Objective This study aims to compare the efficacy of video stylets and video laryngoscopes in facilitating nasotracheal intubation during oral surgery.Methods A total of 80 patients,aged between 18 and 70 years old,with ASA grade Ⅰ or Ⅱ,scheduled for elective oral surgery under general anesthesia,were randomly assigned to either the video stylet group(Group N)or the video laryngoscope group(Group C),with 40 patients in each group.In Group N,a video stylet was used to shape the tracheal tube at a 90-degree angle,with the shaping position being the vertical distance from the Adam's apple to the nostril.The tube was inserted from the nasal cavity into the throat under direct visualization,and positioned behind the glottis.In Group C,the tube was initially blindly inserted into the nasal cavity without a core.Upon reaching the throat,a video laryngoscope was employed to lift the epiglottis and expose the glottis from the mouth.The tube was then inserted with the aid of intubation forceps or cuff inflation.The primary outcome measure was the intubation time.Additional measures included the time taken for nasal passage,glottis exposure,and the number of intubation attempts and assistant interventions required.Vital signs,including MAP and HR,were recorded at five minutes of quiet rest upon entering the room(T0),during glottis exposure(T1),upon passage of the tube through the glottis(T2),and one minute after the tube entered the trachea(T3).Complications such as epistaxis,oral mucosal bleeding,loose incisors,and postop-erative sore throat were also documented.Results The intubation time and nasal passage time in Group N were significantly shorter than those in Group C(P<0.05).The number of cuff inflations and intubation forceps assisted cases in Group N was significantly lower than in Group C(P<0.05).There were no significant differences between the two groups in terms of glottis exposure time,first successful intubation times,C-L glottis classification,and mandibular lift-assisted intubation(P>0.05).The increase in MAP and HR in Group N at T1 and T2 was signifi-cantly less than in Group C(P<0.05).The number of cases with mild epistaxis in Group N was significantly lower than in Group C(P<0.05).Similarly,the number of cases with loose incisors and oral mucosal bleeding in Group N was significantly less than in Group C(P<0.05).Conclusion Compared to the video laryngoscope,the video stylet-guided nasotracheal intubation results in a shorter intubation time,less damage to the oronasopharynx,eliminates the need for intubation forceps,and reduces the patient's stress and vascular stress response during intubation.

Objective To explore the short- and mid-term efficacy of Castor single branch aortic stent combined with subclavian artery bypass grafting for the aortic arch lesions. Methods A retrospective analysis of the clinical data of patients with proximal anchor zone insufficiency aortic arch lesions treated with Castor stent combined with subclavian artery bypass grafting at the Department of Cardiac Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from August 2020 to November 2023 was performed. Results A total of 22 patients were included, including 19 males and 3 females, with an average age of (56±16) years. There were 18 patients of aortic dissection and 4 patients of aortic arch tumors. The success rate of surgical technique was 100.0%, and the average postoperative hospital stay for patients was (10±4) days. The median follow-up time was 20 months. During the follow-up period, there were no major complications such as endoleak, paraplegia, cerebral infarction, and renal insufficiency, and all patients had no readmissions. Conclusion For proximal anchor zone insufficiency aortic arch lesions, the treatment method of using a Castor stent branch placed in the left common carotid artery can effectively extend the anchor zone, avoid the huge trauma of open chest surgery, and achieve a good short- and mid-term efficacy.

