Objective:To investigate whether intestinal rehabilitation therapy (IRT)could optimize the effectiveness of IRT in patients with short bowel syndrome (SBS) caused by acute mesenteric ischemia (AMI) with chronic multivessel lesions.Methods:Clinical data of 18 hospitalized patients diagnosed with AMI leading to SBS and undergoing IRT at the Eastern Theater General Hospital of the People's Liberation Army from Jan 2012 to Oct 2023 was retrospectively analyzed.Result:Following IRT, the revascularization group showed significantly greater increases in ASMI and grip strength compared to the control group [(0.28±0.26) kg/m 2vs. (0.02±0.21) kg/m 2, P=0.033, and (0.97±0.33) kg vs. (0.48±0.34) kg, P=0.007, respectively]. Similarly, the increase in EN intake was significantly higher in the revascularization group compared to the control group [(572.5±93.6) ml/d vs. (375.2±176.3) ml/d, P=0.012], accompanied by a greater improvement in intestinal nitrogen absorption rate [(25.06±14.06)% vs. (13.84±4.62)%, P=0.034] and a more substantial decrease in GSRS scores [(-15.88±3.94) vs. (-6.33±5.13), P=0.030]. Moreover, there were significant differences in the composition of EN formulations between the two groups after IRT ( P=0.046). Additionally, SF-36 scores at discharge were significantly higher in the revascularization group than that in the control group for five indicators including BP, GH, VT, SF, and MH ( P<0.05). Conclusions:For patients with SBS resulting from AMI by chronic multivessel lesions, revascularization therapy may not leading to higher growth in weight and hematological nutritional indicators during IRT, but it is beneficial for improving muscle function, improving EN absorption, increasing the likelihood of PN independence, relieving gastrointestinal symptoms, and enhancing overall quality of life.

Objective:We aimed to develop a novel visualized model based on nomogram to predict postoperative overall survival.Methods:This was a multicenter, retrospective, observational cohort study, including participants with histologically confirmed gastric and colorectal cancer who underwent radical surgery from 11 medical centers in China from August 1, 2015 to June 30, 2018. Baseline characteristics, histopathological data and nutritional status, as assessed using Nutrition Risk Screening 2002 (NRS 2002) score and the scored Patient-Generated Subjective Global Assessment, were collected. The least absolute shrinkage and selection operator regression and Cox regression were used to identify variables to be included in the predictive model. Internal and external validations were performed.Results:There were 681 and 127 patients in the training and validation cohorts, respectively. A total of 188 deaths were observed over a median follow-up period of 59 (range: 58 to 60) months. Two independent predictors of NRS 2002 and Tumor-Node-Metastasis (TNM) stage were identified and incorporated into the prediction nomogram model together with the factor of age. The model's concordance index for 1-, 3- and 5-year overall survival was 0.696, 0.724, and 0.738 in the training cohort and 0.801, 0.812, and 0.793 in the validation cohort, respectively.Conclusions:In this study, a new nomogram prediction model based on NRS 2002 score was developed and validated for predicting the overall postoperative survival of patients with gastric colorectal cancer. This model has good differentiation, calibration and clinical practicability in predicting the long-term survival rate of patients with gastrointestinal cancer after radical surgery.

Objective:To investigate the role of dietary fiber in the intestinal rehabilitation for patients with ultra-short bowel syndrome.Methods:This study included 34 inpatients diagnosed with ultra-short bowel syndrome in the General Surgery Department of the Eastern Theater General Hospital of the People's Liberation Army from January 2012 to October 2023. Patients were grouped based on whether they received intestinal rehabilitation and whether dietary fiber was added to the treatment plan, and were divided into three groups: nutritional therapy group (11 cases), growth hormone + glutamine intestinal rehabilitation treatment group (10 cases) and growth hormone injection + glutamine + dietary fiber intestinal rehabilitation treatment group (13 cases). The therapeutic regimen and its changes, pre- and post-treatment parameters of hematology, nutrition, intestinal absorption, fecal consistency, and quality of life were recorded and compared, and the impact of different treatment regimens on clinical outcomes was analyzed.Results:Compared with nutrition treatment group and growth hormone + glutamine intestinal rehabilitation treatment group, growth hormone injection + glutamine + dietary fiber intestinal rehabilitation treatment group, the increase of enteral nutritional fluid, the decrease of parenteral nutritional energy, the increase of intestinal moisture absorption, the decrease of defecation times and the appreciation of hemoglobin were significantly increased, and the difference was statistically significant ( P<0.05). At the same time, the levels of insulin-like growth factor 1 and insulin-like growth factor binding protein were significantly increased after treatment ( P<0.01). Conclusions:Nutritional support combined with intestinal rehabilitation can significantly improve the nutritional status and intestinal absorption rate of ultra-short bowel syndrome patients. The use of dietary fiber in the intestinal rehabilitation regimen for ultra-short bowel syndrome patients yields more significant benefits, as evidenced by improved clinical outcomes.

