Objective:To explore the feasibility, practicality, and safety of the day surgery management model for the treatment of patent ductus arteriosus with Da Vinci robotic surgery in children.Methods:A non-randomized controlled study was conducted.The clinical data of children with patent ductus arteriosus who underwent Da Vinci robotic surgery at Children′s Hospital, Zhejiang University School of Medicine from August 2020 to December 2023 were collected and retrospectively analyzed.The patients were divided into day surgery group and non-day surgery group according to whether they had discharged within 24 hours. t-test and Chi-square tests were used to compare the differences in clinical features, perioperative complications and prognosis between the two groups of patients.In addition, the satisfaction of the treatment effect was surveyed. Results:A total of 276 children were included in this study, with an age ranging from 6 to 154 months with a median of 34 months.The weight ranged from 6.2 to 63.2 kilograms, with a median of 13.5 kilograms.The operation time ranged from 23 to 90 minutes, with a median of 45 minutes.One hundred and thirty-five patients underwent day surgery and 141 patients underwent non-day surgery.The average age and average weight of the patients in the day surgery and non-day surgery groups was (43.7±30.8) months vs.(42.4±30.2) months and (15.0±6.4) kg vs.(14.8±6.9) kg, respectively.There was no statistically significant difference in age and weight between the two groups (all P>0.05).There was no difference in perioperative data and incidence of perioperative complications between the two groups (all P>0.05).However, the length of hospital stay of the day surgery group was significantly shorter than that of the non-day surgery group[(1.0±0) days vs.(2.5±0.9) days, t=-20.993, P<0.001], and the hospitalization cost of the day surgery group was also significantly lower than that of the non-day surgery group[(50 800±1 100) yuan vs.(53 500±3 900) yuan, t=-10.040, P<0.001].Both families of the two groups were satisfied with the treatment results, and there was no difference in satisfaction between the two groups ( χ2=0.501, P=0.479). Conclusions:The day surgery management model of Da Vinci robotic surgery for the treatment of pediatric patent ductus arteriosus is safe and feasible.To a certain extent, it can reduce the length of hospital stay, treatment costs, and treatment burden.

Objective:To explore the feasibility, practicality, and safety of the day surgery management model for the treatment of patent ductus arteriosus with Da Vinci robotic surgery in children.Methods:A non-randomized controlled study was conducted.The clinical data of children with patent ductus arteriosus who underwent Da Vinci robotic surgery at Children′s Hospital, Zhejiang University School of Medicine from August 2020 to December 2023 were collected and retrospectively analyzed.The patients were divided into day surgery group and non-day surgery group according to whether they had discharged within 24 hours. t-test and Chi-square tests were used to compare the differences in clinical features, perioperative complications and prognosis between the two groups of patients.In addition, the satisfaction of the treatment effect was surveyed. Results:A total of 276 children were included in this study, with an age ranging from 6 to 154 months with a median of 34 months.The weight ranged from 6.2 to 63.2 kilograms, with a median of 13.5 kilograms.The operation time ranged from 23 to 90 minutes, with a median of 45 minutes.One hundred and thirty-five patients underwent day surgery and 141 patients underwent non-day surgery.The average age and average weight of the patients in the day surgery and non-day surgery groups was (43.7±30.8) months vs.(42.4±30.2) months and (15.0±6.4) kg vs.(14.8±6.9) kg, respectively.There was no statistically significant difference in age and weight between the two groups (all P>0.05).There was no difference in perioperative data and incidence of perioperative complications between the two groups (all P>0.05).However, the length of hospital stay of the day surgery group was significantly shorter than that of the non-day surgery group[(1.0±0) days vs.(2.5±0.9) days, t=-20.993, P<0.001], and the hospitalization cost of the day surgery group was also significantly lower than that of the non-day surgery group[(50 800±1 100) yuan vs.(53 500±3 900) yuan, t=-10.040, P<0.001].Both families of the two groups were satisfied with the treatment results, and there was no difference in satisfaction between the two groups ( χ2=0.501, P=0.479). Conclusions:The day surgery management model of Da Vinci robotic surgery for the treatment of pediatric patent ductus arteriosus is safe and feasible.To a certain extent, it can reduce the length of hospital stay, treatment costs, and treatment burden.

Pancreatogenic diabetes is a type of diabetes secondary to pancreatic exocrine disease,and it was officially named by American Diabetes Association in 2014.Chronic pancreatitis and pancreatic cancer are the most common causes of pancreatogenic diabetes.The pathogenesis of this disease remains unclear,and there is still a lack of systematic treatment regimens,which leads to the extremely high misdiagnosis rate of pancreatogenic diabetes in China and globally.In addition,studies have shown that compared with patients with type 2 diabetes,patients with pancreatogenic diabetes tend to have higher risks of death and readmission,which brings great challenges to the health and clinical treatment of patients.Therefore,the comprehensive understanding and early accurate identification and diagnosis of pancreatogenic diabetes are of great significance in reducing the disability and mortality rates of this disease.This article elaborates on the possible pathogenesis of pancreatogenic diabetes.