Objective:To explore the interest of medical students in innovation and entrepreneurship education,providing a reference for optimizing the innovation and entrepreneurship education system.Methods:A total of 510 students from the first to fifth academic years at a medical school were selected as the study subjects.An anonymous online survey was conducted via Questionnaire Star to assess students'understanding of innovation and entrepreneurship cognition,willingness,and the current status of education,and interest scores across different majors were compared.Results:The survey revealed that 92.35%of medical students expressed interest in innovation and entrepreneurship and 96.08%of medical students recognized its importance for personal career development.About 83.53%of medical students believed it was essential for medical schools to cultivate innovation and entrepreneurship awareness,yet only 50.98%viewed it as a means to develop innovative projects.Regarding the current educational environment,over 95%of students affirmed the school's initiatives,supportive atmosphere,and resource provision.However,only 32.35%had participated in extracurricular innovation and entrepreneurship activities.During the process of innovation and entrepreneurship,87.65%of the students believed that lack of experience was the main obstacle.And 80.59%of the students hope that the school could provide venues and financial support.And 90.19%of the students expected that school-enterprise cooperation could increase practical opportunities.Additionally,professional background significantly influenced students'interest,with dental medicine students scoring markedly higher than those in clinical medicine,medical laboratory technology,and other disciplines(P＜0.05).Conclusions:The surveyed medical students demonstrated a positive attitude toward innovation and entrepreneurship,yet gaps remained in practical application and resource accessibility.The institution should refine curricula,strengthen industry-academia collaboration,and develop tailored programs based on disciplinary characteristics to enhance students'innovation and entrepreneurship capabilities.

Minimally invasive surgery represented by laparoscopy has been carried out for more than 30 years, and the technological development has tended to be flat. Currently, the techno-logy is still improving and innovating on the platform of laparoscopy, from traditional laparoscopy to reduced port and single port laparoscopy, from transabdominal to natural orifice transluminal tech-niques, from standard definition and high-definition to 3D and 4K ultra high definition fluorescence guided laparoscopy. The booming development of robotic surgery is also based on the platform of laparoscopy. From the perspective of disease treatment, there is no revolutionary change, such as changing the long-term efficacy of tumor treatment. In this era of technological prosperity but uncertainty, the future of minimally invasive surgery may not be a single technological innovation, but the organic integration and common development of multiple technologies. The authors will focus on the advantages and challenges of various minimally invasive technologies, and look forward to the application prospects of artificial intelligence in precision technology and decision-making in minimally invasive surgery, in order to open up new paths for the sustainable development of mini-mally invasive surgery, overcome current confusion, and move towards a more accurate, efficient, and popularized future.

Objective This study aims to compare the efficacy of video stylets and video laryngoscopes in facilitating nasotracheal intubation during oral surgery.Methods A total of 80 patients,aged between 18 and 70 years old,with ASA grade Ⅰ or Ⅱ,scheduled for elective oral surgery under general anesthesia,were randomly assigned to either the video stylet group(Group N)or the video laryngoscope group(Group C),with 40 patients in each group.In Group N,a video stylet was used to shape the tracheal tube at a 90-degree angle,with the shaping position being the vertical distance from the Adam's apple to the nostril.The tube was inserted from the nasal cavity into the throat under direct visualization,and positioned behind the glottis.In Group C,the tube was initially blindly inserted into the nasal cavity without a core.Upon reaching the throat,a video laryngoscope was employed to lift the epiglottis and expose the glottis from the mouth.The tube was then inserted with the aid of intubation forceps or cuff inflation.The primary outcome measure was the intubation time.Additional measures included the time taken for nasal passage,glottis exposure,and the number of intubation attempts and assistant interventions required.Vital signs,including MAP and HR,were recorded at five minutes of quiet rest upon entering the room(T0),during glottis exposure(T1),upon passage of the tube through the glottis(T2),and one minute after the tube entered the trachea(T3).Complications such as epistaxis,oral mucosal bleeding,loose incisors,and postop-erative sore throat were also documented.Results The intubation time and nasal passage time in Group N were significantly shorter than those in Group C(P<0.05).The number of cuff inflations and intubation forceps assisted cases in Group N was significantly lower than in Group C(P<0.05).There were no significant differences between the two groups in terms of glottis exposure time,first successful intubation times,C-L glottis classification,and mandibular lift-assisted intubation(P>0.05).The increase in MAP and HR in Group N at T1 and T2 was signifi-cantly less than in Group C(P<0.05).The number of cases with mild epistaxis in Group N was significantly lower than in Group C(P<0.05).Similarly,the number of cases with loose incisors and oral mucosal bleeding in Group N was significantly less than in Group C(P<0.05).Conclusion Compared to the video laryngoscope,the video stylet-guided nasotracheal intubation results in a shorter intubation time,less damage to the oronasopharynx,eliminates the need for intubation forceps,and reduces the patient's stress and vascular stress response during intubation.