Objective:To investigate the effects of blood glucose target management combined with early hemoperfusion on inflammatory reaction and stress in patients with hyperlipidemic acute pancreatitis (HL-AP).Methods:A prospective cohort study was used. One hundred and fifty-nine patients with HL-AP from September 2019 to September 2022 in Zhoukou Central Hospital Affiliated to Xinxiang Medical University were selected. The patients were divided into group A, B and C by random number table method with 53 cases in each group. All patients were given routine treatment. On this basis, the patients in group A were given blood glucose target management, the patients in group B were given early hemoperfusion, and the patients in group C were given blood glucose target management combined with early hemoperfusion. Before treatment and 7 d after treatment, the inflammatory factors (including interleukin-10, IL-10; interleukin-18, IL-18; tumor necrosis factor-α, TNF-α; soluble intercellular adhesion molecule-1, sICAM-1; procalcitonin, PCT; high mobility group protein B1, HMGB1; nuclear factor-κB p65, NF-κB p65), stress indexes (including lipid hydrogen peroxide, LHP; advanced protein oxidation products, AOPPs; catalase, CAT; glutathione peroxidase, GSH-Px; epinephrine, E and cortisol), intestinal mucosal barrier indexes (including D-lactate; diamine oxidase, DAO; endotoxin) and hemorheological indexes (including platelet adhesion rate, plasma specific viscosity, whole blood specific viscosity high shear and thrombus length) were detected. The recovery indexes (urinary amylase recovery time, bowel sound recovery time, exhaust recovery time, abdominal pain relief time and hospitalization time), adverse reactions and curative effect were recorded.Results:There were no statistical differences in the detection indexes before treatment among three groups ( P>0.05). Seven days after treatment, the IL-10, CAT and GSH-Px in group C were significantly higher than those in group A and group B. The IL-18, NF-κB p65, TNF-α, sICAM-1, PCT, HMGB1, LHP, AOPPs, E, cortisol, D-lactic acid, DAO and endotoxin were significantly lower than those in group A and group B with statistical differences ( P<0.05), but no statistical differences in the indexes between group A and group B ( P>0.05). Seven days after treatment, the platelet adhesion rate, plasma specific viscosity, whole blood specific viscosity high shear and thrombus length in group C were significantly lower than those in group A and group B, while the indexes in group B were significantly lower than those in group A, with statistical differences ( P<0.05). The urinary amylase recovery time, bowel sound recovery time, exhaust recovery time, abdominal pain relief time and hospitalization time in group C were significantly shorter than those in group A and group B: (5.73 ± 0.64) d vs. (7.49 ± 0.89) and (7.26 ± 0.85) d, (2.45 ± 0.31) d vs. (5.76 ± 0.73) and (5.83 ± 0.79) d, (2.69 ± 0.42) d vs. (6.04 ± 0.81) and (6.07 ± 0.82) d, (1.87 ± 0.29) d vs. (3.58 ± 0.45) and (3.65 ± 0.46) d, (15.24 ± 1.76) d vs. (18.61 ± 2.29) and (18.78 ± 2.34) d, with statistical differences ( P<0.05), but no statistical differences in the indexes between group A and group B ( P>0.05). The total effective rate in group C was significantly higher than that in group A and group B: 90.57% (48/53) vs. 67.92% (36/53) and 60.38% (32/53), with statistical difference ( P<0.05), but no statistical difference in the total effective rate between group A and group B ( P>0.05). There was no statistical difference in the incidence of adverse reactions among three groups ( P>0.05). Conclusions:The blood glucose target management combined with early hemoperfusion in the treatment of HL-AP can effectively reduce inflammatory reaction and stress state, protect intestinal mucosal barrier function, improve blood rheology, and promote recovery.

