Hepatic ischemia-reperfusion injury （HIRI） is an inevitable major complication during surgical procedures such as liver transplantation and partial hepatectomy， and its prevention and treatment are hotspots and difficulties in clinical practice. This article reviews the mechanism of injury caused by energy metabolism disorders during liver ischemia-reperfusion and related treatment strategies and summarizes the current advances in metabolism-related therapies， in order to provide new ideas for further clarifying the onset mechanism of HIRI and exploring effective clinical prevention and treatment strategies for HIRI.

This consensus will introduce the characteristics of fillers used in the surgical cavities of domestic nasal surgery patients based on relevant literature and expert opinions. It will also provide recommendations for the selection of cavity fillers for different nasal diseases, with chronic sinusitis as a representative example.
Humans ; Nasal Cavity/surgery* ; Nasal Surgical Procedures ; China ; Consensus ; Sinusitis/surgery* ; Dermal Fillers

In order to explore the application value of the suction connecting tube combined with gastroscope visual blood clot removal device in the blood clot removal surgery of patients with upper gastrointestinal bleeding, the clinical data of 18 patients with upper gastrointestinal bleeding treated with this device at the Department of Gastroenterology, General Hospital of Central Theater Command from January 2023 to June 2024 were retrospectively analyzed to observe its therapeutic effect. The results showed that the operation time of the device for 18 patients ranged 4-16 minutes (8.2±3.1 min). The total volume of blood clots and blood cleared ranged 120-500 mL (221.1±97.1 mL). Blood and blood clots were successfully removed in a single procedure in 17 patients, with a success rate of 94.4% (17/18). Hemostasis was unsuccessful in 1 patient with gastric cancer and bleeding under endoscopy, and subsequent surgical treatment was performed. No serious complication occurred. The suction connecting tube combined with gastroscope visual blood clot removal device can effectively remove blood and blood clots in the digestive tract, with high success rate, which is worth promotion and application.

Objective:To explore the early predictive value of the triglyceride-glucose (TyG) index and the controlling nutritional status (CONUT) score for severe acute pancreatitis (SAP).Methods:Clinical data from 1 050 hospitalized patients with acute pancreatitis (AP) at the General Hospital of Central Theater Command between January 2019 and December 2023 were retrospectively analyzed. Patients were categorized into mild acute pancreatitis (MAP) group ( n=606), moderately severe acute pancreatitis (MSAP) group ( n=320), and SAP group ( n=124) based on AP severity. General clinical data, laboratory parameters, modified computed tomography severity index (MCTSI), bedside index for severity in acute pancreatitis (BISAP), TyG index, and CONUT score were compared among the three groups. Spearman correlation analysis was used to evaluate the relationship between TyG index, CONUT score and AP severity. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for AP severity. Receiver operating characteristic curves (ROC) were plotted to calculate the area under the curve (AUC), sensitivity, and specificity for evaluating the predictive efficacy of TyG index, CONUT score, and their combination for SAP. Results:Significant differences on TyG index and CONUT score were observed among AP patients with varying severity (all P value <0.001). Spearman correlation analysis further revealed positive correlations of TyG index ( r=0.174), CONUT score ( r=0.306) with AP severity (both P<0.001). Multivariate logistic regression identified neutrophil count ( OR=1.076, 95% CI 1.027-1.125), MCTSI ( OR=2.565, 95% CI 2.250-2.921), BISAP ( OR=3.522, 95% CI 2.726-4.549), TyG index ( OR=1.859, 95% CI 1.276-2.707), and CONUT score ( OR=1.155, 95% CI 1.035-1.288) as independent risk factors for AP severity. The combined predictive model equation was: -7.342+0.76×TyG+0.439×CONUT. ROC analysis showed that the AUC values of the TyG index, CONUT score, and the combined index (TyG index+CONUT score) were 0.583 (95% CI 0.529-0.637), 0.701 (95% CI 0.652-0.75), and 0.755 (95% CI 0.710-0.801), with sensitivities of 0.706, 0.677, and 0.742, and specificities of 0.884, 0.629, and 0.657, respectively (all P value <0.05). Conclusions:TyG index and CONUT score are positively correlated with AP severity and may serve as reliable predictors for SAP. Their combination could enhance the predictive accuracy for AP.

