University from January 2022 to January 2023 were selected as the research subjects.Patients were divided into a predictive nursing intervention group and a conventional nursing group using a random number table method,with 60 patients in each group.The routine nursing group received routine care,while the predictive nursing intervention group received predictive nursing intervention guided by the"5S"management model.The modified Rankin scale(mRS)was used to evaluate the patient's neurological function.The mini-mental state examination(MMSE)was used to evaluate the cognitive function of patients.The differences of mRS and MMSE scores between two groups of patients with different nursing interventions were compared,and the incidence of complications,hospital stay,and disability rate were recorded between both groups.Results After the intervention,the cognitive function score of the predictive nursing intervention group was significantly higher than before the intervention,while the neurological function score was significantly lower than before the intervention.After intervention,the cognitive function score of the predictive nursing intervention group was significantly higher than that of the conventional nursing group(28.02±2.03 vs.24.57±2.25,P＜0.05).The neurological function score was significantly lower than that of the conventional nursing group(1.55±0.67 vs.2.20±0.48,P＜0.05).The hospitalization time and disability rate in the predictive nursing intervention group were significantly lower than those in the conventional nursing group[hospitalization time(days):14.94±6.02 vs.25.33±7.03,disability rate:8.33%(5/60)vs.23.33%(14/60),both P＜0.05].The incidence of pressure injury,lung infection,and urinary system infection was significantly lower than that of the conventional nursing group[pressure injury:1.67%(1/60)vs.10.00%(6/60),lung infection:1.67%(1/60)vs.11.67%(7/60),urinary system infection:0%(0/60)vs.6.67%(4/60),all P＜0.05].Conclusions Under the guidance of the"5S"management model,predictive nursing can significantly improve postoperative cognitive and neurological dysfunction in patients with hypertensive cerebral hemorrhage,reduce disability rates,shorten hospital stay,and reduce the incidence of complications such as pulmonary infections.It has good clinical application prospects.