Objective To compare the benefits and drawbacks of primary patch expansion versus pericardial tube right ventricular-pulmonary artery connection in patients diagnosed with pulmonary atresia with ventricular septal defect (PA/VSD). Methods A retrospective study was conducted on patients diagnosed with PA/VSD who underwent primary right ventricular-pulmonary artery connection surgery at our center between 2010 and 2020. Patients were categorized into two groups based on the type of right ventricular-pulmonary artery connection: a pericardial tube group and a patch expansion group. Clinical data and imaging findings were compared between the two groups. Results A total of 51 patients were included in the study, comprising 31 males and 20 females, with a median age of 12.57 (4.57, 49.67) months. The pericardial tube group included 19 patients with a median age of 17.17 (7.33, 49.67) months, while the patch expansion group consisted of 32 patients with a median age of 8.58 (3.57, 52.72) months. In both groups, the diameter of pulmonary artery, McGoon index, and Nakata index significantly increased after treatment (P<0.001). However, the pericardial tube group exhibited a longer extracorporeal circulation time (P<0.001). The reoperation rate was notably high, with 74.51% of patients requiring further surgical intervention, including 26 (81.25%) patients in the patch expansion group and 12 (63.16%) patients in the pericardial tube group. No statistical differences were observed in long-term cure rates or mortality between the two groups (P＞0.005). Conclusion In patients with PA/VSD, both patch expansion and pericardial tube right ventricular-pulmonary artery connection serve as effective initial palliative treatment strategies that promote pulmonary vessel development and provide a favorable foundation for subsequent radical operations. However, compared to the pericardial tube approach, the patch expansion technique is simpler to perform and preserves some intrinsic potential for pulmonary artery development, making it the preferred procedure.

BACKGROUND:Extracellular vesicles are secreted into the extracellular milieu by a wide range of cell types,including tumor cells,under different physiological and pathophysiological conditions,where a wide range of biological signals and cell-to-cell signaling exists.Tumor-derived extracellular vesicles may exacerbate cancer progression,survival,invasion,and promote angiogenesis. OBJECTIVE:To review the research progress of extracellular vesicles in the diagnosis and treatment of oral squamous cell carcinoma. METHODS:Literature search was performed by the first author in PubMed,WanFang,CNKI and other databases with the keywords"EVs,oral squamous cell carcinoma,diagnosis and treatment,biopsy,tissue engineering"in Chinese and English.Finally,63 articles were included for analysis. RESULTS AND CONCLUSION:(1)In oral squamous carcinoma saliva biopsies,extracellular vesicles play a crucial role in the progression of oral squamous cell carcinoma by acting as an information transfer tool between tumor cells and the surrounding microenvironment,carrying a wide range of biomolecules including soluble proteins,lipids,DNA,and RNA.These tiny vesicles not only play a key role in tumor growth and spread,but also provide important information about the biological properties of the tumor.(2)Saliva biopsy,as a non-invasive diagnostic method,can open up new possibilities for early diagnosis and targeted treatment of oral squamous cell carcinoma by analyzing the extracellular vesicles therein.(3)It has been found that bioactive molecules,such as microRNAs(miRNAs)and specific proteins,contained within extracellular vesicles can serve as biomarkers for oral squamous carcinoma and improve the accuracy of early diagnosis.Specific proteins in extracellular vesicles such as EHD2,CAVIN1,PF4V1,and CXCL7 show potential as novel predictive biomarkers.(4)In addition,this paper highlights the potential application of extracellular vesicles in the treatment of oral squamous carcinoma.Through engineering modifications,extracellular vesicles can serve as a new generation of nanoscale drug delivery systems to enhance the efficiency and specificity of targeted tumor therapy.(5)Future studies will further explore the effect and mechanism of extracellular vesicles in oral squamous cell carcinoma,which is expected to improve patients'survival and quality of life.