Objective : To explore the effect of LncRNA MEG3 in temozolomide (TMZ) resistance of glioma cells. Methods : TMZ⁃resistant glioma cells U87(U87/TMZ) were constructed,qRT⁃PCR was used to detect the LncRNA MEG3 expression level, and MTT was used to detect the cell proliferation ability. The LncRNA MEG3 in U87/TMZ was overexpressed by liposome method (pcDNA⁃MEG3 group), the empty vector was transfected as the empty vector group ( pcDNA group), and the conventionally cultured U87/TMZ was used as the blank group ( Control group),then treated with 10 μg/ml TMZ. The plasmid transfection effect was analyzed by qRT⁃PCR. The expression of LncRNA MEG3⁃related protein was confirmed by Western blot. The cell cloning experiment detects the effect of LncRNA MEG3 on cell proliferation. The effect of LncRNA MEG3 on cell invasion was tested by Transwell. The effect of LncRNA MEG3 on cell apoptosis was detected by flow cytometry. And mouse transplant tumoranimal model was constructed for in vivo experiments. Results : Compared with U87, the expression level of Ln cRNA MEG3 in U87/TMZ was lower (P < 0. 01), and the cell viability of U87/TMZ was higher than that of U87 (P < 0. 01) . After overexpression of MEG3 combined with TMZ, compared with the Control group and the pcDNA group, the pcDNA⁃MEG3 group up⁃regulated the expression of MEG3 mRNA and p53 protein, and down⁃regulated the expression of MDM2 protein, and the proliferation and invasion ability of the pcDNA⁃MEG3 group decreased while the apoptosis ability increased (P < 0. 01) . The construction of mouse transplant tumor animal model showed that the tumor volume and mass of the pcDNA⁃MEG3 group were reduced compared with the pcDNA group (P < 0. 01) . Conclusion Overexpression of LncRNA MEG3 can attenuate the drug resistance of TMZ⁃resistant glioma cells.

