Objective:To investigate the impact of circumferential tumor location (anterior wall, nonanterior wall, or circumferential) on circumferential resection margin (CRM) status, local recurrence, and survival in patients with mid-low rectal cancer.Methods:A retrospective cohort study was conducted using data from 696 patients with mid-low rectal adenocarcinoma who underwent surgery in the Department of Colorectal Surgery at the First Affiliated Hospital of Naval Medical University between December, 2018 and December, 2019. Based on MRI or contrast-enhanced CT findings, the rectal wall was divided into four quadrants: anterior, posterior, left, and right. Tumors were classified into three groups: anterior wall group ( n = 245), nonanterior wall group ( n = 286, tumors predominantly located on the posterior or lateral walls), and circumferential group ( n = 165, tumors involving ≥ 3/4 of the circumference). Propensity score matching (PSM) was used to balance baseline characteristics. Outcomes included pathological CRM positivity, local recurrence rate (LRR), overall survival (OS), and disease-free survival (DFS). Cox regression analysis was performed to identify risk factors for recurrence, and subgroup analysis was conducted in patients who did not receive neoadjuvant therapy. Results:After PSM, both the anterior and circumferential groups had significantly higher pathological CRM positivity rates compared to the nonanterior wall group ( P=0.040 and P=0.039, respectively). The median follow-up time was 64 months (range: 1-71 months). Compared to the nonanterior wall group, the anterior wall group also had a significantly higher 5-year LRR (8.8% vs. 2.3%, P=0.003), and significantly lower 5-year OS (80.7% vs. 91.6%, P=0.001) and DFS (76.6% vs. 84.6%, P=0.029). The circumferential group had a significantly higher 5-year LRR than the nonanterior wall group (11.4% vs. 3.8%, P=0.020), but no significant differences were observed in 5-year OS (81.8% vs. 89.5%, P=0.100) or DFS (70.7% vs. 78.3%, P=0.101). No significant differences were found between the anterior and circumferential groups in 5-year LRR (11.1% vs. 9.7%), OS (76.3% vs. 83.7%), or DFS (69.8% vs. 74.1%) either (all P>0.05). Cox univariate analysis and multivariate analysis identified anterior wall tumors (HR=3.751, 95%CI: 1.373-10.215, P=0.010), circumferential tumors (HR=3.240, 95%CI: 1.109-9.466, P=0.032), pathological CRM positivity (HR=3.071, 95%CI: 1.144-8.245, P=0.026), and lymph node metastasis (HR=2.584, 95%CI: 1.192-5.601, P=0.016) as independent risk factors for LRR. Conversely, a greater distance from tumor to the anal verge (per 1 cm increase, HR=0.831, 95%CI: 0.712-0.970, P=0.019), and neoadjuvant therapy (HR=0.442, 95%CI: 0.204-0.957, P=0.038) were identified as independent protective factors against LRR. In patients who did not receive neoadjuvant therapy, locally advanced nonanterior wall tumors exhibited markedly low LRR (1.3% for pathological stage II-III, 1.6% for pT3-4 stage). Conclusion:Rectal tumors located in the anterior wall or involving the circumference are associated with higher CRM positivity rates, increased local recurrence, and poorer survival. These patients should be prioritized for neoadjuvant therapy. In contrast, nonanterior wall tumors have a low recurrence rate, and selective omission of neoadjuvant therapy may be considered for these cases.

