Objective To explore the application of the “cross-shaped coordinate line localization method” in laparoscopic cholecystectomy (LC) to realize critical view of safety (CVS) as well as summarize its safety and practicality. Methods Eighty-four patients who were treated with the “cross-shaped coordinate line localization method” at the Department of General Surgery of Wuxi Branch of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from February 2020 to February 2023 were selected as the observation group, and 84 patients who were randomly selected to receive the traditional LC treatment during the same period were selected as the control group. In the observation group, the “cross-shaped coordinate line localization method” was used as the boundary mark to reach CVS, and complete cholecystectomy. In the control group, the traditional blunt and sharp operation methods were used to free gallbladder triangle, and dissect out the cystic ducts and cystic arteries one by one and ligate them off. The intraoperative, postoperative and related complications of the two groups were compared and analyzed. Results All 168 patients successfully completed LC without serious surgical complications or conversion to open cases. The observation group took longer operation time to than the control group [(89.5±12.3) min vs. (67.7±8.9) min, P<0.001), and intraoperative blood loss was less than the control group [(7.0±3.9) mL vs. (15.2±4.6) mL, P<0.001). The rate of biliary and vascular anomalies in the observation group was higher than that in the control group (9.5% vs. 1.2%, P=0.040). The observation group had higher mobility on the first postoperative day than the control group, and time to first postoperative feeding and time to first postoperative flatus were earlier than those of the control group (P<0.05). The overall incidence rate of related complications in the observation group was lower than that in the control group (2.4% vs. 10.7%, P=0.029). There was no statistically significant difference between the two groups in terms of drain placement and length of hospital stay (P>0.05). Conclusions The “cross-shaped coordinate line localization method”, with its constant anatomical position as the basic symbol, can help surgeons quickly lock the safe operation area and realize CVS of the gallbladder triangle to avoid bile duct injury and reduce the incidence of related complications.

Objective To explore the changes and predictive value of serum interleukin-1(IL-1),interleu-kin-12(IL-12)and interferon α(IFN-α)levels in early pregnancy in hepatitis B pregnant women with abnor-mal liver function.Methods A total of 100 hepatitis B pregnant women with normal liver function in early pregnancy in Shijiazhuang Maternal and Child Health Hospital from January 2022 to May 2022 were selected,and were divided into normal liver function group(52 cases)and abnormal liver function group(48 cases)ac-cording to whether there was abnormal liver function in middle and late pregnancy,and another 50 healthy pregnant women of the same gestational week in the same period in Shijiazhuang Maternal and Child Health Hospital were selected as the control group.The general information,liver function indicators[alanine amin-otransferase(ALT),aspartate aminotransferase(AST),glutamine transferase(GGT)],serum interleukin(IL)-1,IL-12,and interferon α(IFN-α)levels among the three groups were compared.The serum levels of IL-1,IL-12,IFN-α in pregnant women with different degrees of liver dysfunction in the liver dysfunction group were compared,and the relationship between the serum levels of IL-1,IL-12,IFN-α and the degree of liver dysfunction was analyzed,as well as the value of predicting liver dysfunction in pregnant women with hepatitis B in the middle and late pregnancy.Results The serum levels of ALT,AST,GGT,IL-1 and IL-12 in early pregnancy from high to low in three groups were liver dysfunction group,normal liver function group,and control group(P＜0.05),while the level of IFN-α in early pregnancy from low to high in three groups were liver dysfunction group,normal liver function group,and control group(P＜0.05).In the abnormal liver func-tion group,there were 12 cases with abnormal concentration values of 3 enzymes,16 cases with abnormal con-centration values of 2 enzymes,and 20 cases with abnormal concentration values of 1 enzyme.The levels of IL-1 and IL-12 from high to low were pregnant women with 3 abnormal values of enzyme,2 abnormal values of enzyme,and 1 abnormal value of enzyme(P＜0.05).The level of IFN-α from low to high were pregnant women with 3 abnormal values of enzyme,2 abnormal values of enzyme,and 1 abnormal value of enzyme(P＜0.05).The levels of serum IL-1 and IL-12 in the abnormal liver function group were positively correlated with the degree of liver function abnormality(r=0.771,0.793,P＜0.05),while the levels of IFN-α were negatively correlated with the degree of liver function abnormality(r=-0.755,P＜0.05).The area under the curve of serum IL-1,IL-12 and IFN-α in the early pregnancy for predicting abnormal liver function of hep-atitis B pregnant women in the middle and late pregnancy was 0.936(95％CI:0.869-0.976,P＜0.05).Conclusion The levels of serum IL-1,IL-12 and IFN-α in early pregnancy of hepatitis B pregnant women are closely related to the degree of liver dysfunction in the middle and late pregnancy,and the combined detection of the three serum indicators has a high predictive value for predicting the liver dysfunction in the middle and late pregnancy of hepatitis B pregnant women.

