Objective:To analyze the clinical efficacy of laparoscopic common bile duct exploration and stone removal via the cystic duct with a flexible ureteroscope.Methods:The clinical data of 96 patients with cholecystolithiasis and choledocholithiasis who were admitted to the Department of Hepatobiliary Surgery, the Third Hospital of Nanchang from September 2021 to November 2024 were retrospectively analyzed. There were 49 male and 47 female patients, aged (59.2±13.9) years. The 96 patients were randomly divided into two groups according to the surgical methods: the flexible ureteroscope group ( n=48) and the choledochotomy group ( n=48), patients who underwent laparoscopic cholecystectomy plus flexible ureteroscope for common bile duct exploration and stone removal via the cystic duct were included in the flexible ureteroscope group; patients who underwent laparoscopic cholecystectomy plus choledocholithotomy and T-tube drainage placement were included in the choledochotomy group. Clinical data including operation time, intraoperative blood loss, postoperative intestinal function recovery time, abdominal drainage tube removal time, postoperative hospital stay and postoperative complications were compared between the two groups. Results:Compared with the choledochotomy group, the operation time [150 (120, 176) min vs. 197 (165, 240) min], intraoperative blood loss [20 (10, 30) ml vs. 30 (20, 50) ml], postoperative intestinal function recovery time [2 (1, 2) d vs. 3 (2, 4) d], abdominal drainage tube removal time [6 (4, 7) d vs. 7 (6, 8) d], and postoperative hospital stay [8 (6, 9) d vs. 16 (13, 17) d] in the flexible ureteroscope group were all reduced, and the differences were statistically significant (all P<0.05). The incidence of postoperative complications in the choledochotomy group was 10.4% (5/48), compared with 2.1% (1/48) in the flexible ureteroscope group. There was no statistically significant difference ( χ2=1.60, P=0.206). Conclusion:Compared with laparoscopic choledocholithotomy plus T-tube drainage, laparoscopic common bile duct exploration and stone removal via the cystic duct with a flexible ureteroscope can shorten the hospital stay of patients with choledocholithiasis, offering a minimally invasive, safe and effective treatment method.

Objective:To investigate the detection status of serological markers for hepatitis B virus (HBV) among Tibetan college students and their relationship with HBV- deoxyribonucleic acid (DNA) load.Methods:A cross-sectional study was carried out to retrospectively analyze data from 1 514 Tibetan college students who visited the Affiliated Hospital of Xizang Minzu University for consultations or health examinations between June 1, 2021 and June 1, 2022. The prevalence of HBV infection among these students was analyzed, the primary epidemiological patterns of HBV markers were identified, and their relationship with HBV-DNA load was determined.Results:The positive rate of hepatitis B surface antigen (HBsAg) among the 1 514 Tibetan college students was 6.7% (101/1 514), while the positive rate for Hepatitis B surface antibody (HBsAb) was 42.2% (639/1 514). The primary serological pattern of HBV infection consisted of positive results for HBsAg, HBeAg, and HBcAb, which accounted for 48.5% of cases. This pattern showed significantly higher rates of HBV-DNA positivity and elevated viral load compared with other serological patterns ( χ2 = 8.70, P < 0.05). Conclusions:The HBV infection rate among Tibetan college students is 6.7%. The primary infection pattern is characterized by positive tests for HBsAg, HBeAg, and HBcAb, with an HBV-DNA positivity rate as high as 87.0% and elevated viral loads.

Objective:To investigate the detection status of serological markers for hepatitis B virus (HBV) among Tibetan college students and their relationship with HBV- deoxyribonucleic acid (DNA) load.Methods:A cross-sectional study was carried out to retrospectively analyze data from 1 514 Tibetan college students who visited the Affiliated Hospital of Xizang Minzu University for consultations or health examinations between June 1, 2021 and June 1, 2022. The prevalence of HBV infection among these students was analyzed, the primary epidemiological patterns of HBV markers were identified, and their relationship with HBV-DNA load was determined.Results:The positive rate of hepatitis B surface antigen (HBsAg) among the 1 514 Tibetan college students was 6.7% (101/1 514), while the positive rate for Hepatitis B surface antibody (HBsAb) was 42.2% (639/1 514). The primary serological pattern of HBV infection consisted of positive results for HBsAg, HBeAg, and HBcAb, which accounted for 48.5% of cases. This pattern showed significantly higher rates of HBV-DNA positivity and elevated viral load compared with other serological patterns ( χ2 = 8.70, P < 0.05). Conclusions:The HBV infection rate among Tibetan college students is 6.7%. The primary infection pattern is characterized by positive tests for HBsAg, HBeAg, and HBcAb, with an HBV-DNA positivity rate as high as 87.0% and elevated viral loads.