Objective:To explore the interest of medical students in innovation and entrepreneurship education,providing a reference for optimizing the innovation and entrepreneurship education system.Methods:A total of 510 students from the first to fifth academic years at a medical school were selected as the study subjects.An anonymous online survey was conducted via Questionnaire Star to assess students'understanding of innovation and entrepreneurship cognition,willingness,and the current status of education,and interest scores across different majors were compared.Results:The survey revealed that 92.35%of medical students expressed interest in innovation and entrepreneurship and 96.08%of medical students recognized its importance for personal career development.About 83.53%of medical students believed it was essential for medical schools to cultivate innovation and entrepreneurship awareness,yet only 50.98%viewed it as a means to develop innovative projects.Regarding the current educational environment,over 95%of students affirmed the school's initiatives,supportive atmosphere,and resource provision.However,only 32.35%had participated in extracurricular innovation and entrepreneurship activities.During the process of innovation and entrepreneurship,87.65%of the students believed that lack of experience was the main obstacle.And 80.59%of the students hope that the school could provide venues and financial support.And 90.19%of the students expected that school-enterprise cooperation could increase practical opportunities.Additionally,professional background significantly influenced students'interest,with dental medicine students scoring markedly higher than those in clinical medicine,medical laboratory technology,and other disciplines(P＜0.05).Conclusions:The surveyed medical students demonstrated a positive attitude toward innovation and entrepreneurship,yet gaps remained in practical application and resource accessibility.The institution should refine curricula,strengthen industry-academia collaboration,and develop tailored programs based on disciplinary characteristics to enhance students'innovation and entrepreneurship capabilities.

Minimally invasive surgery represented by laparoscopy has been carried out for more than 30 years, and the technological development has tended to be flat. Currently, the techno-logy is still improving and innovating on the platform of laparoscopy, from traditional laparoscopy to reduced port and single port laparoscopy, from transabdominal to natural orifice transluminal tech-niques, from standard definition and high-definition to 3D and 4K ultra high definition fluorescence guided laparoscopy. The booming development of robotic surgery is also based on the platform of laparoscopy. From the perspective of disease treatment, there is no revolutionary change, such as changing the long-term efficacy of tumor treatment. In this era of technological prosperity but uncertainty, the future of minimally invasive surgery may not be a single technological innovation, but the organic integration and common development of multiple technologies. The authors will focus on the advantages and challenges of various minimally invasive technologies, and look forward to the application prospects of artificial intelligence in precision technology and decision-making in minimally invasive surgery, in order to open up new paths for the sustainable development of mini-mally invasive surgery, overcome current confusion, and move towards a more accurate, efficient, and popularized future.

After nearly 40 years of development, minimally invasive techniques have been widely applied in curative surgeries for various types of tumors. The safety and efficacy of minimally invasive surgery has being fully validated. With the continuous iteration and updating of medical equipments, the convenience and precision of surgeries have been significantly enhanced, marking the advancement of minimally invasive surgery into a phase of high-level platform. With the rapid development of information technology, we have gradually entered the era of intelligent medicine, where the integration of technologies such as artificial intelligence will inject new vitality into the development of minimally invasive surgery. Combined with the latest research trends, the authors provide an in-depth analysis of how artificial intelligence plays a unique role in key aspects of minimally invasive surgery, including preoperative assessment and planning, intraoperative moni-toring and alerting, and comprehensive postoperative management. Additionally, the authors discuss how to utilize these innovative technologies to further promote reforms in medical education and prospects for the development of telemedicine service. In the era of intelligent medicine, the develop-ment of minimally invasive surgery should adhere to the principle of "bold innovation, cautious practice", guided by the concept of "patient-centeredness". By promoting interdisciplinary collabora-tion between medicine and engineering, accelerating the translation of scientific and technological achievements into clinical practice, we can ensure that minimally invasive surgical techniques better serve the health and well-being of the people.