Objective:To investigate the impact of circumferential tumor location (anterior wall, nonanterior wall, or circumferential) on circumferential resection margin (CRM) status, local recurrence, and survival in patients with mid-low rectal cancer.Methods:A retrospective cohort study was conducted using data from 696 patients with mid-low rectal adenocarcinoma who underwent surgery in the Department of Colorectal Surgery at the First Affiliated Hospital of Naval Medical University between December, 2018 and December, 2019. Based on MRI or contrast-enhanced CT findings, the rectal wall was divided into four quadrants: anterior, posterior, left, and right. Tumors were classified into three groups: anterior wall group ( n = 245), nonanterior wall group ( n = 286, tumors predominantly located on the posterior or lateral walls), and circumferential group ( n = 165, tumors involving ≥ 3/4 of the circumference). Propensity score matching (PSM) was used to balance baseline characteristics. Outcomes included pathological CRM positivity, local recurrence rate (LRR), overall survival (OS), and disease-free survival (DFS). Cox regression analysis was performed to identify risk factors for recurrence, and subgroup analysis was conducted in patients who did not receive neoadjuvant therapy. Results:After PSM, both the anterior and circumferential groups had significantly higher pathological CRM positivity rates compared to the nonanterior wall group ( P=0.040 and P=0.039, respectively). The median follow-up time was 64 months (range: 1-71 months). Compared to the nonanterior wall group, the anterior wall group also had a significantly higher 5-year LRR (8.8% vs. 2.3%, P=0.003), and significantly lower 5-year OS (80.7% vs. 91.6%, P=0.001) and DFS (76.6% vs. 84.6%, P=0.029). The circumferential group had a significantly higher 5-year LRR than the nonanterior wall group (11.4% vs. 3.8%, P=0.020), but no significant differences were observed in 5-year OS (81.8% vs. 89.5%, P=0.100) or DFS (70.7% vs. 78.3%, P=0.101). No significant differences were found between the anterior and circumferential groups in 5-year LRR (11.1% vs. 9.7%), OS (76.3% vs. 83.7%), or DFS (69.8% vs. 74.1%) either (all P>0.05). Cox univariate analysis and multivariate analysis identified anterior wall tumors (HR=3.751, 95%CI: 1.373-10.215, P=0.010), circumferential tumors (HR=3.240, 95%CI: 1.109-9.466, P=0.032), pathological CRM positivity (HR=3.071, 95%CI: 1.144-8.245, P=0.026), and lymph node metastasis (HR=2.584, 95%CI: 1.192-5.601, P=0.016) as independent risk factors for LRR. Conversely, a greater distance from tumor to the anal verge (per 1 cm increase, HR=0.831, 95%CI: 0.712-0.970, P=0.019), and neoadjuvant therapy (HR=0.442, 95%CI: 0.204-0.957, P=0.038) were identified as independent protective factors against LRR. In patients who did not receive neoadjuvant therapy, locally advanced nonanterior wall tumors exhibited markedly low LRR (1.3% for pathological stage II-III, 1.6% for pT3-4 stage). Conclusion:Rectal tumors located in the anterior wall or involving the circumference are associated with higher CRM positivity rates, increased local recurrence, and poorer survival. These patients should be prioritized for neoadjuvant therapy. In contrast, nonanterior wall tumors have a low recurrence rate, and selective omission of neoadjuvant therapy may be considered for these cases.

China prospective multicenter birth cohort (Prospective Omics Health Atlas birth cohort, POHA birth cohort) study was officially launched in 2022. This study, in collaboration with 12 participating units, aims to establish a high-quality, multidimensional cohort comprising 20 000 naturally conceived families and assisted reproductive families. The study involves long-term follow-up of parents and offspring, with corresponding biological samples collected at key time points. Through multi-omics testing and analysis, the study aims to conduct multi-omics big data research across the entire maternal and infant life cycle. The goal is to identify new biomarkers for maternal and infant diseases and provide scientific evidence for risk prediction related to maternal diseases and neonatal health.