Objective To investigate the expression of long non-coding RNA(lncRNA)small nucleolar RNA host gene(SNHG)25 and microRNA(miR)-497-5p in glioma tissues and their relationship with clinical features and prognosis.Methods A total of 157 glioma patients admitted to the hospital from January 2019 to January 2020 were selected as the glioma group,and 100 patients who underwent surgical treatment due to craniocerebral injury in the same hospital during the same period were selected as the control group.The ex-pression levels of lncRNA SNHG25 and miR-497-5p were detected in glioma tissues and normal brain tissues resected during operation.The patients were followed up for 3 years.The correlation between the expression levels of lncRNA SNHG25 and miR-497-5p was analyzed,and the relationship between the expression level of lncRNA SNHG25 and miR-497-5p and the clinical characteristics and prognosis of patients were analyzed.Re-sults Compared with the control group,the expression level of lncRNA SNHG25 in the glioma group was in-creased(P＜0.05),and the expression level of miR-497-5p was decreased(P＜0.05).Compared with the maximum diameter of tumors＜4 cm,World Health Organization(WHO)central nervous system tumor grade Ⅰ-Ⅱ,the expression level of lncRNA SNHG25 was increased and the expression level of miR-497-5p was decreased in glioma tissues with the maximum diameter of tumors ≥4 cm and WHO central nervous sys-tem tumor grade Ⅲ-Ⅳ(P＜0.05).The expression level of lncRNA SNHG25 in glioma patients was nega-tively correlated with miR-497-5p(r=-0.370,P＜0.05).The cumulative survival rate of lncRNA SNHG25 high expression group was lower than that of lncRNA SNHG25 low expression group(P＜0.05),and the cu-mulative survival rate of miR-497-5p low expression group was lower than that of miR-497-5p high expression group(P＜0.05).Grade Ⅲ-Ⅳ of WHO central nervous system tumor grade and high expression of lncRNA SNHG25 were risk factors for poor prognosis of glioma patients(P＜0.05),while high expression of miR-497-5p was a protective factor(P＜0.05).Conclusion The expression of lncRNA SNHG25 is increased and the expression of miR-497-5p is decreased in glioma tissues,which is related to the maximum diameter of tumor and high WHO central nervous system tumor grade,and can lead to poor prognosis of glioma patients.

Currently, there is a lack of localized guidelines or consensus on the management of Ebstein anomaly (EA) in China, particularly concerning the treatment of neonates and infants. The 2024 Expert Consensus issued by the American Association for Thoracic Surgery provides detailed guidance on the clinical management of EA, covering key aspects such as the timing of surgical interventions, selection of surgical techniques, and postoperative management. The interpretation of this consensus is of great significance for thoracic surgeons in China to understand the latest international academic developments and can serve as a valuable reference for clinical practice. The consensus outlines the latest surgical techniques adopted internationally, including the Starnes procedure, biventricular repair, and 1.5 ventricle repair, and provides an in-depth analysis of the optimal timing and strategies for interventions in different cases. This offers a theoretical foundation and technical reference for advancing the field in China, contributing to the standardization and regulation of EA treatment.

Currently, there is a lack of localized guidelines or consensus on the management of Ebstein anomaly (EA) in China, particularly concerning the treatment of neonates and infants. The 2024 Expert Consensus issued by the American Association for Thoracic Surgery provides detailed guidance on the clinical management of EA, covering key aspects such as the timing of surgical interventions, selection of surgical techniques, and postoperative management. The interpretation of this consensus is of great significance for thoracic surgeons in China to understand the latest international academic developments and can serve as a valuable reference for clinical practice. The consensus outlines the latest surgical techniques adopted internationally, including the Starnes procedure, biventricular repair, and 1.5 ventricle repair, and provides an in-depth analysis of the optimal timing and strategies for interventions in different cases. This offers a theoretical foundation and technical reference for advancing the field in China, contributing to the standardization and regulation of EA treatment.