Objective:To evaluate the clinical and prognostic differences in acute myeloid leukemia with myelodysplasia-related changes (AML-MRC) children under different diagnostic criteria (World Health Organization (WHO) 2016 and WHO 2022 criteria).Methods:In this retrospective cohort study, clinical characteristics and prognosis information of 260 acute myeloid leukemia (AML) children admitted to Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences from August 2017 to August 2021 were analyzed retrospectively. According to WHO 2016 and WHO 2022 diagnostic criteria, patients were divided into AML-MRC group and non-AML-MRC group, the prognostic and genetic differences between two groups were compared respectively. Meanwhile, the characteristics of children with 8 MRC-related genes defined in WHO 2022 diagnostic criteria were described. Mann-Whitney U test, chi-square test were used for comparison between groups. Survival curve was plotted by Kaplan-Meier method, and comparison between groups was performed by Log-Rank method. Results:Among the 260 children, there were 148 males and 112 females. The follow-up time was 26 (16, 38) months. A total of 28 children (10.8%) were diagnosed with AML-MRC according to the WHO 2016 diagnostic criteria. Compared with non-AML-MRC children, the frequency of PTPN11, RUNX11, SH2B3, MPL and STAG2 mutations was higher in AML-MRC children (25.0% (7/28) vs. 4.3% (10/232), 14.3% (4/28) vs. 3.9% (9/232), 10.7% (3/28) vs. 2.2% (5/232), 10.7% (3/28) vs. 2.2% (5/232), 10.7% (3/28) vs. 0.9% (2/232), all P<0.05). The 2-year overall survival (OS) and events free survival (EFS) rate of 28 AML-MRC children under WHO 2016 diagnostic criteria were worse than those of 232 non-AML-MRC children ((62.1±10.8)% vs. (94.5±1.6)%, χ2=22.1 ,P<0.001;(48.0±10.6)% vs. (70.9±3.2)%, χ2=6.33, P=0.012). Twenty-seven children (10.4%) were eventually diagnosed with AML-MRC according to WHO 2022 criteria, their 2-year OS rate were worse than 233 non-AML-MRC children ((60.8±11.1)% vs. (94.5±1.6)%, χ2=24.49 ,P<0.001), and there was no statistically significant difference in EFS rate between two groups at 2 years ((55.1±10.8)% vs. (70.1±3.2)%, χ2=2.44 , P=0.119). Conclusions:Compared with the 2022 WHO diagnostic criteria, the survival rates of children with AML-MRC under the 2016 WHO diagnostic criteria were worse than that of children without MRC.The new version of the AML-MRC diagnostic criteria emphasizes the importance of genes.

