Purpose To analyze the sonographic features of incarcerated gravid uterus and evaluate the diagnostic value of ultrasonography.Materials and Methods Clinical data of eight patients diagnosed with incarcerated gravid uterus at Sichuan Provincial Maternity and Child Health Care Hospital from January 2018 to December 2023 were retrospectively analyzed.Clinical manifestations,sonographic characteristics,management approaches and pregnancy outcomes were evaluated.Results Among the eight confirmed cases,seven presented with initial symptoms of dysuria and urinary retention,while one reported irregular lower abdominal pain.Ultrasonography consistently demonstrated:retroverted and retroflexed uterine position with the uterine body posterior to the cervix.Elongated cervix(range:4.0-8.6 cm)displaced anteriorly.Overdistended,elongated and superiorly displaced bladder in seven cases.Management included successful manual reduction via knee-chest position after catheterization in seven patients.One patient was managed conservatively with close monitoring and delivered by cesarean section at term.All eight patients achieved successful term deliveries with favorable maternal and neonatal outcomes.Conclusion Prenatal ultrasonography plays a crucial role in diagnosing and managing incarcerated gravid uterus.Early recognition of characteristic sonographic features facilitates prompt diagnosis and intervention,thereby mitigating risks of adverse pregnancy outcomes.

Natural arabinogalactan， an important polysaccharide， has a wide range of sources， a complex structure， various biological activities， and great application potential. Natural arabinogalactan is mainly rich in plants and microorganisms， and its structure varies due to different sources， including types Ⅰ， type Ⅱ， type Ⅱ-related types， and new configurations. Natural arabinogalactan has shown a variety of biological activities， such as anti-tumor， anti-oxidation， anti-coagulation， anti-aging， blood glucose-lowering， intestinal health-maintaining， anti-inflammatory， and immunomodulatory activities. In addition， natural arabinogalactan shows good biocompatibility and low toxicity， serving as a potential material in the biomedical field. Natural arabinogalactan has been designed as a carrier in the drug delivery system to effectively improve drug stability and targeting. Natural arabinogalactan is often added to skin care products to help delay skin aging and enhance skin barrier function because of their moisturizing and antioxidant properties. Additionally， natural arabinogalactan acts as a thickener， stabilizer， and emulsifier to improve the texture and taste while enhancing the nutritional value of food products. The review of latest research reports is helpful to further understand the relationship between the structure， biological activity， and functional application of natural arabinogalactan and provides an important reference for future research and development.

Purpose To analyze the sonographic features of incarcerated gravid uterus and evaluate the diagnostic value of ultrasonography.Materials and Methods Clinical data of eight patients diagnosed with incarcerated gravid uterus at Sichuan Provincial Maternity and Child Health Care Hospital from January 2018 to December 2023 were retrospectively analyzed.Clinical manifestations,sonographic characteristics,management approaches and pregnancy outcomes were evaluated.Results Among the eight confirmed cases,seven presented with initial symptoms of dysuria and urinary retention,while one reported irregular lower abdominal pain.Ultrasonography consistently demonstrated:retroverted and retroflexed uterine position with the uterine body posterior to the cervix.Elongated cervix(range:4.0-8.6 cm)displaced anteriorly.Overdistended,elongated and superiorly displaced bladder in seven cases.Management included successful manual reduction via knee-chest position after catheterization in seven patients.One patient was managed conservatively with close monitoring and delivered by cesarean section at term.All eight patients achieved successful term deliveries with favorable maternal and neonatal outcomes.Conclusion Prenatal ultrasonography plays a crucial role in diagnosing and managing incarcerated gravid uterus.Early recognition of characteristic sonographic features facilitates prompt diagnosis and intervention,thereby mitigating risks of adverse pregnancy outcomes.