Objective:To analyze the clinical efficacy of laparoscopic common bile duct exploration and stone removal via the cystic duct with a flexible ureteroscope.Methods:The clinical data of 96 patients with cholecystolithiasis and choledocholithiasis who were admitted to the Department of Hepatobiliary Surgery, the Third Hospital of Nanchang from September 2021 to November 2024 were retrospectively analyzed. There were 49 male and 47 female patients, aged (59.2±13.9) years. The 96 patients were randomly divided into two groups according to the surgical methods: the flexible ureteroscope group ( n=48) and the choledochotomy group ( n=48), patients who underwent laparoscopic cholecystectomy plus flexible ureteroscope for common bile duct exploration and stone removal via the cystic duct were included in the flexible ureteroscope group; patients who underwent laparoscopic cholecystectomy plus choledocholithotomy and T-tube drainage placement were included in the choledochotomy group. Clinical data including operation time, intraoperative blood loss, postoperative intestinal function recovery time, abdominal drainage tube removal time, postoperative hospital stay and postoperative complications were compared between the two groups. Results:Compared with the choledochotomy group, the operation time [150 (120, 176) min vs. 197 (165, 240) min], intraoperative blood loss [20 (10, 30) ml vs. 30 (20, 50) ml], postoperative intestinal function recovery time [2 (1, 2) d vs. 3 (2, 4) d], abdominal drainage tube removal time [6 (4, 7) d vs. 7 (6, 8) d], and postoperative hospital stay [8 (6, 9) d vs. 16 (13, 17) d] in the flexible ureteroscope group were all reduced, and the differences were statistically significant (all P<0.05). The incidence of postoperative complications in the choledochotomy group was 10.4% (5/48), compared with 2.1% (1/48) in the flexible ureteroscope group. There was no statistically significant difference ( χ2=1.60, P=0.206). Conclusion:Compared with laparoscopic choledocholithotomy plus T-tube drainage, laparoscopic common bile duct exploration and stone removal via the cystic duct with a flexible ureteroscope can shorten the hospital stay of patients with choledocholithiasis, offering a minimally invasive, safe and effective treatment method.

AIM: To understand the current status and differences in visual acuity of children of the same age from different regions of Xi'an, and to take an effective basis for the prevention of children's myopia.METHODS: Random stratified sampling was used to select the uncorrected distance visual acuity and computed dioptric data of 41 285 children aged 6-12 from 6 towns, 10 urban and rural areas and 112 country schools screened by Xi'an Central Hospital in December 2022.RESULTS: The myopia detection rate in different regions of Xi'an is 47.16% in towns, 38.59% in urban and rural areas, and 32.29% in the country, and the total myopia rate is 37.50%. The myopia rate of 6-12 years old in towns is higher than that in urban and rural areas, and that of urban and rural areas is higher than that of country; the myopia rate of girls is higher than that of boys; myopia rate increases with age; mild myopia: the myopia rate in towns is significantly higher than that of the urban and rural areas and the country; high myopia: the myopia rate in the country is significantly higher than that of the towns and the urban and rural areas. The total rate of deficient hyperopia reserves in different regions of Xi'an is 92.08% in towns, 93.67% in urban and rural areas, and 90.92% in the country, and the total rate of deficient hyperopia reserves is 92.09%. The rate of deficient hyperopia reserves at the age of 6-12 is higher in the urban and rural areas than in the towns, and higher in the towns than in the country; the total rate of deficient hyperopia reserve is higher in girls than in boys; it is the peak period of the development of hyperopia reserve rate before the age of 8.CONCLUSION: The total myopia rate and the total vision reserve deficiency rate of 6-12 years old in different regions of Xi'an are different, and 8-9 years old is the accelerated period of myopia development, and the peak of deficient hyperopia reserve is before the age of 8 years old. With the growth of age, the myopia rate shows a certain growth trend, and the rate of deficient hyperopia reserve shows a decreasing trend after reaching the peak. The total myopia rate and insufficient acuity reserve rate of girls are higher than those of boys.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been reapproved for heart failure (HF) therapy in patients with and without diabetes. However, the initial glucose-lowering indication of SGLT2i has impeded their uses in cardiovascular clinical practice. A challenge of SGLT2i then becomes how to separate their anti-HF activity from glucose-lowering side-effect. To address this issue, we conducted structural repurposing of EMPA, a representative SGLT2 inhibitor, to strengthen anti-HF activity and reduce the SGLT2-inhibitory activity according to structural basis of inhibition of SGLT2. Compared to EMPA, the optimal derivative JX01, which was produced by methylation of C2-OH of the glucose ring, exhibited weaker SGLT2-inhibitory activity (IC₅₀ > 100 nmol/L), and lower glycosuria and glucose-lowering side-effect, better NHE1-inhibitory activity and cardioprotective effect in HF mice. Furthermore, JX01 showed good safety profiles in respect of single-dose/repeat-dose toxicity and hERG activity, and good pharmacokinetic properties in both mouse and rat species. Collectively, the present study provided a paradigm of drug repurposing to discover novel anti-HF drugs, and indirectly demonstrated that SGLT2-independent molecular mechanisms play an important role in cardioprotective effects of SGLT2 inhibitors.

