Objective To explore the influencing factors for delayed resuscitation from anaesthesia in patients undergoing pancreatic cancer surgery and to develop a prediction model and evaluate its predictive performance.Methods This study included 300 patients who had surgery under general anaesthesia for pancreatic cancer at a Tier-IIIA hospital in Jiangsu Province between September 2023 and February 2024.The patients who had the surgery between September and December 2023(n=208)were assigned to the modelling group,and those between January to February 2024(n=92)to the validation group.Baseline perioperative data were recorded.Binary logistic regression was used to identify risk factors for delayed resuscitation,and a risk prediction model was finally developed and validated.Results Over 60 years of age,bispectral index(BIS)monitoring,combined with regional block anaesthesia,and rescue analgesia were identified as the risk factors for delayed resuscitation(all P<0.05).The Hosmer-Lemeshow test confirmed a good model fit(P>0.05).The C-index value was 0.807 for the modelling group and 0.841 for the validation group.The area under the curve(AUC)of receiver operating characteristic(ROC)was 0.807(95%CI 0.738～0.876)for the modelling group and 0.841(95%CI 0.742～0.940)for the validation group,with both calibration curves close to the ideal curve.Conclusion The developed prediction model for delayed resuscitation exhibits a good predictive performance and it can serve as a reference for clinical staff.

Foreign bodies in the tongue are rare in clinical practice. Accurate localization and appropriate surgical path selection are essential to reduce surgical risk and postoperative complications. This paper reports a case in which the fishbone foreign body at the base of tongue was removed using a translingual ventral approach aided with imaging localization.
Humans ; Foreign Bodies/diagnostic imaging* ; Tongue/surgery*

Objective To explore the influencing factors for delayed resuscitation from anaesthesia in patients undergoing pancreatic cancer surgery and to develop a prediction model and evaluate its predictive performance.Methods This study included 300 patients who had surgery under general anaesthesia for pancreatic cancer at a Tier-IIIA hospital in Jiangsu Province between September 2023 and February 2024.The patients who had the surgery between September and December 2023(n=208)were assigned to the modelling group,and those between January to February 2024(n=92)to the validation group.Baseline perioperative data were recorded.Binary logistic regression was used to identify risk factors for delayed resuscitation,and a risk prediction model was finally developed and validated.Results Over 60 years of age,bispectral index(BIS)monitoring,combined with regional block anaesthesia,and rescue analgesia were identified as the risk factors for delayed resuscitation(all P<0.05).The Hosmer-Lemeshow test confirmed a good model fit(P>0.05).The C-index value was 0.807 for the modelling group and 0.841 for the validation group.The area under the curve(AUC)of receiver operating characteristic(ROC)was 0.807(95%CI 0.738～0.876)for the modelling group and 0.841(95%CI 0.742～0.940)for the validation group,with both calibration curves close to the ideal curve.Conclusion The developed prediction model for delayed resuscitation exhibits a good predictive performance and it can serve as a reference for clinical staff.