Objective:To investigate the effect of cesarean scar defect and endometrial cavity fluid on the pregnancy outcomes of infertility patients with previous cesarean scar uterus undergoing in vitro fertilization-embryo transfer (IVF-ET). Methods:This was a retrospective cohort study. Totally 732 cases of patients with previous cesarean scar uterus were selected from frozen-thawed embryo transfer (FET) cycles in the Fertility Center, Shenzhen Zhongshan Urology Hospital from January 2019 to March 2020. They were divided into four groups: group A ( n=39) including patients with previous cesarean scar defect and without endometrial cavity fluid; group B ( n=82) including patients with previous cesarean scar defect and with endometrial cavity fluid; group C ( n=495) including patients without previous cesarean scar defect and without endometrial cavity fluid; group D ( n=116) including patients without previous cesarean scar defect and with endometrial cavity fluid. The general data and pregnancy outcomes were compared among these groups. Multivariate logistics regression analysis of pregnancy outcome indexes was performed. Results:The transplantation age of group A was higher than that of group B [(38.33±3.55) years vs. (36.93±3.59) years, P=0.045], the endometrial thickness of luteal transformation day and the rate of good-quality embryo transplantation of group C were higher than those of group D [(9.40±1.56) mm vs. (9.03±1.59) mm, P=0.025; 75.76% (375/495) vs. 65.52% (76/116), P=0.024]. The egg retrieval age of group A was higher than that of group C [(37.72±3.55) years vs. (36.25±4.52) years, P=0.049], but the endometrial thickness of luteal transformation day was thinner [(8.74±1.58) mm vs. (9.40±1.56) mm, P=0.012], and the differences were statistically significant. The implantation rate, the biochemical pregnancy rate and the clinical pregnancy rate of group C were higher than those of group D [34.23% (230/672) vs. 22.58% (35/155), P=0.007; 48.28% (239/495) vs. 37.93% (44/116), P=0.044; 42.83% (212/495) vs. 30.17% (35/116), P=0.012]. The early abortion rate in group D was higher than that in group B [40.00% (14/35) vs. 17.24 % (5/29), P=0.047], the difference was statistically significant. Multivariate logistics regression analyses were used with adjustment for possible confounders: the maternal age at embryo transfer, the maternal age at egg retrieval, anti-Müllerian hormone (AMH),antral follicle count (AFC), basic follicle-stimulating hormone (FSH), endometrial CD138 results, FET protocol, and embryo attributes, the number of embryos transferred, embryo quality, the endometrial thickness and the progesterone value on the day of luteal transformation, the result showed that the implantation rate, the biochemical pregnancy rate and the clinical pregnancy rate of group D were lower than those of group C [22.58% (35/155) vs. 34.23% (230/672), P=0.006; 37.93% (44/116) vs. 48.28% (239/495), P=0.047; 30.17% (35/116) vs. 42.83% (212/495), P=0.022] and the differences were statistically significant. The implantation rate, the biochemical pregnancy rate and the clinical pregnancy rate of group B were higher than those of group D [29.52% (31/105) vs. 22.58% (35/155), P=0.049; 48.78% (40/82) vs. 37.93% (44/116), P=0.012; 35.37% (29/82) vs. 30.17% (35/116), P=0.030] and the differences were statistically significant. Conclusion:Endometrial cavity fluid is the main factor that obviously affects the pregnancy outcome of infertility patients with previous cesarean scar uterus undergoing FET cycles.

Objective:To investigate the effect of cesarean scar defect and endometrial cavity fluid on the pregnancy outcomes of infertility patients with previous cesarean scar uterus undergoing in vitro fertilization-embryo transfer (IVF-ET). Methods:This was a retrospective cohort study. Totally 732 cases of patients with previous cesarean scar uterus were selected from frozen-thawed embryo transfer (FET) cycles in the Fertility Center, Shenzhen Zhongshan Urology Hospital from January 2019 to March 2020. They were divided into four groups: group A ( n=39) including patients with previous cesarean scar defect and without endometrial cavity fluid; group B ( n=82) including patients with previous cesarean scar defect and with endometrial cavity fluid; group C ( n=495) including patients without previous cesarean scar defect and without endometrial cavity fluid; group D ( n=116) including patients without previous cesarean scar defect and with endometrial cavity fluid. The general data and pregnancy outcomes were compared among these groups. Multivariate logistics regression analysis of pregnancy outcome indexes was performed. Results:The transplantation age of group A was higher than that of group B [(38.33±3.55) years vs. (36.93±3.59) years, P=0.045], the endometrial thickness of luteal transformation day and the rate of good-quality embryo transplantation of group C were higher than those of group D [(9.40±1.56) mm vs. (9.03±1.59) mm, P=0.025; 75.76% (375/495) vs. 65.52% (76/116), P=0.024]. The egg retrieval age of group A was higher than that of group C [(37.72±3.55) years vs. (36.25±4.52) years, P=0.049], but the endometrial thickness of luteal transformation day was thinner [(8.74±1.58) mm vs. (9.40±1.56) mm, P=0.012], and the differences were statistically significant. The implantation rate, the biochemical pregnancy rate and the clinical pregnancy rate of group C were higher than those of group D [34.23% (230/672) vs. 22.58% (35/155), P=0.007; 48.28% (239/495) vs. 37.93% (44/116), P=0.044; 42.83% (212/495) vs. 30.17% (35/116), P=0.012]. The early abortion rate in group D was higher than that in group B [40.00% (14/35) vs. 17.24 % (5/29), P=0.047], the difference was statistically significant. Multivariate logistics regression analyses were used with adjustment for possible confounders: the maternal age at embryo transfer, the maternal age at egg retrieval, anti-Müllerian hormone (AMH),antral follicle count (AFC), basic follicle-stimulating hormone (FSH), endometrial CD138 results, FET protocol, and embryo attributes, the number of embryos transferred, embryo quality, the endometrial thickness and the progesterone value on the day of luteal transformation, the result showed that the implantation rate, the biochemical pregnancy rate and the clinical pregnancy rate of group D were lower than those of group C [22.58% (35/155) vs. 34.23% (230/672), P=0.006; 37.93% (44/116) vs. 48.28% (239/495), P=0.047; 30.17% (35/116) vs. 42.83% (212/495), P=0.022] and the differences were statistically significant. The implantation rate, the biochemical pregnancy rate and the clinical pregnancy rate of group B were higher than those of group D [29.52% (31/105) vs. 22.58% (35/155), P=0.049; 48.78% (40/82) vs. 37.93% (44/116), P=0.012; 35.37% (29/82) vs. 30.17% (35/116), P=0.030] and the differences were statistically significant. Conclusion:Endometrial cavity fluid is the main factor that obviously affects the pregnancy outcome of infertility patients with previous cesarean scar uterus undergoing FET cycles.