Laparoscopic renal pedicle lymphatic disconnection is the most effective method for treating chyluria that has failed to respond to conservative management. Chylous hemothorax is a rare clinical occurrence resulting from the anatomic abnormality. This paper reported a case, who was admitted with painless gross hematuria for 1 month and was diagnosed with left chylous hematuria. Laparoscopic left renal pedicle lymphatic disconnection was performed, and bilateral chylous hemothorax occurred after the operation. After conservative treatment such as bilateral closed thoracic drainage and blood transfusion support, the patient recovered well. After 2 months of follow-up, there was no obvious effusion in the bilateral thoracic cavity, and the chylous test of urine fluid was negative.

Objective:To explore the effect of systematic pain management on pain of children with traumatic limb fractures.Methods:A total of 185 children with traumatic limb fracture who were treated in Children's Hospital of Hebei Province from January 2019 to December 2020 were selected as the research objects by the convenient sampling method. According to the random number table method, they were randomly divided into the intervention group (93 cases) and the control group (92 cases) . Children in both groups were treated with fracture surgery under general anesthesia. The intervention group used systematic pain management for intervention, and the control group used conventional pain management for intervention. The operation time, wake up time, extubation time, Ramsay sedation score after wake-up and Modified Objective Pain Score (MOPS) at admission, 24, 48 h after admission, and 24, 48 h after surgery were compared between the two groups.Results:There was no statistically significant difference in operation time, wake-up time, extubation time and Ramsay sedation scores after wake-up between the two groups ( P>0.05) . On admission, there was no statistically significant difference in the MOPS scores of children between the two groups ( P>0.05) . At 24 and 48 hours after admission and 24 and 48 hours after operation, MOPS scores of the intervention group were lower than those of the control group, and the differences were statistically significant ( P<0.01) . Conclusions:Compared with conventional pain management, systemic pain management can alleviate the pain of traumatic limb fractures in children.

Objective To investigate the congenital heart disease (CHD) prevalence of students in Liangshan prefecture in Sichuan province,and to explore the risk factors of CHD.Methods Stratified cluster sampling was conducted in collecting demographic data.Heart auscultation was used to screening the CHD,and colour Doppler flow imaging was used to diagnose the CHD.Results A total of 10 021 student were collected in this study.About 19.74％ of total cases had cardiac murmur.Sixty-eight students were diagnosed as CHD through colour Doppler flow imaging,accounting for 0.68％.In addition,the top three ranks of CHD were atrial septal defect,patent ductus arteriosus,interventricular septal defect.Our study also found that per capita income of CHD families was lower than non-CHD families,meanwhile,the CHD prevalence of Yi nationality was higher than other nationalities.There was no statistical significance in age,gender,height,weight,body mass index,head circumference,waist circumference between different types of CHD.Conclusions The CHD prevalence of students in Liangshan prefecture has been in a high level in China; therefore we need pay more attention on screening for the CHD.