Intraoperative cell salvage (IOCS) has been widely applied as an important blood conservation measure in surgical operations. However, there is currently a lack of clinical practice guidelines for the implementation of IOCS in patients with malignant tumors. This report aims to provide clinicians with recommendations on the use of IOCS in patients with malignant tumors based on the review and assessment of the existed evidence. Data were derived from databases such as PubMed, Embase, the Cochrane Library and Wanfang. The guideline development team formulated recommendations based on the quality of evidence, balance of benefits and harms, patient preferences, and health economic assessments. This study constructed seven major clinical questions. The main conclusions of this guideline are as follows: 1) Compared with no perioperative allogeneic blood transfusion (NPABT), perioperative allogeneic blood transfusion (PABT) leads to a more unfavorable prognosis in cancer patients (Recommended); 2) Compared with the transfusion of allogeneic blood or no transfusion, IOCS does not lead to a more unfavorable prognosis in cancer patients (Recommended); 3) The implementation of IOCS in cancer patients is economically feasible (Recommended); 4) Leukocyte depletion filters (LDF) should be used when implementing IOCS in cancer patients (Strongly Recommended); 5) Irradiation treatment of autologous blood to be reinfused can be used when implementing IOCS in cancer patients (Recommended); 6) A careful assessment of the condition of cancer patients (meeting indications and excluding contraindications) should be conducted before implementing IOCS (Strongly Recommended); 7) Informed consent from cancer patients should be obtained when implementing IOCS, with a thorough pre-assessment of the patient's condition and the likelihood of blood loss, adherence to standardized internally audited management procedures, meeting corresponding conditions, and obtaining corresponding qualifications (Recommended). In brief, current evidence indicates that IOCS can be implemented for some malignant tumor patients who need allogeneic blood transfusion after physician full evaluation, and LDF or irradiation should be used during the implementation process.

Background and Aims:Laparoscopic cholecystectomy(LC)is a common surgical method for the treatment of gallbladder diseases.However,some patients experience symptoms such as dyspepsia after surgery,which can affect their quality of life.Compound azinomide enteric-coated tablets,a novel drug,may improve dyspeptic symptoms after LC.This study was conducted to explore the clinical efficacy of compound azinomide enteric-coated tablets in treating post-LC dyspepsia symptoms through a multicenter clinical trial.Methods:A multicenter,superior efficacy,open-label,parallel-controlled design was used.Patients with postoperative dyspepsia were enrolled in 7 centers between January 2023 and May 2024.Patients were randomly assigned to either the observation or control groups using a random number table.The observation group received compound azinomide enteric-coated tablets,while the control group was treated with a combination of oryzae pancreatin tablets and ursodeoxycholic acid tablets.Both groups were treated for 4 weeks.The primary endpoints included gastrointestinal symptom scores and quality of life scores assessed before and at 14 and 28 d after treatment.Additionally,the incidence of adverse reactions and cost-effectiveness ratio(CER)were compared between the groups.Results:A total of 303 patients were included,with 150 in the observation group and 153 in the control group.Baseline characteristics were balanced between the groups before treatment(all P>0.05).After treatment,the observation group showed significantly higher effective rates at 14 d and 28 d than the control group(44.7%vs.29.4%;98.0%vs.73.9%,both P<0.05).The observation group also had significantly lower symptom scores and quality of life scores at both 14 and 28 d,with a significantly higher improvement rate in symptom scores compared to the control group(all P<0.05).Further analysis of the improvement rate and treatment efficacy for individual symptoms revealed that,except for the 14-d improvement in abdominal pain/discomfort,the observation group showed better improvement in all other symptoms at 14 d and in all symptoms at 28 d compared to the control group(all P<0.05).No adverse reactions were observed in either group.The CER for the observation group was 283.78 yuan/efficacy rate at 14 d and 128.57 yuan/efficacy rate at 28 d,while the control group's CER was 729.93 yuan/efficacy rate at 14 d and 290.22 yuan/efficacy rate at 28 d.Conclusion:Compound azinomide enteric-coated tablets demonstrated good clinical efficacy in treating dyspepsia symptoms after LC with excellent safety and high cost-effectiveness.Despite some limitations,the results provide a new treatment option for dyspepsia after LC.Larger-scale randomized controlled trials are needed to validate this study's conclusions further.