OBJECTIVE：To optim ize the water extraction-ethanol precipitation technology of polysaccharide from Litchi chinensis seed，and to evaluate its hypoglycemic activity in vitro . METHODS ：The content of polysaccharides was determined by phenol-sulfuric acid colorimetry ，and the extraction rate of polysaccharides was calculated. Single factor test and response surface methodology were used to optimize the water extraction technology with the ratio of material to liquid ，extraction times and extraction time as factors ，and the extraction rate of polysaccharide as index. Single factor test was used to screen the concentration volume fraction of water extract and ethanol precipitation Using acarbose as contro l，4-nitrophenol-α-D-glucopyranoside method was used to investigate in vitro inhibitory activity of polysaccharide from L. chinensis seed to α-glucosidase. RESULTS ：The optimal technology was the ratio of material to liquid 1∶19 （g/mL），decocting for 3 times，1 h for each time ，concentrating the water extract to 40％ of original volume ，and adding ethanol to 80％ volume fraction. After deproteinization by Sevage method ，the crude polysaccharide of L. chinensis seed was obtained. The results of 3 times of validation tests showed that ，extraction rates of polysaccharide were 7.61％，7.89％，7.99％，average extraction rate was 7.83％（RSD＝2.52％，n＝3）. The contents of polysaccharide were 55.57％，55.83％ and 56.66％，average content was 56.02％（RSD＝1.81％，n＝3）. The inhibitory activity of the polysaccharide from L. chinensis seed to α-glucosidase were increased as concentration ；its IC 50 was 0.056 mg/mL，which was lower than positive control acarbose （0.196 mg/mL）. CONCLUSIONS：The optimal water extraction-ethanol precipitation technology of polysaccharide from L. chinensis seed is stable and feasible. The polysaccharide from L. chinensis seed show significant in vitro inhibitory effect on α-glucosidase，which is better than that of acarbose.

Objective:To summarize the characteristics of chest CT imaging and prognosis of children with necrotizing pneumonia (NP) after flexible bronchoscopy, in order to improve the clinician′s diagnosis and treatment of this disease.Methods:The clinical information, imaging features of the sixty-six patients suffering from NP, who were diagnosed and treated in Qingdao Women and Children′s Hospital from September 2015 to April 2019, were retrospectively analyzed. Fourty-six cases who were treated with flexible bronchoscopy alveolar lavage(treatment group) were comparative analyzed with the left 20 cases who were not treated with flexible bronchoscopy alveolar lavage(control group).Results:In treatment group, all patients appered lung consolidation at early stages, and multiple balloon chambers emerged in consolidation shadows in late period. There was no statistic difference in basic information, clinical manifestations, laboratory examinations and etiology between the control group and treatment group( P>0.05). The treatment group had a lower incidence of pulmonary complications and a higher lung shadow full absorption rate, which showed the statistical difference( P<0.05). Conclusion:The flexible bronchoscopy alveolar lavage plays an important role in the process of treating the children with NP, and chest CT provides reliable imaging evidence in the early diagnosis and prognosis of the NP children.

Objective: To assess the effects of different nutritional support methods on postoperative recovery in patients with gastric cancer. Methods: 98 patients who received radical gastrectomy were divided into three groups: parenteral nutrition group (PN group) (n=36), early enteral nutrition group (EEN group) (n=33) and early oral feeding group (EON group) (n=29). Tolerance of enteral nutrition, postoperative recovery and economic indicators were compared. Results: The number of laparoscopic-assisted surgeries was 18, 17 and 25 in PN group, EEN group and EON group, respectively. There was no significant difference in sex, age and body mass index(BMI) among the three groups. Gastrointestinal function recovered slowly in 3 cases, including 2 cases in EEN group and 1 case in EON group. 1 case in EON group had abdominal hemorrhage. Median postoperative hospital stay in PN, EEN and EON group was 11.0, 11.0 and 8.0 days respectively, and significant reduction can be found in EON group(P<0.001). The complication rates were 30.5% (11 cases), 12.1% (4 cases), and 13.8% (4 cases), respectively, with no statistically significant difference(P=0.102). The median nutritional support costs for PN group, EEN group, and EON group were 4 543.3, 974.2, and 265.0 yuan, respectively. The median albumin consumption was 90.0, 40.0, and 0 g, respectively. The EON groups were significantly lower (P<0.001). The results of the laparoscopic assisted subgroup and the ones of whole group were consistent. Conclusion Compared with parenteral nutrition and early enteral nutrition, early oral feeding can reduce the amount of albumin consumption, decrease the cost of nutrition support and shorten the average hospital stay after surgey without increasing the incidence of complications.