Objective To analyze the role of NOD-like receptor thermal protein domain associated protein 3(NLRP3)inflammasome in a therapeutic mild hypothermia(34℃)treated isolated rat myocardial ischemia-reperfusion model and explore its mechanism.Methods Sixty clean grade adult male SD rats,aged 7-10 weeks,weighing 250-300 g.Using a random number table method,the rats were divid-ed into five groups:blank control group(group S),myocardial ischemia-reperfusion group(group IR),34℃mild hypothermia post-treated myocardial ischemia-reperfusion group(group MH),34℃mild hypother-mia post-treated myocardial ischemia-reperfusion+3-TYP group(group HT),and 34℃mild hypothermia post-treated myocardial ischemia-reperfusion+3-TYP+MCC950 group(group HTM),12 rats in each group.Group S perfused the rat heart at 37℃with a balanced perfusion solution for 180 minutes.Group IR re-ceived balanced perfusion of the rat heart at 37℃for 30 minutes,followed by ischemia for 30 minutes and reperfusion with 37℃perfusion for 120 minutes.Group MH perfused the rat heart at 37℃for 30 minutes,followed by ischemia for 30 minutes and reperfusion with 34℃perfusion solution for 120 minutes.Group HT perfused the hearts of rats at 37℃for 30 minutes,followed by ischemia for 30 minutes,silent mating type information regulation 2 homolog 3(sirt3)inhibitor 3-TYP was added to the perfusate,and then per-fused at 34℃for 120 minutes.Group HTM perfused the hearts of rats at 37℃for 30 minutes,followed by ischemia for 30 minutes,sirt3 inhibitor 3-TYP and NLRP3 inhibitor MCC950 were added to the perfusate,and then perfused at 34℃for 120 minutes.The isolated heart was obtained 120 minutes after reperfusion,and the concentrations of IL-6 and IL-1β in the perfused cardiac fluid was measured using ELISA method,Western blot method for detecting the relative content of NLRP3 and sirt3 proteins in myocardial tissue,1%triphenyl tetrazolium chloride staining for calculating myocardial infarction area,and HE staining for observ-ing myocardial pathological changes.Results Compared with group S,HR were significantly slowed down,LVSP,±dp/dtmax were significantly decreased,and LVEDP were significantly increased 30,60,90,and 120 minutes after reperfusion,the concentrations of IL-6 and IL-1β in cardiac fluid leakage,and the per-centage of myocardial infarction area were significantly increased in groups IR,MH,HT,and HTM(P＜0.05),the content of sirt3 protein in myocardial tissue were significantly reduced,while the content of NLRP3 protein were significantly increased in groups IR,HT,and HTM(P＜0.05),the contents of sirt3 and NLRP3 protein in the myocardial tissue were significantly increased in group MH(P＜0.05).Com-pared with group IR,HR were significantly increased,LVSP,±dp/dtmax were significantly increased,and LVEDP were significantly decreased 30,60,90,and 120 minutes after reperfusion,the concentrations of IL-6 and IL-1β in cardiac fluid leakage and the percentage of myocardial infarction area were significantly decreased in groups MH and HTM(P＜0.05),the content of sirt3 protein in myocardial tissue was signifi-cantly increased,while the content of NLRP3 protein was significantly decreased in group MH(P＜0.05),the content of NLRP3 protein in myocardial tissue was significantly reduced in group HTM(P＜0.05).Compared with group MH,HR were significantly slowed down,LVSP,±dp/dtmax were significantly de-creased,and LVEDP were significantly increased 30,60,90,and 120 minutes after reperfusion,the con-centrations of IL-6 and IL-1β in cardiac fluid leakage,the percentage of myocardial infarction area,and the content of NLRP3 protein in myocardial tissue were significantly increased in group HT(P＜0.05),the content of sirt3 protein in myocardial tissue was significantly reduced in groups HT and HTM(P＜0.05).Compared with group HT,HR were significantly increased,LVSP,±dp/dtmax were significantly increased,and LVEDP were significantly decreased 30,60,90,and 120 minutes after reperfusion,the concentrations of IL-6 and IL-1β in cardiac fluid leakage,the percentage of myocardial infarction area,and the content of NLRP3 protein in myocardial tissue were significantly reduced in group HTM(P＜0.05).Conclusion Therapeutic mild hypothermia(34℃)can improve hemodynamic parameters of isolated hearts and reduce the concentrations of IL-6 and IL-1β,NLRP3 protein content in myocardial tissue,percentage of myocardial infarction area,improve myocardial pathological changes,and reduce myocardial ischemia-reperfusion injury in rats,the mechanism may be related to the mitochondrial mediated sirt3 pathway inhibiting the high expres-sion of inflammatory corpuscle NLRP3.