Objective To explore the antioxidant capacity of the volatile oil components of the Mongolian medicine Zhenbaowan and the mechanism of action in the treatment of rheumatoid arthritis(RA)by using bioinformatics technology,GC-MS technology,and antioxidant activity experiment.Methods The volatile oil in Zhenbaowan was extracted using water vapor distillation and the volatile oil components were qualitatively analyzed by GC-MS.Based on the results of GC-MS analysis,bioinfor-matics analysis was used to investigate the main components,key targets,and pathways of the volatile oil of Zhenbaowan in pre-venting and treating RA.Meanwhile,the antioxidant activity of the volatile oil was determined and analyzed using the 2,2-Diphen-yl-1-picrylhydrazyl(DPPH)method.Results A total of 115 volatile oil components were identified in Zhenbaowan,of which the top 48 components accounted for 97.66%of the total volatile oil content.Bioinformatics analysis revealed that Zhenbaowan can regulate signal transduction,inflammation,and protein phosphorylation through 147 RA-related targets,and intervene in signaling pathways such as PI3K-Akt,MAPK,and RAS.Molecular docking results showed that the seven main components of Zhenbaowan volatile oil can spontaneously bind to the five core targets.Antioxidant activity tests have proved that the volatile oil of Zhenbaowan has a more significant antioxidant capacity.Conclusion Using GC-MS high-throughput analysis technology combined with bioinformatic analysis and antioxidant activity test,the pharmacodynamic substances and mechanism of action of the volatile oil components of Zhenbaowan,a Mongolian medicine,in the treatment of RA are hypothesized.It provides a theoretical basis for the further study of the volatile oil components of Zhenbaowan.

Pancreatic neuroendocrine neoplasms (pNENs) are highly heterogeneous, and the management of pNENs patients can be intractable. To address this challenge, an expert committee was established on behalf of the Chinese Pancreatic Surgery Association, Chinese Society of Surgery, Chinese Medical Association, which consisted of surgical oncologists, gastroenterologists, medical oncologists, endocrinologists, radiologists, pathologists, and nuclear medicine specialists. By reviewing the important issues regarding the diagnosis and treatment of pNENs, the committee concluded evidence-based statements and recommendations in this article, in order to further improve the management of pNENs patients in China.

Objective:To analyze the clinical efficacy of two-stage total hip arthroplasty in the treatment of chronic septic hip arthritis.Methods:From January 2008 to March 2020, 17 patients with chronic septic hip arthritis (17 hips) received two-stage total hip arthroplasty at Department of Orthopaedic Surgery, The First Affiliated Hospital to of Fujian Medical University. They were 11 males and 6 females, with an average age of 54.5 years (from 19 to 77 years) and 9 left and 8 right hips affected. There were 10 cases of primary septic hip and 7 cases of secondary infection after hip surgery. Three patients had undergone debridement in other hospitals and one patient had developed a sinus tract. In the first stage operation, the diseased femoral head and neck were resected to implant an articulating spacer after thorough debridement; in the second stage operation, the spacer was removed to implant a uncemented artificial hip prosthesis in 16 cases or a cemented artificial hip prosthesis in one case. Recorded were the results of microbial culture, operation time, intraoperative blood loss, and therapeutic outcomes of the patients.Results:Pathogenic data were available in 13 patients and the culture was negative in 4. The pathogens were detected by metagenomic next-generation sequencing in 2 patients with culture negative. In the first stage operation, operation time averaged 140.6 min (from 90 to 176 min) and intraoperative blood loss 361.8 mL(from 100 to 1 000 mL); in the second stage operation, operation time averaged 130.3 min (from 91 to 166 min)and blood loss 291.2 mL(from 50 to 700 mL). The average interval between the first and the second stage operations was 115.0 days(from 66 to 227 d). During the interval, spacer fracture occurred in one case, spacer dislocation in one case and lower extremity deep venous thrombosis in one case. All the patients were followed up for 12 to 82 months (average, 36.7 months) after second stage operation. The inflammatory indexes decreased to normal in all the 17 patients and infection recurrence was observed in none of them.Conclusions:Two-stage total hip arthroplasty may result in a high rate of successful treatment of chronic septic hip arthritis. Specific use of sensitive antibiotics after identification of specific pathogenic microorganisms by multiple methods is the key to a successful treatment.

