The preferred treatment for adrenal functional tumors is laparoscopic surgical resection. However, in recent years, various ablation techniques have gradually been applied in the treatment of adrenal tumors. This report presents the successful diagnosis and treatment experience of 4 aldosterone-producing adenomas and 1 cortisol-secreting adenoma treated with a combined cold and hot ablation system at Xi’an Daxing Hospital from Dec. 2023 to Dec. 2024, providing a new treatment approach for clinical exploration.

The preferred treatment for adrenal functional tumors is laparoscopic surgical resection. However, in recent years, various ablation techniques have gradually been applied in the treatment of adrenal tumors. This report presents the successful diagnosis and treatment experience of 4 aldosterone-producing adenomas and 1 cortisol-secreting adenoma treated with a combined cold and hot ablation system at Xi’an Daxing Hospital from Dec. 2023 to Dec. 2024, providing a new treatment approach for clinical exploration.

Objective:To explore the risk factors for stone recurrence after laparoscopic common bile duct exploration (LCBDE) combined with laparoscopic cholecystectomy (LC) and to develop a risk prediction model.Methods:Clinical data of 344 patients with bile duct stones who underwent LCBDE combined with LC at Hebei General Hospital from January 2016 to March 2022 were retrospectively analyzed, including 165 males and 179 females, aged (62.72±13.56) years old. Patients were divided into two groups based on whether stones recurred during the follow-up period: recurrence group ( n=37) and non-recurrence group ( n=307). Clinical data such as common bile duct diameter, stone size, number of stones and duration of T-tube drainage were collected from the patients. Logistic regression was used to analyze the risk factors for postoperative stone recurrence, and then developed a logistic regression model. The predictive efficacy of the model was assessed by the area under the receiver operating characteristic (ROC) curve, and the Hosmer-Lemeshow test. Results:The results of multifactorial logistic regression analysis showed that patients with ≥2 choledochal stones had a high risk of stone recurrence after LCBDE combined with LC ( OR=3.094, 95% CI: 1.069-8.954, P=0.037). In contrast, regular postoperative oral choleretic medication was a protective factor for stone recurrence after LCBDE combined with LC ( OR=0.160, 95% CI: 0.072-0.354, P=0.001). A logistic regression model, based on the number of common bile duct stones and regular postoperative oral choleretic medication, was developed to predict the recurrence of bile duct stones in patients who underwent LCBDE combined with LC. The area under the ROC curve for this model was found to be 0.821 (95% CI: 0.758-0.885). The Hosmer-Lemeshow test, χ 2=7.26, P=0.509, suggested that there is good agreement between the model's predicted probabilities and ideal probabilities. Conclusions:The number of stones (≥2) is an independent risk factor for stone recurrence after LCBDE combined with LC in patients with bile duct stones. Regular postoperative oral choleretic medication is a protective factor for stone recurrence after LCBDE combined with LC. Predictive models based on the number of choledochal stones and regular postoperative oral choleretic medication have better efficacy in predicting postoperative stone recurrence.

Objective To observe the therapeutic effect of laparoscopic sleeve gastrectomy (LSG) in treating patients with obesity and polycystic ovary syndrome (PCOS). Methods In this retrospective analysis, clinical materials of 60 patients with obesity and PCOS by LSG were analyzed, and postoperative improvements of PCOS symptoms were observed. Results A total of 60 patients had a preoperative mean body mass index (BMI) of (39.4±5.4) kg/m² and an average age of (26.3±6.1) years old, and all of them successfully completed LSG. After follow-up of 12 to 18 months, 50 cases (83.3%) had normalized menstrual cycles, with an average recovery time of (4.5 ±2.2) months after surgery, and 7 cases had natural pregnancy after surgery. Before surgery, ultrasound results in 35 patients indicated polycystic ovarian morphology (PCOM), and 29 cases (82.9%) regained normal ovarian status with an average recovery duration of (6.3±2.8) months. Complicated hyperandrogenemia was observed in 31 patients, and 29 cases (93.5%) exhibited normalization of testosterone levels within 18 months after surgery. At 18 months after surgery, the BMI was (26.47±4.70) kg/m², the average weight loss was (32.4±7.4) %. Conclusion LSG is a safe and effective treatment for obese PCOS.

Objective:To review the research advance on post-spaceflight recuperation and rehabilitation strategies. Literature resource and selection 　Relevant literatures on post-flight rehabilitation and convalescence of astronauts published in domestic and abroad. Literature quotation 　Twenty-nine references were cited. Literature synthesis 　The long-term spaceflight environment results in adaptive modifications of multiple systems of astronaut′s body. These modifications can have a negative impact on astronauts′ physical health and overall productivity. Post-spaceflight rehabilitation is an important measure to ensure the health of astronauts. By employing physical therapy and exercise training, combining with natural healing factors, and implementing phased reconditioning plan, astronauts can quickly readapt to the gravity environment, restore physical functions, and achieve a good physical and mental state in preparation for the next spaceflight mission. Conclusions:It is urgent to develop individualized exercise prescriptions by effectively enhance post-spaceflight rehabilitation outcomes, and to establish reasonable evaluation indicators.

