Objective To explore the short-term efficacy of endoscopic submucosal dissection (ESD) in the treatment of early carcinoma in the remnant stomach. Methods A retrospective study was conducted on 45 patients with early residual gastric cancer underwent ESD at the Endoscopy Center of Zhongshan Hospital, Fudan University from December 2014 to April 2024, with a total of 45 lesions. The patients were divided into an anastomotic group (n=15) and a non-anastomotic group (n=30) based on the location of tumor occurrence, and their clinical data, endoscopic diagnosis and treatment, and histopathological conditions were compared between the two groups. Results All 45 patients had lesions with redness and erosion. There were 9 cases of poor lifting of submucosal injection in the anastomotic group and 2 cases in the non-anastomotic group, respectively, and the difference was statistically significant (P<0.05). ESD surgery was performed on 13 lesions in the anastomotic group and 28 lesions in the non-anastomotic group, with surgery times of 80.00 (50.00, 100.00) min and 55.00 (43.75, 80.00) min, respectively. The difference in surgery time between the two groups was statistically significant (P=0.03). Among the 45 patients, ESD surgery achieved curative resection in 35 cases, including 11 cases in the anastomotic group and 24 cases in the non-anastomotic group, with no statistically significant difference. Conclusions Careful preoperative evaluation of early carcinoma in the remnant stomach is essential to prevent oversight. Lesions at anastomotic sites and suture lines present higher technical challenges for complete resection. ESD is safe and effective, with auxiliary traction technique available when necessary.

Trigeminal neuralgia is characterized by intense pain in the sensory distribution area of the trigeminal nerve. It can be triggered by non-noxious stimuli such as brushing teeth and washing face. At present, the treatment of trigeminal neuralgia mainly includes oral drugs and surgical treatments. A 92-year-old patient with trigeminal neuralgia was reported. The pain could not be alleviated because the patient was unable to tolerate the side effects of drugs and surgical treatment. Taking into account the onset time and the duration of the curative effect, botulinum toxin type A was combined with cobrotoxin for the treatment of the patient. As a result, the pain symptoms were rapidly alleviated and remained in a relieved state for 8 months. The clinical characteristics of this patient were summarized in this article, and the possible synergistic mechanisms of action of the 2 drugs were discussed. The ultimate objective is to furnish a broader spectrum of alternatives and references for clinical practice.

To explore the clinicopathological characteristics, endoscopic manifestations, and efficacy of endoscopic procedure for early gastroesophageal junction cancer, a retrospective analysis was conducted on the patients who underwent endoscopic submucosal dissection (ESD) and pathologically confirmed early cancer of the gastroesophageal junction at Zhongshan Hospital, Fudan University and Xiamen Branch from November 2014 to October 2021. The pathological and gastroscopic features, as well as short-term efficacy of ESD were analyzed. Among the 401 patients, there were 332 males with the age of 66.02±7.93 years, and 69 females with the age of 66.26±9.31 years. The male-to-female ratio was 4.8∶1. Siewert type Ⅱ accounted for 70.82% (284/401). Lesions involving the lesser curvature accounted for 57.10% (229/401). Endoscopic manifestation of mucosal erythema accounted for 96.26% (386/401). Lesion morphology of 0-Ⅱc type accounted for 38.15% (153/401) and tubular adenocarcinoma accounted for 86.53% (347/401). The en bloc resection rate of ESD was 99.75% (400/401), with a curative resection rate of 72.82% (292/401). It is indicates that early gastroesophageal junction cancer predominantly occurs in middle-aged and elderly males. It is mostly Siewert type Ⅱ, and involves the lesser curvature, and primarily presents as type 0-Ⅱc morphology. The lesions are most commonly manifested as mucosal redness and are predominantly moderately to well-differentiated adenocarcinomas. ESD demonstrates a safe and effective therapeutic approach for early gastroesophageal junction cancer.