Supervision of teaching is of great significance to the substantive equivalence of "online" and "offline" teaching. Compared with the conventional supervision of offline teaching, supervision of online teaching has its particularity. The School of Medicine of Shanghai Jiao Tong University has formulated the online teaching supervision program, relying on the constantly improving supervision system in long-term practice and based on the quality control concept of OBE (outcomes-based education) which aims to improve the learning effect of students. The supervision program of online teaching includes full coverage of expert supervision, smooth feedback channels for students, prompt communication and solutions by management supervision, etc. And the effect of online teaching supervision on students' learning effect can be tested in practice. The effect of the online teaching has been investigated by the questionnaire survey. The results show that online teaching expert supervision has higher satisfaction and students learning effect is better, which illustrates that the online supervision program has played a positive role in teaching.

Objective To establish a reasonable evaluation system of the training effect of residents and professional master degree graduates in order to meet the needs of the construction of medical education system.Methods A questionnaire study had been conducted by stratified sampling to evaluate the abilities of the residents and medical professional degree graduates who had finished residency training in Beijing from 2015 to 2016.The trainees were evaluated by themselves,their colleagues and patients they had dealt with.Results The results showed that 95.29％ of the trainees and 99.00％ of their colleagues or patients thought that the overall abilities of the trainees were "excellent" or "better",and the evaluation results of all kinds of personnel above were consistent.Statistical analysis showed that some of the sub items of each ability index were evaluated better than the others,such as professional ethics,team cooperation ability and interpersonal communication ability,while some of the sub abilities need to be improved such as the information and management ability as well as teaching and research ability.The comparative analysis indicated that the postgraduates were superior to the residents in abilities of clinical diagnosis and treatment,information and management ability,and teaching and research ability.Conclusion The study showed that the training effect of residents and professional degree graduates had met the basic requirements,but the comprehensive quality and innovation ability needs to be promoted.The combination of degree education and resident training helps to cultivate the comprehensive ability of medical talents.

Objective: This study aims to explore the influence of birth order and age difference on the emotional and behavioral problems among children from two-child family, so as to provide advice on parenting. Methods: A total of 482 students in grades 2 to 5 from the 5 primary schools in Guangzhou were selected, all of whom came from two-child families (excluding twin children). Emotional and behavioral problems were investigated by using the Conner’s Parental Symptom Questionnaire (PSQ). Results: Among children from two-child families, higher prevalence of behavioral problems, learning problems, impulsive hyperactivity and hyperactivity index in older compared with younger children (β=-0.09，-0.16，-0.09，-0.10,P<0.05). The scores of behavioral problems and hyperactivity index were significantly higher among those of children who were 6-9 years older than young siblings, compared to those who were 0-3 years older than younger siblings(β=0.20,0.21,P<0.05). No similar pattern was found among the younger siblings(P>0.05). Conclusion Among school-age children from two-child families, emotional and behavioral problems of the elder ones were more serious than the younger ones’. Age difference between siblings shows impact on the emotional and behavioral development among elder children, however no significant impact is noticed among the younger ones.