Objective To evaluate the clinical efficacy of stellate ganglion block(SGB)combined with intranasal dexmedetomidine for the treatment of insomnia.Methods A total of 64 patients aged 18 to 75 with insom-nia were randomly assigned to either the experimental group(DS group)or the control group(S group).The S group received SGB treatment for 14 consecutive days,whereas the DS group received an additional intranasal dexmedeto-midine spray at a dose of 100 μg,administered 30 minutes before bedtime on days 1 through 6,in conjunction with SGB.We measured and recorded the Pittsburgh Sleep Quality Index(PSQI),Self-Rating Depression Scale(SDS),Self-Rating Anxiety Scale(SAS)scores,and Psychomotor Vigilance Test(PVT)results for both groups at three time points:baseline(T1),the day after treatment(T2),and one month after treatment(T3).Results Intra-group Com-parison:In both the DS and S groups,PSQI scores and dimensionspecific scores at T2 and T3 were significantly lower compared to T1(P<0.05).SAS and SDS scores in both groups showed a significant reduction at T3 compared to T1 and T2(P<0.05),while PVT results exhibited no significant changes(P>0.05).Inter-group Comparison:The PSQI scores and dimensionspecific scores in the DS group at T2(8.44±2.99)and T3(8.22±2.60)were significantly lower than those in the S group at T2(10.88±2.56)and T3(10.88±2.84)(P<0.05).However,no significant differences were observed in SDS and SAS scores between the DS and S groups at T2 and T3(P>0.05).Conclusion Compared to standalone SGB,the combination of SGB with intranasal dexmedetomidine significantly enhances sleep quality in patients with insomnia,while not impacting their levels of anxiety,depression,or alertness.

Objective:To explore the effect of Tripterygium glycosides tablets combined with rituximab on the Wnt/β-catenin signaling pathway and nailfold microcirculation in adult patients with nephrotic syndrome (NS).Methods:Eighty adult patients with NS treated in the Affiliated Hospital of Jining Medical College from January 2022 to January 2023 were selected and they were randomly divided into two groups by treatment method, with 40 patients in each group. Both groups were treated with prednisone acetate, while the control group was treated with rituximab. The study group was treated with Tripterygium glycosides tablets based on the control group, and the treatment lasted for 6 months. After treatment for 6 months, the therapeutic effects, Wnt/β-catenin signaling pathway-related mRNA and proteins, nail fold microcirculation index and adverse effects were compared between the two groups.Results:After treatment for 6 months, the total effective rate in the study group was higher than that in the control group : 87.50%(35/40) vs. 67.50%(27/40), there was statistical difference ( χ2 = 4.59, P<0.05). After treatment for 3, 6 months, the levels of Wnt4, β-catenin mRNA and protein were lower than those before treatment, and in the study group were lower than those in the control group :after treatment for 3 months: 4.86 ± 0.55 vs. 6.11 ± 0.70, 5.02 ± 0.68 vs. 5.96 ± 0.74, 3.68 ± 0.61 vs. 4.13 ± 0.66, 3.42 ± 0.55 vs. 4.27 ± 0.59; after treatment for 6 months: 3.12 ± 0.44 vs. 4.59 ± 0.53, 3.05 ± 0.41 vs. 4.11 ± 0.46, 2.00 ± 0.53 vs. 2.86 ± 0.61, 1.24 ± 0.30 vs. 2.67 ± 0.32, there were statistical differences ( P<0.05). After treatment for 3, 6 months, the scores for the flow state and morphology of nailfold microcirculation in the study group were lower than those in the control group: after treatment for 3 months: (1.44 ± 0.26) scores vs. (1.58 ± 0.31) scores, (1.18 ± 0.24) scores vs. (1.49 ± 0.30) scores; after treatment for 6 months: (0.80 ± 0.10) scores vs. (1.38 ± 0.12) scores, (0.97 ± 0.11) scores vs. (1.25 ± 0.12) scores, there were statistical differences ( P<0.05). The incidence of adverse reactions between the two groups had no statistical difference ( P>0.05). Conclusions:The combination of Tripterygium glycosides tablets and rituximab has a definite effect on the treatment of adult NS, which is beneficial for improving nailfold microcirculation. The possible mechanism may be related to the downregulation of the Wnt/β-catenin signaling pathway.