Objective:To explore the influence of artificial intelligence(AI)-assisted compressive sensing(ACS)technique with different acceleration factors on the image quality and scan time of three dimensional time-of-flight magnetic resonance angiography(3D-TOF-MRA)for brain.Methods:Thirty participants who underwent brain magnetic resonance imaging(MRI)at Tongzhou Branch of Beijing Friendship Hospital were recruited.All subjects underwent imaging scans about four different parameters:a non-accelerated technique(control group),ACS technique integrated with acceleration factor of 4.03(ACS4 group),ACS technique integrated with acceleration factor of 5.02(ACS5 group),and ACS technique integrated with acceleration factor of 6.06(ACS6 group).The image clarity,ranking of imaging capabilities of distal branch blood vessels and the ratio of pseudo-stenosis were qualitatively analyzed.The signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR),edge sharpness,and scan time were quantitatively analyzed.Results:There was not difference in vessel clarity among three ACS groups at the proximal and middle intracranial segments.For distal segments of blood vessel,the ACS4 group[3.0(3.0,3.0)]and ACS5 group[3.0(3.0,3.0)]were better than ACS6[2.5(2.0,3.0)](q=29.800,27.500,P<0.05).The imaging capabilities of distal-branch vessel of ACS4 group and ACS5 group were better than ACS6 group.There was no stenosis in the proximal and middle segments of the images of the three ACS group,and there were no stenosis in the images of distal vessels of ACS4 group and ACS5 group.A total of 5 cases were pseudo-stenosis in the distal vessels of ACS6 group.Compared with the control group,the incidence of pseudo-stenosis in the distal vessels of ACS6 group was 16.7%.The SNR and CNR values of quantitative analysis for proximal vessels in ACS6 group were higher than them in ACS4 group(q=27.800,26.200,P<0.05),and there was not significant difference in them among ACS4 group,ACS6 group and ACS5 group(P>0.05).The differences of SNR and CNR values in the middle and distal segments of blood vessels among different groups were not significant(P>0.05).There was not significant difference in the edge sharpness of blood vessels among ACS4 group,ACS5 group,and ACS6 group(P>0.05),while all of them were higher than those of control group,and the differences were significant(q=48.150,53.367,44.883,P<0.001).Compared with control group,the scan-time of ACS4 group was reduced by 55.19%,and that of ACS5 group was reduced by 64.07%,and that of ACS6 group was reduced by 70%.Conclusion:ACS technique can accelerate the imaging speed of brain 3D-TOF-MRA and ensure image quality.It is clinically recommended to set the ACS acceleration factor as 5.02 to undergo brain 3D-TOF-MRA scans.

Objective:To evaluate the effect of preoperative anxiety on the consciousness and autonomic nervous activity during propofol anesthesia.Methods:This study was a secondary analysis of data from the clinical trial in a prospective single-arm study. One hundred and thirty patients, aged 18-65 yr, with a body mass index of 18.5-27.9 kg/m 2, of American Society of Anesthesiologists Physical Status classification I or Ⅱ, scheduled to receive propofol anesthesia, were selected from the Second People′s Hospital of Lianyungang. The six-item of the state anxiety inventory (SAI) of the State-Trait Anxiety Inventory was used to assess the anxiety of patients 1 h before surgery. The patients were divided into 2 groups according to the cut-off value of 12: obvious anxiety symptom (SAI score >12) group (group A, n=49) and no obvious anxiety symptom (SAI score ≤12) group (group B, n=81). After admission to the operating room, the patient was required to hold a 50 ml syringe filled with water. Propofol was given by target-controlled infusion (TCI) with the target plasma concentration set at 5 μg/ml. When the effect-site concentration (Ce) of propofol increased to 3.5 μg/ml (all the patients lost consciousness), the closed-loop TCI was used to maintain BIS value between 45 and 55. The patients were monitored for 20 min after stopping the pump infusion (anesthesia recovery period). The disappearance time of verbal command, disappearance time of eyelash reflex, time of syringe dropping, recovery time of verbal command, recovery time of eyelash reflex, Ce at the recovery of verbal command, Ce at the recovery of eyelash reflex, Ce within the first 5 min of the closed-loop TCI, and consumption of propofol during anesthesia were recorded. The peripheral perfusion index, low frequency power and high frequency power of heart rate variability were recorded, and the ratio of low frequency power to high frequency power was calculated. Pearson correlation analysis was used to assess the correlation between preoperative SAI score and consciousness-related indicators, simulated Ce of propofol and consumption of propofol. Results:Compared with group B, the disappearance time of verbal command, disappearance time of eyelash reflex, and time of syringe dropping were significantly prolonged, the consumption of propofol, simulated Ce at recovery of verbal command and within the first 5 min of closed-loop TCI were increased, the peripheral perfusion index was decreased at each time point before administration and at 14-20 min of anesthesia recovery, and the low-frequency power was decreased during anesthesia maintenance in group A ( P<0.05). The SAI score was positively correlated with the disappearance time of verbal command ( r=0.220, P=0.012), time of syringe dropping ( r=0.206, P=0.029), consumption of propofol ( r=0.330, P<0.001), and the simulated Ce at the recovery of verbal command ( r=0.215, P=0.015) and simulated Ce at recovery of eyelash reflex ( r=0.207, P=0.022). Conclusions:Preoperative anxiety may lead to prolonged loss of consciousness and more marked inhibition of sympathetic nerve activity during propofol anesthesia.