Objective: To establish a mouse model of osteoarthritis (OA) and study the bone microarchitecture and bone metabolism of tibial subchondral bone in early stage of OA. Methods: The mouse model of post-traumatic osteoarthritis (PTOA) with anterior cruciate ligament (ACLT) was established by using c57 mice. The Sham operation group served as the control group. All mice were fed with conventional diet. All mice were sacrificed after 4 weeks. The degeneration of knee joint was observed by HE staining and Safranin O-Fast Green staining. The number of osteoclasts was counted by TRAP staining. Micro CT was used to analyze the quantitative parameters of the microstructure of tibia subchondral bone in mice. Serum levels of bone resorption biomarker CTX I and cartilage degeneration marker CTX II were determined. Results: After ACLT 4 weeks, the average score of OARSI in ACLT group was 3.2, which was higher than that in Sham group, and the joint degeneration occurred in mice, presenting the pathological characteristics of early OA. Compared with the sham operation phase, the total subchondral bone volume (TV) of ACLT group was 4.72 mm³, increased by 13.6%; the bone trabecular resolution (Tb.Sp) was 0.130 and 0.154 mm, respectively, and the ACLT group also increased by 18.8%; the bone volume/tissue volume (BV/TV) was 0.470 and 0.294, respectively, and the ACLT group decreased by 48.9%; the bone trabecular thickness (Tb.Th) was 0.162 and 0.083 mm groups, ACLT decreased by 37.5%. Trap staining showed that the number of osteoclasts per unit volume in ACLT group was 72, which was significantly higher than that in sham operation group. The CTX I of mice in the sham operated ACLT group and sham operated group were 20.9 ng/ml and 18.29 ng/ml, with an increase of 48.9% in the ACLT group; the CTX II of mice in the ACLT group and sham operated group were 35.5 ng/ml and 28.6 ng/ml, with an increase of 24.1% in the ACLT group. Conclusion ACLT Mouse model can successfully construct early OA, which confirms the early loss of osteochondral bone and the pathological changes of osteoclast activation in OA, and provides a new specific target for the treatment of OA.

Objective To assess the effects of different nutritional support methods on postoperative recovery in patients with gastric cancer. Methods 98 patients who received radical gastrectomy were divided into three groups: parenteral nutrition group (PN group) (n＝36), early enteral nutrition group (EEN group) (n＝33) and early oral feeding group (EON group) (n＝29). Tolerance of enteral nutrition, postoperative recovery and economic indicators were compared. Results The number of laparoscopic?assisted surgeries was 18, 17 and 25 in PN group, EEN group and EON group, respectively. There was no significant difference in sex, age and body mass index ( BMI) among the three groups. Gastrointestinal function recovered slowly in 3 cases, including 2 cases in EEN group and 1 case in EON group. 1 case in EON group had abdominal hemorrhage. Median postoperative hospital stay in PN,EEN and EON group was 11.0, 11.0 and 8.0 days respectively, and significant reduction can be found in EON group(P＜0.001). The complication rates were 30.5%(11 cases), 12.1%(4 cases), and 13.8%(4 cases), respectively, with no statistically significant difference ( P＝0.102). The median nutritional support costs for PN group, EEN group, and EON group were 4 543.3, 974.2, and 265.0 yuan, respectively. The median albumin consumption was 90.0, 40.0, and 0 g, respectively. The EON groups were significantly lower ( P＜0.001). The results of the laparoscopic assisted subgroup and the ones of whole group were consistent. Conclusion Compared with parenteral nutrition and early enteral nutrition, early oral feeding can reduce the amount of albumin consumption, decrease the cost of nutrition support and shorten the average hospital stay after surgey without increasing the incidence of complications.