Objective:To review the research advance on post-spaceflight recuperation and rehabilitation strategies. Literature resource and selection 　Relevant literatures on post-flight rehabilitation and convalescence of astronauts published in domestic and abroad. Literature quotation 　Twenty-nine references were cited. Literature synthesis 　The long-term spaceflight environment results in adaptive modifications of multiple systems of astronaut′s body. These modifications can have a negative impact on astronauts′ physical health and overall productivity. Post-spaceflight rehabilitation is an important measure to ensure the health of astronauts. By employing physical therapy and exercise training, combining with natural healing factors, and implementing phased reconditioning plan, astronauts can quickly readapt to the gravity environment, restore physical functions, and achieve a good physical and mental state in preparation for the next spaceflight mission. Conclusions:It is urgent to develop individualized exercise prescriptions by effectively enhance post-spaceflight rehabilitation outcomes, and to establish reasonable evaluation indicators.

Objective:To study the clinical characteristics of SARS-CoV-2 infection in neonates.Methods:From December 2022 to January 2023, neonates with PCR confirmed SARS-CoV-2 infection admitted to the Department of Neonatology of our hospital were retrospectively studied.The clinical data including epidemiological history, clinical manifestations, laboratory results, treatment and prognosis were analyzed.Results:A total of 174 neonates were enrolled, including 152(87.4%) with clear exposure to SARS-CoV-2 patients prior to onset. 73 cases (42.0%) were mild type, 72(41.4%) were moderate type, 26(14.9%) were severe type and 3(1.7%) were critically severe type. 109 cases had fever, 118 had respiratory symptoms including cough, nasal congestion and spitting up bubbles, 56 had gastrointestinal symptoms including decreased appetite, vomiting, and diarrhea and 35 had neurological symptoms including drowsiness, poor response and irritability. All 174 patients had positive nucleic acid test. White blood cell (WBC) was normal in 151 cases, decreased in 14 and increased in 9. 8 cases showed elevated C-reactive protein(CRP). Lactate dehydrogenase (LDH) was increased in 74 cases, creatine kinase (CK) increased in 22 cases and alanine aminotransferase (ALT) increased in 3 cases. Chest X-ray or CT scan showed 102 cases with pneumonia. 26 cases required nasal cannula oxygen therapy and 4 cases required respiratory support (3 invasive and 1 non-invasive). 173 cases were discharged fully recovered and 1 died after withdrawal of treatment for total anomalous pulmonary venous drainage (TAPVD) .Conclusions:Neonates are susceptible to SARS-CoV-2.Most patients have a history of exposure prior to disease onset. 83.3% of all cases are mild and moderate types.Respiratory symptoms are common. Symptomatic treatments are effective with an overall good prognosis.

Objectives:To explore the association between different blood pressure levels at baseline and early-onset heart disease among young adults under 40 years in China. Methods:This prospective cohort study included 35 993 subjects who participated in the physical examination of the employees of Kailuan Group for the first time from 2006 to 2012 and were younger than 40 years,with complete blood pressure data and had no history of heart disease.Participants were followed up to the end of 2021.The primary endpoint was early-onset heart disease(including coronary heart disease,atrial fibrillation,and heart failure).According to 2018 Chinese guidelines for the management of hypertension,the participants were divided into four groups:normal blood pressure group(n=13 208),elevated blood pressure group(n=16 576),stage 1 hypertension group(n=4 357),and stage 2-3 hypertension group(n=1 852).The cumulative incidence of heart disease among participants with different blood pressure levels at baseline was compared using log-rank test.Multivariate Cox proportional hazard regression model was used to analyze the impact of different blood pressure levels at baseline on early-onset heart disease in this cohort. Results:After a mean follow-up of(12.5±2.6)years,the cumulative incidence of early-onset heart disease in normal blood pressure group,elevated blood pressure group,stage 1 hypertension group,stage 2-3 hypertension group were 0.47%,0.97%,3.56%and 4.42%respectively(log-rank P<0.01).After adjusting for confounding factors such as age and sex,Cox regression analysis showed that the HR(95%CI)of heart disease in the elevated blood pressure group,hypertension grade 1 group and hypertension grade 2-3 group were 1.59(1.12-2.24),2.08(1.41-3.08)and 3.20(2.11-4.85)(all P<0.01),respectively,compared with the normal blood pressure group. Conclusions:Elevated blood pressure is a risk factor for early-onset heart disease among young Chinese population.

Background and Objectives: Psoriasis is a chronic inflammatory skin disease, which the mechanisms behind its initiation and development are related to many factors. DMSCs (dermal mesenchymal stem cells) represent an important member of the skin microenvironment and play an important role in the surrounding environment and in neighbouring cells, but they are also affected by the microenvironment. We studied the glucose metabolism of DMSCs in psoriasis patients and a control group to reveal the relationship among glucose metabolism, cell proliferation activity，and VEC (vascular endothelial cell) differentiation in vitro, we demonstrated the biological activity and molecular mechanisms of DMSCs in psoriasis. Methods: and Results: We found that the OCR of DMSCs in psoriatic lesions was higher than that in the control group, and mRNA of GLUT1 and HK2 were up-regulated compared with the control group. The proliferative activity of DMSCs in psoriasis was reduced at an early stage, and mRNA involved in proliferation, JUNB and FOS were expressed at lower levels than those in the control group. The number of blood vessels in psoriatic lesions was significantly higher than that in the control group (p＜0.05), which the mRNA of VEC differentiation, CXCL12, CXCR7, HEYL and RGS5 tended to be increased in psoriatic lesions compared to the control group, in addition to Notch3. Conclusions We speculated that DMSCs affected local psoriatic blood vessels through glucose metabolism, and the differentiation of VECs, which resulted in the pathophysiological process of psoriasis.