The implementation of new medical technology projects is a key way for hospitals to improve their medical technology level and core competitiveness. Standardizing medical technology management has become an important part of the construction of the medical quality system in public hospitals of China. In May 2022, a tertiary comprehensive hospital established a " 243" cross departmental collaborative management system, organically integrating multiple information systems within the hospital, and building a medical new technology whole-process information management platform covering the basic system layer, business platform layer, and system function layer. It was officially launched in November 2022, realizing the full process closed-loop management of medical new technology projects from application, approval, project initiation, tracking to completion, improving management quality and efficiency. As of March 2024, the platform had accepted 203 applications for new technologies, of which 139 had been approved and achieved good results, providing references for other hospitals to standardize the management of medical new technologies and reduce medical risks.

Objective To investigate the protective effect of Gynostemma pentaphyllum on memory of individuals rapidly ascending to high altitudes.Methods Twenty-one healthy subjects were randomly divided into a G.pentaphyllum food group(n=12)and a control group(n=9).The first group consumed G.pentaphyllum food for seven consecutive days while the control group received placebos.Both groups ascended from the plains to an altitude of 3600 m.Memory function was assessed using the matching memory and sequential memory tests of a cognitive evaluation system on day 1 and day 7 on the plains,and at 24 and 48 h after ascending to the high altitude.Scores of acute mountain sickness symptoms were also recorded.Results After 24 h of stay at the high altitude,the score of headache of the G.pentaphyllum food group was significantly lower than that of the control group(P＜0.05).Cognitive test results showed that the matching memory accuracy and sequential memory accuracy of the control group at 24 and 48 h were significantly lower than those on the plains(P＜0.05).In contrast,the G.pentaphyllum food group performed significantly better than the control group in these metrics(P＜0.05).Conclusion Regular consumption of G.pentaphyllum food can effectively alleviate headache symptoms in individuals rapidly ascending to high altitudes and mitigate the decline in working memory,short-term memory,and memory spans caused by acute hypoxic exposure.

Objective:To explore the influence of artificial intelligence(AI)-assisted compressive sensing(ACS)technique with different acceleration factors on the image quality and scan time of three dimensional time-of-flight magnetic resonance angiography(3D-TOF-MRA)for brain.Methods:Thirty participants who underwent brain magnetic resonance imaging(MRI)at Tongzhou Branch of Beijing Friendship Hospital were recruited.All subjects underwent imaging scans about four different parameters:a non-accelerated technique(control group),ACS technique integrated with acceleration factor of 4.03(ACS4 group),ACS technique integrated with acceleration factor of 5.02(ACS5 group),and ACS technique integrated with acceleration factor of 6.06(ACS6 group).The image clarity,ranking of imaging capabilities of distal branch blood vessels and the ratio of pseudo-stenosis were qualitatively analyzed.The signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR),edge sharpness,and scan time were quantitatively analyzed.Results:There was not difference in vessel clarity among three ACS groups at the proximal and middle intracranial segments.For distal segments of blood vessel,the ACS4 group[3.0(3.0,3.0)]and ACS5 group[3.0(3.0,3.0)]were better than ACS6[2.5(2.0,3.0)](q=29.800,27.500,P<0.05).The imaging capabilities of distal-branch vessel of ACS4 group and ACS5 group were better than ACS6 group.There was no stenosis in the proximal and middle segments of the images of the three ACS group,and there were no stenosis in the images of distal vessels of ACS4 group and ACS5 group.A total of 5 cases were pseudo-stenosis in the distal vessels of ACS6 group.Compared with the control group,the incidence of pseudo-stenosis in the distal vessels of ACS6 group was 16.7%.The SNR and CNR values of quantitative analysis for proximal vessels in ACS6 group were higher than them in ACS4 group(q=27.800,26.200,P<0.05),and there was not significant difference in them among ACS4 group,ACS6 group and ACS5 group(P>0.05).The differences of SNR and CNR values in the middle and distal segments of blood vessels among different groups were not significant(P>0.05).There was not significant difference in the edge sharpness of blood vessels among ACS4 group,ACS5 group,and ACS6 group(P>0.05),while all of them were higher than those of control group,and the differences were significant(q=48.150,53.367,44.883,P<0.001).Compared with control group,the scan-time of ACS4 group was reduced by 55.19%,and that of ACS5 group was reduced by 64.07%,and that of ACS6 group was reduced by 70%.Conclusion:ACS technique can accelerate the imaging speed of brain 3D-TOF-MRA and ensure image quality.It is clinically recommended to set the ACS acceleration factor as 5.02 to undergo brain 3D-TOF-MRA scans.