Objective To observe and analyze the clinical efficacy of Hewei Jiangni Formula in treating patients with non-erosive gastroesophageal reflux disease(NERD)and cold-heat complex syndrome and explore its regulatory mechanism on visceral hypersensitivity.Methods Sixty patients with NERD and cold-heat complex syndrome diagnosed at the Gastroenterology Clinic of Dongfang Hospital,Beijing University of Chinese Medicine from January 2021 to Decemer 2023,were randomly divided into the Hewei Jiangni Formula group and omeprazole group,with 30 patients per group.The Hewei Jiangni Formula group was treated with Hewei Jiangni Formula and omeprazole enteric-coated tablets placebo,whereas the omeprazole group was treated with omeprazole enteric-coated tablets and Hewei Jiangni Formula placebo.The treatment period was scheduled to last for 8 weeks.The primary outcome indicators(Gastroesophageal Reflux Disease Quality of Life Questionnaire(GERD-Q)scale score:response rate,total score,and single symptom score)and secondary outcome indicators(traditional Chinese medicine clinical scores scale)were recorded before and after treatment in both groups.Ten healthy individuals were recruited from the Physical Examination Center of Dongfang Hospital,Beijing University of Chinese Medicine,as the healthy control group.The expression levels of mast cell tryptase(MCT),protease-activated receptor 2(PAR2),transient receptor potential vanilloid 1(TRPV1),substance P(SP),calcitonin gene-related peptide(CGRP),5-hydroxytryptamine(5-HT),and 5-hydroxytryptamine 3 receptor(5-HT3R)were recorded.These indicators were then used for the following comparisons:the NERD patients vs.the healthy group before treatment;the Hewei Jiangni Formula group vs.the omeprazole group after treatment;the intra-group comparisons within both NERD groups.Changes in serum levels of these indicators were observed before and after treatment in both NERD groups.Results According to the GERD-Q scores before and after treatment,the effective rate was 90.00%in the Hewei Jiangni Formula group and 86.67%in the omeprazole group,with no significant differences.Both groups exhibited improved symptoms of heartburn,regurgitation,upper abdominal pain,and sleep disorders caused by heartburn or regurgitation(P<0.05);however,neither group exhibited significantly improved nausea(P>0.05).Before treatment,MCT,PAR2,TRPV1,SP,CGRP,5-HT,and 5-HT3R expression levels in both NERD groups were significantly higher than those in the healthy control group(P<0.05).After treatment with Hewei Jiangni Formula or omeprazole enteric-coated tablets,the expression levels of these indicators decreased in both groups(P<0.05).The omeprazole group was superior to Hewei Jiangni Formula in reducing 5-HT3R expression(P<0.05).Conclusion Hewei Jiangni Formula significantly improves the symptoms of patients with NERD and cold-heat complex syndrome,with efficacy comparable to that of omeprazole enteric-coated tablets.It is superior to omeprazole in improving symptoms of spleen yang deficiency,such as loss of appetite,fatigue,borborygmus with loose stools,and cold extremities.Hewei Jiangni Formula reduces MCT,PAR2,TRPV1,SP,CGRP,5-HT,and 5-HT3R expression levels,regulates related signaling pathways,and alleviates visceral hypersensitivity.

Objective To observe and analyze the clinical efficacy of Hewei Jiangni Formula in treating patients with non-erosive gastroesophageal reflux disease(NERD)and cold-heat complex syndrome and explore its regulatory mechanism on visceral hypersensitivity.Methods Sixty patients with NERD and cold-heat complex syndrome diagnosed at the Gastroenterology Clinic of Dongfang Hospital,Beijing University of Chinese Medicine from January 2021 to Decemer 2023,were randomly divided into the Hewei Jiangni Formula group and omeprazole group,with 30 patients per group.The Hewei Jiangni Formula group was treated with Hewei Jiangni Formula and omeprazole enteric-coated tablets placebo,whereas the omeprazole group was treated with omeprazole enteric-coated tablets and Hewei Jiangni Formula placebo.The treatment period was scheduled to last for 8 weeks.The primary outcome indicators(Gastroesophageal Reflux Disease Quality of Life Questionnaire(GERD-Q)scale score:response rate,total score,and single symptom score)and secondary outcome indicators(traditional Chinese medicine clinical scores scale)were recorded before and after treatment in both groups.Ten healthy individuals were recruited from the Physical Examination Center of Dongfang Hospital,Beijing University of Chinese Medicine,as the healthy control group.The expression levels of mast cell tryptase(MCT),protease-activated receptor 2(PAR2),transient receptor potential vanilloid 1(TRPV1),substance P(SP),calcitonin gene-related peptide(CGRP),5-hydroxytryptamine(5-HT),and 5-hydroxytryptamine 3 receptor(5-HT3R)were recorded.These indicators were then used for the following comparisons:the NERD patients vs.the healthy group before treatment;the Hewei Jiangni Formula group vs.the omeprazole group after treatment;the intra-group comparisons within both NERD groups.Changes in serum levels of these indicators were observed before and after treatment in both NERD groups.Results According to the GERD-Q scores before and after treatment,the effective rate was 90.00%in the Hewei Jiangni Formula group and 86.67%in the omeprazole group,with no significant differences.Both groups exhibited improved symptoms of heartburn,regurgitation,upper abdominal pain,and sleep disorders caused by heartburn or regurgitation(P<0.05);however,neither group exhibited significantly improved nausea(P>0.05).Before treatment,MCT,PAR2,TRPV1,SP,CGRP,5-HT,and 5-HT3R expression levels in both NERD groups were significantly higher than those in the healthy control group(P<0.05).After treatment with Hewei Jiangni Formula or omeprazole enteric-coated tablets,the expression levels of these indicators decreased in both groups(P<0.05).The omeprazole group was superior to Hewei Jiangni Formula in reducing 5-HT3R expression(P<0.05).Conclusion Hewei Jiangni Formula significantly improves the symptoms of patients with NERD and cold-heat complex syndrome,with efficacy comparable to that of omeprazole enteric-coated tablets.It is superior to omeprazole in improving symptoms of spleen yang deficiency,such as loss of appetite,fatigue,borborygmus with loose stools,and cold extremities.Hewei Jiangni Formula reduces MCT,PAR2,TRPV1,SP,CGRP,5-HT,and 5-HT3R expression levels,regulates related signaling pathways,and alleviates visceral hypersensitivity.