Background and Aims:Laparoscopic cholecystectomy(LC)is a common surgical method for the treatment of gallbladder diseases.However,some patients experience symptoms such as dyspepsia after surgery,which can affect their quality of life.Compound azinomide enteric-coated tablets,a novel drug,may improve dyspeptic symptoms after LC.This study was conducted to explore the clinical efficacy of compound azinomide enteric-coated tablets in treating post-LC dyspepsia symptoms through a multicenter clinical trial.Methods:A multicenter,superior efficacy,open-label,parallel-controlled design was used.Patients with postoperative dyspepsia were enrolled in 7 centers between January 2023 and May 2024.Patients were randomly assigned to either the observation or control groups using a random number table.The observation group received compound azinomide enteric-coated tablets,while the control group was treated with a combination of oryzae pancreatin tablets and ursodeoxycholic acid tablets.Both groups were treated for 4 weeks.The primary endpoints included gastrointestinal symptom scores and quality of life scores assessed before and at 14 and 28 d after treatment.Additionally,the incidence of adverse reactions and cost-effectiveness ratio(CER)were compared between the groups.Results:A total of 303 patients were included,with 150 in the observation group and 153 in the control group.Baseline characteristics were balanced between the groups before treatment(all P>0.05).After treatment,the observation group showed significantly higher effective rates at 14 d and 28 d than the control group(44.7%vs.29.4%;98.0%vs.73.9%,both P<0.05).The observation group also had significantly lower symptom scores and quality of life scores at both 14 and 28 d,with a significantly higher improvement rate in symptom scores compared to the control group(all P<0.05).Further analysis of the improvement rate and treatment efficacy for individual symptoms revealed that,except for the 14-d improvement in abdominal pain/discomfort,the observation group showed better improvement in all other symptoms at 14 d and in all symptoms at 28 d compared to the control group(all P<0.05).No adverse reactions were observed in either group.The CER for the observation group was 283.78 yuan/efficacy rate at 14 d and 128.57 yuan/efficacy rate at 28 d,while the control group's CER was 729.93 yuan/efficacy rate at 14 d and 290.22 yuan/efficacy rate at 28 d.Conclusion:Compound azinomide enteric-coated tablets demonstrated good clinical efficacy in treating dyspepsia symptoms after LC with excellent safety and high cost-effectiveness.Despite some limitations,the results provide a new treatment option for dyspepsia after LC.Larger-scale randomized controlled trials are needed to validate this study's conclusions further.

Objective:To explore the effect of Tripterygium glycosides tablets combined with rituximab on the Wnt/β-catenin signaling pathway and nailfold microcirculation in adult patients with nephrotic syndrome (NS).Methods:Eighty adult patients with NS treated in the Affiliated Hospital of Jining Medical College from January 2022 to January 2023 were selected and they were randomly divided into two groups by treatment method, with 40 patients in each group. Both groups were treated with prednisone acetate, while the control group was treated with rituximab. The study group was treated with Tripterygium glycosides tablets based on the control group, and the treatment lasted for 6 months. After treatment for 6 months, the therapeutic effects, Wnt/β-catenin signaling pathway-related mRNA and proteins, nail fold microcirculation index and adverse effects were compared between the two groups.Results:After treatment for 6 months, the total effective rate in the study group was higher than that in the control group : 87.50%(35/40) vs. 67.50%(27/40), there was statistical difference ( χ2 = 4.59, P<0.05). After treatment for 3, 6 months, the levels of Wnt4, β-catenin mRNA and protein were lower than those before treatment, and in the study group were lower than those in the control group :after treatment for 3 months: 4.86 ± 0.55 vs. 6.11 ± 0.70, 5.02 ± 0.68 vs. 5.96 ± 0.74, 3.68 ± 0.61 vs. 4.13 ± 0.66, 3.42 ± 0.55 vs. 4.27 ± 0.59; after treatment for 6 months: 3.12 ± 0.44 vs. 4.59 ± 0.53, 3.05 ± 0.41 vs. 4.11 ± 0.46, 2.00 ± 0.53 vs. 2.86 ± 0.61, 1.24 ± 0.30 vs. 2.67 ± 0.32, there were statistical differences ( P<0.05). After treatment for 3, 6 months, the scores for the flow state and morphology of nailfold microcirculation in the study group were lower than those in the control group: after treatment for 3 months: (1.44 ± 0.26) scores vs. (1.58 ± 0.31) scores, (1.18 ± 0.24) scores vs. (1.49 ± 0.30) scores; after treatment for 6 months: (0.80 ± 0.10) scores vs. (1.38 ± 0.12) scores, (0.97 ± 0.11) scores vs. (1.25 ± 0.12) scores, there were statistical differences ( P<0.05). The incidence of adverse reactions between the two groups had no statistical difference ( P>0.05). Conclusions:The combination of Tripterygium glycosides tablets and rituximab has a definite effect on the treatment of adult NS, which is beneficial for improving nailfold microcirculation. The possible mechanism may be related to the downregulation of the Wnt/β-catenin signaling pathway.