Objective:To evaluate the effect of preoperative anxiety on the consciousness and autonomic nervous activity during propofol anesthesia.Methods:This study was a secondary analysis of data from the clinical trial in a prospective single-arm study. One hundred and thirty patients, aged 18-65 yr, with a body mass index of 18.5-27.9 kg/m 2, of American Society of Anesthesiologists Physical Status classification I or Ⅱ, scheduled to receive propofol anesthesia, were selected from the Second People′s Hospital of Lianyungang. The six-item of the state anxiety inventory (SAI) of the State-Trait Anxiety Inventory was used to assess the anxiety of patients 1 h before surgery. The patients were divided into 2 groups according to the cut-off value of 12: obvious anxiety symptom (SAI score >12) group (group A, n=49) and no obvious anxiety symptom (SAI score ≤12) group (group B, n=81). After admission to the operating room, the patient was required to hold a 50 ml syringe filled with water. Propofol was given by target-controlled infusion (TCI) with the target plasma concentration set at 5 μg/ml. When the effect-site concentration (Ce) of propofol increased to 3.5 μg/ml (all the patients lost consciousness), the closed-loop TCI was used to maintain BIS value between 45 and 55. The patients were monitored for 20 min after stopping the pump infusion (anesthesia recovery period). The disappearance time of verbal command, disappearance time of eyelash reflex, time of syringe dropping, recovery time of verbal command, recovery time of eyelash reflex, Ce at the recovery of verbal command, Ce at the recovery of eyelash reflex, Ce within the first 5 min of the closed-loop TCI, and consumption of propofol during anesthesia were recorded. The peripheral perfusion index, low frequency power and high frequency power of heart rate variability were recorded, and the ratio of low frequency power to high frequency power was calculated. Pearson correlation analysis was used to assess the correlation between preoperative SAI score and consciousness-related indicators, simulated Ce of propofol and consumption of propofol. Results:Compared with group B, the disappearance time of verbal command, disappearance time of eyelash reflex, and time of syringe dropping were significantly prolonged, the consumption of propofol, simulated Ce at recovery of verbal command and within the first 5 min of closed-loop TCI were increased, the peripheral perfusion index was decreased at each time point before administration and at 14-20 min of anesthesia recovery, and the low-frequency power was decreased during anesthesia maintenance in group A ( P<0.05). The SAI score was positively correlated with the disappearance time of verbal command ( r=0.220, P=0.012), time of syringe dropping ( r=0.206, P=0.029), consumption of propofol ( r=0.330, P<0.001), and the simulated Ce at the recovery of verbal command ( r=0.215, P=0.015) and simulated Ce at recovery of eyelash reflex ( r=0.207, P=0.022). Conclusions:Preoperative anxiety may lead to prolonged loss of consciousness and more marked inhibition of sympathetic nerve activity during propofol anesthesia.

The implementation of new medical technology projects is a key way for hospitals to improve their medical technology level and core competitiveness. Standardizing medical technology management has become an important part of the construction of the medical quality system in public hospitals of China. In May 2022, a tertiary comprehensive hospital established a " 243" cross departmental collaborative management system, organically integrating multiple information systems within the hospital, and building a medical new technology whole-process information management platform covering the basic system layer, business platform layer, and system function layer. It was officially launched in November 2022, realizing the full process closed-loop management of medical new technology projects from application, approval, project initiation, tracking to completion, improving management quality and efficiency. As of March 2024, the platform had accepted 203 applications for new technologies, of which 139 had been approved and achieved good results, providing references for other hospitals to standardize the management of medical new technologies and reduce medical risks.