Objective To assess the effects of different nutritional support methods on postoperative recovery in patients with gastric cancer. Methods 98 patients who received radical gastrectomy were divided into three groups: parenteral nutrition group (PN group) (n＝36), early enteral nutrition group (EEN group) (n＝33) and early oral feeding group (EON group) (n＝29). Tolerance of enteral nutrition, postoperative recovery and economic indicators were compared. Results The number of laparoscopic?assisted surgeries was 18, 17 and 25 in PN group, EEN group and EON group, respectively. There was no significant difference in sex, age and body mass index ( BMI) among the three groups. Gastrointestinal function recovered slowly in 3 cases, including 2 cases in EEN group and 1 case in EON group. 1 case in EON group had abdominal hemorrhage. Median postoperative hospital stay in PN,EEN and EON group was 11.0, 11.0 and 8.0 days respectively, and significant reduction can be found in EON group(P＜0.001). The complication rates were 30.5%(11 cases), 12.1%(4 cases), and 13.8%(4 cases), respectively, with no statistically significant difference ( P＝0.102). The median nutritional support costs for PN group, EEN group, and EON group were 4 543.3, 974.2, and 265.0 yuan, respectively. The median albumin consumption was 90.0, 40.0, and 0 g, respectively. The EON groups were significantly lower ( P＜0.001). The results of the laparoscopic assisted subgroup and the ones of whole group were consistent. Conclusion Compared with parenteral nutrition and early enteral nutrition, early oral feeding can reduce the amount of albumin consumption, decrease the cost of nutrition support and shorten the average hospital stay after surgey without increasing the incidence of complications.

Objective To study the pulmonary artery shrink pressure(PASP) and pulmonary function in children with asthmatic diseases,and screen pulmonary arterial hypertension (PAH).To probe the correlation between PASP and pulmonary function.Methods Ninety children with asthmatic diseases from November 2014 to April 2015 at the Department of Respiratory,Women and Children's Hospital of Qingdao City were chosed as asthmatic group,and 90healthy children in the same period were selected as healthy control group.PASP and pulmonary function were detected by Doppler ultrasound and tidal flow-volume loop respectively within 24 hours of admission,the respite degrees were assessed by clinical and tidal flow-volume loop.SPSS 13.0 statistical software was used for statistical analysis.Results PASP of the asthmatic group and the healthy control group was (3.24 ±0.66) kPa and (3.15 ±0.49) kPa,and the difference was statistically significant (F =7.50,P ＜ 0.05).There were 10 cases of PAH in the asthmatic group,which had statistically difference with the healthy control group (x2 =10.59,P ＜ 0.05).The tidal volume per kilogram,the ratio of time to peak tidal expiratory flow to total expiratory time,the ratio of volume to peak expiratory flow to total expiratory volume of the asthmatic group were (6.62 ± 1.63) mL/kg,(26.76 ± 6.48) ％ and (26.66 ± 6.54) ％,and these three indicators of the healthy control group were (8.38 ± 0.80) mL/kg,(34.35 ± 2.84) ％ and (34.23 ±3.02) ％,but that of the former group were less than that of the lower respectively (F =86.28,138.08,113.27,all P ＜0.05).PASP had negative correlation with the ratio of time to peak tidal expiratory fow to total expiratory time in the asthmatic group (r =-9.45,P ＜ 0.05).PASP was increased with the aggravation of respite,and it had statistical difference between the mild or moderate asthmatic group [(3.43 ± 0.50) kPa,(3.66 ± 0.59) kPa] and the severe group [(4.20 ± 0.75) kPa] (x2 =24.81,12.55,all P ＜ 0.05),and the cases of PAH had significant differences among these 3 groups (0,2,8 cases in mild,mode rate and severe group,respectively) (x2 =54.92,P ＜ 0.05).Conclusions For children with more severe airway obstruction and wheezing,the risk of PASP and PAH will be higher.It is helpful to reduce right ventricular function damage for children with asthmatic diseases by measuring PASP and screening PAH in the early stage according to the clinical condition and lung function.