Objective To evaluate the clinical efficacy of stellate ganglion block(SGB)combined with intranasal dexmedetomidine for the treatment of insomnia.Methods A total of 64 patients aged 18 to 75 with insom-nia were randomly assigned to either the experimental group(DS group)or the control group(S group).The S group received SGB treatment for 14 consecutive days,whereas the DS group received an additional intranasal dexmedeto-midine spray at a dose of 100 μg,administered 30 minutes before bedtime on days 1 through 6,in conjunction with SGB.We measured and recorded the Pittsburgh Sleep Quality Index(PSQI),Self-Rating Depression Scale(SDS),Self-Rating Anxiety Scale(SAS)scores,and Psychomotor Vigilance Test(PVT)results for both groups at three time points:baseline(T1),the day after treatment(T2),and one month after treatment(T3).Results Intra-group Com-parison:In both the DS and S groups,PSQI scores and dimensionspecific scores at T2 and T3 were significantly lower compared to T1(P<0.05).SAS and SDS scores in both groups showed a significant reduction at T3 compared to T1 and T2(P<0.05),while PVT results exhibited no significant changes(P>0.05).Inter-group Comparison:The PSQI scores and dimensionspecific scores in the DS group at T2(8.44±2.99)and T3(8.22±2.60)were significantly lower than those in the S group at T2(10.88±2.56)and T3(10.88±2.84)(P<0.05).However,no significant differences were observed in SDS and SAS scores between the DS and S groups at T2 and T3(P>0.05).Conclusion Compared to standalone SGB,the combination of SGB with intranasal dexmedetomidine significantly enhances sleep quality in patients with insomnia,while not impacting their levels of anxiety,depression,or alertness.

Objective To observe the effects of octreotide on fecal characteristics and humoral immunity in neonates with necrotizing enterocolitis(NEC).Methods A retrospective study was conducted on 60 newly born NEC patients at Hebei PetroChina Central Hospital from March 2022 to September 2023.The patients were separated into the observation group(30 cases)and the routine group(30 cases)based on treatment methods.The conventional group was treated with total parenteral nutrition and gastrointestinal decompression plus piperacillin sodium and tazobactam sodium for 7 days.The observation group was treated with octreotide in addition to the routine group for 5 days.The treatment efficacy,general clinical data,degree of intestinal microbiota disorder,expression levels of intestinal microbiota markers and immune indicators were compared between the two groups.Results The total effective rate of the observation group was higher than that of the routine group(P＜0.05).After treatment,body weight of the observation group was higher than that of the routine group.The hospitalization time,vomiting relief time,abdominal distension relief time,diarrhea relief time and complete recovery time of fecal characteristics were lower in the observation group than those in the routine group.Compared with before treatment,the degree of intestinal microbiota disorder and high mobility group box protein 1(HMGB1)were reduced in both groups after treatment,and expression levels of human β defensin 2(HBD2),autoinducer-2(AI-2)and serum immunoglobulin(Ig)A,IgG and IgM were increased(P＜0.05).After treatment,HMGB1 was lower in the observation group than that in the routine group,while HBD2,AI-2 and serum IgA,IgG and IgM were higher than those in the routine group(P＜0.05).Conclusion Octreotide can effectively treat children with NEC,improve stool characteristics,and enhance immunity.