Objective:To investigate whether the prophylactic use of a dose of sensitive antibiotics before revision for periprosthetic joint infection (PJI) may affect the positive rate of intraoperative specimen culture.Methods:This prospective study recruited the patients who underwent revision due to PJI from July 1, 2017 to February 1, 2019 at Department of Orthopaedics, The First Affiliated Hospital to Fujian Medical University. After use of antibiotics was stopped in all patients for 2 weeks before operation, synovial fluid was extracted for culture to confirm pathogenic bacteria and drug sensitivity and some/all of the prostheses were removed during operation. According to their sequence number of admission, the patients were randomly divided into group A and group B. Samples were taken in group A after a dose of sensitive antibiotics was administered 30 to 60 minutes before revision while a dose of sensitive antibiotics was given in group B after all samples were taken. Intra-operatively, synovial fluid, tissue grinding fluid (TGF) and ultrasonic prosthesis lysate (UPL) were taken for aerobic and anaerobic culture. According to whether there was a positive culture of at least one microbiological specimen, the preoperative and intraoperative culture results were analyzed and compared between the 2 groups.Results:A total of 32 PJI patients were included in this study due to positive culture of synovial fluid before operation, with 16 cases in group A and 16 in group B. The most common infection bacteria were staphylococci (59.3%, 19/32). There was no significant difference in age, gender, mode of operation, Tsukayama classification, prosthesis removal, preoperative ESR, CRP, synovial fluid white blood cell count (SF-WBC) or polymorphonuclear cell percentage (PMN) between the 2 groups. The positive rates of synovial fluid, tissue, TGF and UPL were 81.3% (13/16), 62.5% (10/16), 93.8% (15/16) and 93.8% (15/16) for group A, and 87.5% (14/16), 68.8% (11/16), 93.8% (15/16) and 100.0% (16/16) for group B, showing insignificant differences between the 2 groups ( P>0.05). The positive rates of TGF and UPL culture showed no significant difference between them in group A or in group B ( P>0.05), but they were significantly higher than those of traditional tissue culture ( P<0.05). Conclusions:As prophylactic use of antibiotics before PJI revision may not affect the positive rate of intraoperative specimen culture, it is not necessary to postpone use of prophylactic antibiotics before PJI revision. Furthermore, as positive rates of TGF and UPL culture are similar but significantly higher than those of traditional tissue culture, tissue grinding can be used to improve the positive rate of tissue culture.

Pancreatic neuroendocrine neoplasms (pNENs) are highly heterogeneous, and the management of pNENs patients can be intractable. To address this challenge, an expert committee was established on behalf of the Group of Pancreatic Surgery, Chinese Society of Surgery, Chinese Medical Association, which consisted of surgical oncologists, gastroenterologists, medical oncologists, endocrinologists, radiologists, pathologists, and nuclear medicine specialists. By reviewing the important issues regarding the diagnosis and treatment of pNENs, the committee concluded evidence-based statements and recommendations in this article, in order to further improve the management of pNENs patients in China.

Pancreatic neuroendocrine neoplasms (pNENs) are highly heterogeneous, and the management of pNENs patients can be intractable. To address this challenge, an expert committee was established on behalf of the Group of Pancreatic Surgery, Chinese Society of Surgery, Chinese Medical Association, which consisted of surgical oncologists, gastroenterologists, medical oncologists, endocrinologists, radiologists, pathologists, and nuclear medicine specialists. By reviewing the important issues regarding the diagnosis and treatment of pNENs, the committee concluded evidence-based statements and recommendations in this article, in order to further improve the management of pNENs patients in China.

Objective To investigate the role of next generation sequencing technology in the detection of pathogenic bacteria in synovial fluid of prosthetic joint infection.Methods Nine samples of synovial fluid specimens of prosthetic joint infection patients with positive microbial culture from October,1 2016 to April 1,2017 were collected.Each specimen (200 μl) was used for next generation sequencing.Total DNA was extracted from synovial fluid samples.The collected DNA samples were amplified by PCR in the V4 region of 16S rDNA gene.The amplified products were sequenced using the Illumina Miseq platform,2× 250 bp double-end sequencing strategy.The sequencing results were compared with the SILVA database to analyze the types of bacteria and relative abundance in the DNA samples.A total of 200 μl sterile double-distilled deionized water was used as control.Results Nine cases of microbial culture positive prosthetic joint infection synovial fluid DNA samples were sequenced by 16S rDNA amplicon sequencing and yielded 3 132 415 high-quality reads and 3 752 operational taxonomic units (OTU).At the level of bacteria,a total of 9 different bacterial gates were detected on 9 DNA samples.At the level of bacteria,34 different bacteria were detected by 16S rDNA amplicon sequencing.Each DNA sample was detected by 16S rDNA amplicon sequencing and the bacterial genus was identical to that of laboratory culture.16S rDNA amplicon sequencing detected more species of bacteria [6(3,9.5)] than bacterial cultures [(1.0(1.0,1.0)].There was statistically significant difference in the number of bacteria detected in the same specimen between the 16S rDNA amplicon sequencing and the laboratory culture (Z=2.533,P=0.011).Among them,the dominant bacterial population (highest abundance) detected by 16S rDNA amplicon sequencing in four DNA samples was consistent with the results of laboratory culture.Conclusion In the prosthetic joint infection,the 16S rDNA amplicon sequencing technology can accurately detect pathogens that are consistent with the laboratory culture,and can detect other bacteria outside the laboratory culture.This technology can provide the basis for clinical diagnosis and antibiotic selection.