Objective:To explore the early predictive value of the triglyceride-glucose (TyG) index and the controlling nutritional status (CONUT) score for severe acute pancreatitis (SAP).Methods:Clinical data from 1 050 hospitalized patients with acute pancreatitis (AP) at the General Hospital of Central Theater Command between January 2019 and December 2023 were retrospectively analyzed. Patients were categorized into mild acute pancreatitis (MAP) group ( n=606), moderately severe acute pancreatitis (MSAP) group ( n=320), and SAP group ( n=124) based on AP severity. General clinical data, laboratory parameters, modified computed tomography severity index (MCTSI), bedside index for severity in acute pancreatitis (BISAP), TyG index, and CONUT score were compared among the three groups. Spearman correlation analysis was used to evaluate the relationship between TyG index, CONUT score and AP severity. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for AP severity. Receiver operating characteristic curves (ROC) were plotted to calculate the area under the curve (AUC), sensitivity, and specificity for evaluating the predictive efficacy of TyG index, CONUT score, and their combination for SAP. Results:Significant differences on TyG index and CONUT score were observed among AP patients with varying severity (all P value <0.001). Spearman correlation analysis further revealed positive correlations of TyG index ( r=0.174), CONUT score ( r=0.306) with AP severity (both P<0.001). Multivariate logistic regression identified neutrophil count ( OR=1.076, 95% CI 1.027-1.125), MCTSI ( OR=2.565, 95% CI 2.250-2.921), BISAP ( OR=3.522, 95% CI 2.726-4.549), TyG index ( OR=1.859, 95% CI 1.276-2.707), and CONUT score ( OR=1.155, 95% CI 1.035-1.288) as independent risk factors for AP severity. The combined predictive model equation was: -7.342+0.76×TyG+0.439×CONUT. ROC analysis showed that the AUC values of the TyG index, CONUT score, and the combined index (TyG index+CONUT score) were 0.583 (95% CI 0.529-0.637), 0.701 (95% CI 0.652-0.75), and 0.755 (95% CI 0.710-0.801), with sensitivities of 0.706, 0.677, and 0.742, and specificities of 0.884, 0.629, and 0.657, respectively (all P value <0.05). Conclusions:TyG index and CONUT score are positively correlated with AP severity and may serve as reliable predictors for SAP. Their combination could enhance the predictive accuracy for AP.

In order to explore the application value of the suction connecting tube combined with gastroscope visual blood clot removal device in the blood clot removal surgery of patients with upper gastrointestinal bleeding, the clinical data of 18 patients with upper gastrointestinal bleeding treated with this device at the Department of Gastroenterology, General Hospital of Central Theater Command from January 2023 to June 2024 were retrospectively analyzed to observe its therapeutic effect. The results showed that the operation time of the device for 18 patients ranged 4-16 minutes (8.2±3.1 min). The total volume of blood clots and blood cleared ranged 120-500 mL (221.1±97.1 mL). Blood and blood clots were successfully removed in a single procedure in 17 patients, with a success rate of 94.4% (17/18). Hemostasis was unsuccessful in 1 patient with gastric cancer and bleeding under endoscopy, and subsequent surgical treatment was performed. No serious complication occurred. The suction connecting tube combined with gastroscope visual blood clot removal device can effectively remove blood and blood clots in the digestive tract, with high success rate, which is worth promotion and application.