Objective:To establish a disease risk prediction model for the newborn screening system of inherited metabolic diseases by artificial intelligence technology.Methods:This was a retrospectively study. Newborn screening data ( n=5 907 547) from February 2010 to May 2019 from 31 hospitals in China and verified data ( n=3 028) from 34 hospitals of the same period were collected to establish the artificial intelligence model for the prediction of inherited metabolic diseases in neonates. The validity of the artificial intelligence disease risk prediction model was verified by 360 814 newborns ' screening data from January 2018 to September 2018 through a single-blind experiment. The effectiveness of the artificial intelligence disease risk prediction model was verified by comparing the detection rate of clinically confirmed cases, the positive rate of initial screening and the positive predictive value between the clinicians and the artificial intelligence prediction model of inherited metabolic diseases. Results:A total of 3 665 697 newborns ' screening data were collected including 3 019 cases ' positive data to establish the 16 artificial intelligence models for 32 inherited metabolic diseases. The single-blind experiment ( n=360 814) showed that 45 clinically diagnosed infants were detected by both artificial intelligence model and clinicians. A total of 2 684 cases were positive in tandem mass spectrometry screening and 1 694 cases were with high risk in artificial intelligence prediction model of inherited metabolic diseases, with the positive rates of tandem 0.74% (2 684/360 814)and 0.46% (1 694/360 814), respectively. Compared to clinicians, the positive rate of newborns was reduced by 36.89% (990/2 684) after the application of the artificial intelligence model, and the positive predictive values of clinicians and artificial intelligence prediction model of inherited metabolic diseases were 1.68% (45/2 684) and 2.66% (45/1 694) respectively. Conclusion:An accurate, fast, and the lower false positive rate auxiliary diagnosis system for neonatal inherited metabolic diseases by artificial intelligence technology has been established, which may have an important clinical value.

Objective To investigate risk factors of the prognosis of patients with severe fever with thrombocytopenia syndrome (SFTS).Methods From May 2012 to July 2014,17 cases of severe fever with thrombocytopenia syndrome in Renmin Hospital of Wuhan University were treated.Clinical data including history of epidemiology,clinical manifestations,complications,physical examination and laboratory test results on admission and the third day after admission were retrospectively analyzed and compared with the death group and recovery group by application of Spearman correlation analysis.Results Elderly male patients with neuropsychiatric symptoms,or abnormal liver function,or abnormal blood clotting function had higher risk of the poor prognosis.In SFTS patients,AST,ALT was significantly increased,AST 539 U/L (229.73,545.4) U/L (r =0.597,P =0.015) was a risk factor affecting prognosis.Elevated blood ammonia indicated serious liver dysfunction and neurological dysfunction which were manifested as irritability,delirium,and trembling limbs.In SFTS patients,platelets were significantly decreased accompanied with mouth ulcers / bleeding gums,gastrointestinal bleeding.PLT 24.88 × 10 9/L-1 (12.75,35.00) ×10 9/L-1 (r=0.557,P=0.005) or APTT 86.06 s (66.88,114.18) (r=0.798,P=0.001) or D-dimmer 9.79 mg / L (4.09,16.51) mg/L (r =0.597,P =0.015) are risk factors affecting poor prognosis.Conclusions On the third days after admission,AST,WBC,PLT,APTT,Ddimmer are risk factors for prognosis of patients with severe fever with thrombocytopenia syndrome infected by a novel bunyavirus.

Coronary Vessel Anomalies ; therapy ; Coronary Vessels ; Humans ; Percutaneous Coronary Intervention