Objective:To compare the effect of modified postauricular transverse incision and traditional vertical incision for microvascular decompression in the treatment of hemifacial spasm.Methods:Prospective study method was used. A total of 116 patients with hemifacial spasm in Handan Central Hospital from January 1, 2019 to January 1, 2020 were selected, and divided into two groups according to the admission order. Both groups underwent microvascular decompression; control group (57 cases) received traditional vertical incision, while treatment group (59 cases) received modified postauricular transverse incision. The brainstem auditory evoked potential (BAEP), pain degree, surgical indicators, facial aesthetic satisfaction and complications were compared between two groups.Results:After treatment, the BAEP of latency, wave interval and wave amplitude in the two groups increased compared with that before treatment, and the BAEP of latency, wave interval and wave amplitude in the treatment group were higher than those in the control group: (1.89 ± 0.15) ms vs. (1.62 ± 0.21) ms, (7.89 ± 0.15) ms vs. (6.25 ± 0.41) ms, (1.79 ± 0.19) ms vs. (1.54 ± 0.11) ms ( P<0.05). After treatment, the visual analogue score (VAS) of patients in the two groups decreased compared with that before treatment, and the VAS of patients in the treatment group was lower than that in the control group: (1.15 ± 0.27) points vs. (2.18 ± 0.24) points ( P<0.05). The operation time, intraoperative bleeding volume and postoperative scar length of patients in the treatment group were less than those in the control group: (60.41 ± 3.81) h vs. (76.87 ± 3.87) h, (30.18 ± 4.19) ml vs. (56.87 ± 4.15) ml and (4.18 ± 1.07) cm vs. (6.87 ± 1.05) cm ( P<0.05). The satisfaction rate of patients in the treatment group was higher than that in the control group: 91.53% (54/59) vs. 71.93% (41/57) ( P<0.05). The complication rate of patients in the treatment group was lower than that in the control group: 5.08% (3/59) vs. 21.05% (12/57) ( P<0.05). Conclusions:Compared with traditional vertical incision, the modified transverse incision for microvascular decompression in the treatment of hemifacial spasm can reduce intraoperative blood loss and postoperative scar area, enhance brainstem auditory evoked potential, and improve facial aesthetics, which is worthy of recommendation.

Objective To examine the kinetics of plasma S100A12 and soluble receptor for advanced glycation end products (sRAGE) in infants and young children undergoing cardiopulmonary bypass ( CPB),and to investigate whether they could protective the occurrence of noninfectious pulmonary complication (NPC) after cardiac surgery.Methods This was a case-control study.The subjects included all children aged ＜3 years old who underwent cardiac surgery with CPB during the period from June 1st to July 31st 2011.The patient who showed pulmonary inflammation or had abnormal liver or renal function before surgery was excluded.The remain patients were divided into 2 groups according to whether they had developed NPC postoperatively.Twenty patients were grouped into NPC because they developed the complications of pleural effusion,chylothorax,partial lung collapse,pulmonary hypertensive crisis,airway disorders,pneumothorax,pneumomediastinum,or phrenic nerve palsy.Forty patients were categorized into the no-NPC group.Plasma concentrations of S100A12 and sRAGE were measured using ELISA at baseline,before CPB,immediately after CPB,1 h,12 h and 24 h after operation.Differences concentrations between two groups were analyzed with t test.A stepwise logistic regression analysis was used to indentify the independent risk factor for NPC.A P value ＜0.05 was considered statistically significant.Results Plasma levels of S100A12 and sRAGE dramatically increased immediately after CPB ( P ＜ 0.01 ).The levels of sRAGE dropped to lower than baseline level (P ＜0.05),while S100A12 was still at high level 24h after operation (P ＜0.01 ).Levels of S100A12 and sRAGE immediately after CPB in NPC group were significantly higher than the no-NPC group (P ＜ 0.05).Twenty-four hours after operation,levels of S100A12 were still higher in NPC group than no-NPC (P ＜ 0.01 ),while levels of sRAGE were similar in the two groups ( P ＞ 0.05 ).In the stepwise logistic regression analysis,plasma S100A12 level immediately after CPB remained as a independently predictor for postoperative NPC (OR =1.042,95％ CI:1.010 ～ 1.076,P =0.011 ).Levels of S100A12 immediately after CPB were positively associated with mechanical ventilation time ( r =0.47,P ＜ 0.01 ),duration of surgical Intensive Care Unit ( r =0.407,P =0.002) and hospital stay ( r =0.421,P =0.01 ).Conclusions Plasma levels of S100A12 and sRAGE were significantly increased immediately after CPB and the elevated plasma S100A12 immediately after CPB served as an early reliable biomarker of the occurrence and the prognosis of NPC after CPB in infants and young children.

Objective:To investigate the clinical value of total parenteral nutrition for patients with tetanus. Methods:TPN was used in 13 tetanus patients. The nutrition parameters were recorded in these patients and compared with those in 25 tetanus patients without TPN. Results:Compared with the control, body weight, albumin, Hb, peripheral lymphocyte count in TPN group were higher and the complication and mortality were less. Conclusions:Total parenteral nutrition can improve nutrition parameters and prognosis of tetanus patients.

Objective:The study was attempted to improve the manipulation and eliminate patient's fear for gastroscopy combined with intravenous injection.Methods:A total of 1350 patients wasrandomized into test group (n=1100 given intraveous protofol and midazolam)and the control (n=250,without anesthetics).Patient's feeling,heart rate,blood oxygen saturation,blood pressure,operative duration and operator' satisfaction were recored and analysed.Results:Data in test group showed less complaints,easier manipulation,high satisfaction and no difference in operative duration and blood oxygen saturation as compared with the control.After intravenous administration of protofol and midazolam,patient's heart rate and blood pressure (systolic and diastolic pressure) significantly decreased.Conclusions:With intravenous use of protofol and midazolam,gastroscopy can be achieved effectively,painlessly and safely.