Objective:To observe the effects of Qifu Lizhong Enema Prescription on ulcerative colitis rats with yang deficiency of spleen and kidney syndrome; To discuss its mechanism.Methods:Totally 70 male SD rats were randomly divided into blank group, model group, mesalazine group, Qifu Lizhong Guanchang Prescription high-, medium- and low-dosage groups; blank group ( n=10), other groups ( n=12). Except for the blank group, the other groups used bitter cold purgative therapy (Dahuang Decoction) by gavage, and combined with trinitrobenzen sulfonic acid (TNBS) +55% ethanol compound method to induce UC rat model. After successful modeling, the blank group and model group were given 1 ml normal saline enema daily, Qifu Lizhong Enema Prescription groups were given Qifu Lizhong Enema Prescription 3.00, 1.50, 0.75 g/kg enema daily, and the mesalazine group was given mesalazine 0.03 g/kg enema daily, once a day for consecutive 14 days. After 14 days, Disease Activity Index (DAI) score was performed, and hematoxylin-eosin staining (HE) was used to observe the pathological tissues of the colon. The expressions of Occludin and adhesion molecules A (JAM-A) protein in colon tissue were detected by immunohistochemistry and Western blot. Results:HE results showed that the mucosal structure was damaged, inflammatory cells were infiltrated, edema and ulcer foci were observed in model group. The mucosal structure of mesalazine group and Qifu Lizhong Enema Prescription groups were intact, and inflammatory infiltration, edema and ulcer of neoepithelial were improved. Compared with model group, the DAI scores of Qifu Lizhong Enema Prescription groups decreased ( P<0.01), the expressions of Occludin and JAM-A in Qifu Lizhong Guanchang Prescription high- and medium-dosage groups significantly increased ( P<0.05). Conclusion:Qifu Lizhong Enema Prescription can significantly relieve the symptoms and pathological morphology of UC rats, and the mechanism of repairing intestinal mucosal barrier may be related to up-regulating the expressions of Occludin and JAM-A proteins.

Objective This paper aims to explore the application value of mixed reality in oral and maxillofacial surgery and to conduct dynamic tracking using an in vitro model.Methods By collecting preoperative enhanced CT data of patients,rebuilding 3D digital model,combined with 3D printing technology,dynamic tracking of lesions was realized in the in vitro model,and the efficiency of different registration methods was compared.Results The 3D vi-sualized head and neck model was obtained by combining multiple anatomical models,and dynamic tracking was com-pleted in vitro.The average tracking time of the facial mark recognition method was T45°=3.67 frames,T90°=10.67 frames,and T total=12 seconds 28 frames(30 frames per second).The average tracking time of QR code recognition method was T45°=1.67 frames,T90°=2.33 frames,and T total=11 seconds 13 frames(30 frames per second).Conclu-sion The combination of MR technology and 3D printing technology can realize the dynamic tracking of lesions in vitro,which lays a foundation for the clinical applica-tion of MR technology to implement precise,personal-ized surgical programs.

Background/Aims: Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. Methods: A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. Results: Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. Conclusions In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.