Objective To investigate the correlation between atherogenic index of plasma (AIP) and the severity of hypertriglyceridemic acute pancreatitis (HTG-AP) and the value of AIP combined with Bedside Index for Severity in Acute Pancreatitis (BISAP) score in the early prediction of severe HTG-AP (sHTG-AP). Methods A retrospective analysis was performed for the clinical data of 170 patients with HTG-AP who were hospitalized in The General Hospital of Central Theater Command from January 2017 to December 2021, and according to related guidelines, they were divided into the sHTG-AP group with 28 patients and non-sHTG-AP group with 142 patients. Peripheral blood samples were collected from all patients within 24 hours after admission, and the two groups were compared in terms of sex, age, laboratory test results, AIP, BISAP score, and modified CT severity index (MCTSI) score. The chi-square test or the Fisher's exact test was used for comparison of categorical data between groups; the Mann-Whitney U test was used for comparison of continuous data between groups. The Spearman rank correlation test was used to investigate the correlation between each factor and the severity of HTG-AP, and the binary logistic regression analysis were used to investigate the independent risk factors for sHTG-AP. The receiver operating characteristic (ROC) curve was plotted to assess the predictive efficacy of each indicator. Results There were significant differences between the two groups in the medical history of diabetes, lymphocyte count, albumin, Ca 2+ , triglyceride, high-density lipoprotein cholesterol, AIP, BISAP score, MCTSI score, length of hospital stay, and hospital costs (all P < 0.05). The sHTG-AP group had a longer length of hospital stay, higher hospital costs, and a higher AIP value. AIP (odds ratio [ OR ]=1.244, 95% confidence interval [ CI ]: 1.062-1.458, P =0.007), BISAP score ( OR =5.525, 95% CI : 1.646-18.543, P =0.006), and MCTSI score ( OR =2.029, 95% CI : 1.245-3.305, P =0.004) were risk factors for sHTG-AP. AIP, BISAP score, and MCTSI score were positively correlated with the severity of HTG-AP ( r =0.291, 0.631, and 0.649, all P < 0.001), and AIP was positively correlated with BISAP score and MCTSI score ( r =0.190 and 0.215, both P < 0.05). AIP had an optimal cut-off value of 1.095 in predicting sHTG-AP, and AIP, BISAP score, and AIP combined with BISAP score had an area under the ROC curve of 0.759, 0.887, 0.925, respectively, a sensitivity of 0.821, 0.857, and 0.786, respectively, and a specificity of 0.627, 0.817, and 0.937, respectively (all P < 0.001). Conclusion AIP is a risk factor for sHTG-AP and is correlated with disease severity, and AIP combined with BISAP score has a relatively high value in the early prediction of sHTG-AP.

Objective:To study the safety and efficacy on timing of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) stageⅡbased on increase in remnant liver volume.Methods:19 patients (male: female 13: 6; average age 53 years) with liver tumors treated by ALPPS from April 2014 to December 2020 were retrospectively studied. Patients with FLV/ESLV (future liver volume/ estimated standard liver volume) increase of more than 50% within 1 week followed by stageⅡALPPS were included into the rapid group ( n=8). Those who failed to have 50% increase in FLV/ESLV within 1 week were included into the control group ( n=11). The two groups were compared in the ALPPS stage II in operating time, blood loss, postoperative complications, mortality rate and hospital stay. Results:All 19 patients underwent ALPPS stage II uneventfully. One patient in the control group died from liver failure within 30 days of operation. The operation time (3.2±1.8)h, blood loss (554±227) ml and postoperative hospital stay (12.6±2.4) d in the rapid group were significantly better than those in the control group (4.7±2.2) h, [(760±314) ml, (18.2±6.4) d (all P<0.05)]. The two groups had similar complication rates in both post stageⅠ[37.5%(3/8) vs. 45.4%(5/11)] , or stageⅡ [37.5%(3/8) vs. 36.4%(4/11)] (both P>0.05). Conclusion:Rapid increase in FLR volume of more than 50% within a week was safe and feasible to proceed to ALPPS stage II. This conclusion needs to be confirmed by further studies using large sample sizes.

It is an important way to improve the teaching quality by carrying out innovative experiments among medical students. In the process of experimental teaching, anatomy teachers expand the anatomy knowledge to basic scientific research techniques, so as to enhance students' confidence in participating in innovative experimental projects. Meanwhile, the teachers combine introduction of the anatomical structures with hot medical research issues, in order to help students to select appropriate innovative experimental topics. What's more, the new media teaching is integrated into the teaching of anatomy, enlightening students to perfect the experimental designs. Finally, in the teaching practice of regional anatomy, students are guided to carry out innovative experiments and write research papers. Abovementioned measures not only improve the teaching quality of anatomy, but also improve the students' scientific research ability, laying a foundation for them to participate in innovative experimental projects.

Objective To investigate the levels of IL-6 in serum and gastric mucosa of servicemen before and after mili-tary maneuver and their significance .Methods The level of serum IL-6 in 60 servicemen was studied by enzyme-linked immunosorbent assay .The expression of IL-6 in gastric mucosa from the 60 servicemen was detected by immunochemical staining.Results The level of IL-6 in serum of servicemen after military maneuver was significantly higher than that before military maneuver (P<0.01).IL-6 was found to be expressed in the cytoplasm of epithelioglandular cells and also in the cytoplasm of mesenchymal cells .The expression of IL-6 in gastirc mucosa was significantly stronger after military maneuver than before military maneuver (P<0.01).Conclusion IL-6 might be involved in the development of pathological changes in gastric mucosa caused by military stress in troops .Examination of the level of IL-6 in the early stage of military stress might help assess the chance of gastric mucosa lesion and its severity .