Objective To analyze the effects of three sterilization methods,namely,pressure steam,low-temperature plasma and ethylene oxide,on the magnetic flux of magnetic surgical devices and their sterilization costs.Methods A total of 234 magnetic surgical devices of different specifications and models(magnetic rings)were randomly divided into Group A,Group B and Group C after the paired number was labelled,and each group consisted of 78 pieces(39 pairs).After packaging each pair of devices according to sterilization specifications,Group A was sterilized by pressure steam,Group B was sterilized by low-temperature plasma,and Group C was sterilized by ethylene oxide.We measured the magnetic flux of three sets of magnetic rings before and after sterilization,and comparatively analyzed the sterilization cost and sterilization time of the single package.Results There was no statistically significant difference in the impact of the three sterilization methods on the magnetic flux of the magnetic surgical devices(P＞0.05),but there was a significant difference in the magnetic flux before and after sterilization for each sterilization method(P＜0.001);the sterilization cost was(1.96±0.16)yuan for Group A,(23.17±0.32)yuan for Group B,and(8.16±0.18)yuan for Group C,showing statistically significant differences among the three groups(P＜0.01).The sterilization time was(65.21±3.36)min for Group A,(45.46±1.39)min for Group B,and(1020.38±12.21)min for Group C,with statistically significant differences among the three groups(P＜0.01).Conclusion None of the three sterilization methods affects the magnetic flux of the magnetic surgical devices.Pressure steam method shows the lowest cost of single package,low-temperature plasma method shows the highest cost of single package,while ethylene oxide method shows the highest sterilization time.Pressure steam should be the preferred sterilization method for magnetic surgical devices.

Western bioethics,with its theoretical basis in individualism,is essentially a form of universalist ethics that makes it difficult to respond to the complexities of moral life.Scholars represented by Engelhardt and MacIntyre have profoundly reflected on universalist ethics from the perspective of moral pluralism,but they have not been able to fundamentally resolve the disputes.Grasping the theoretical lineage of the controversy between universalism and particularism can provide an important reference for the construction of bioethics based on Confucianism in contemporary China.Furthermore,from the perspective of opposing universalism and particularism,as well as in response to the issues of the era of life science and technology and the cultural background of China,it can not only realize the modern interpretation of Confucian ethics,but also promote the effective application of modern bioethics theory.

[Objective] To explore the clinical application of cutaneous ureterostomy-flap embedding in radical cystectomy plus urinary diversion. [Methods] The clinical data of 10 patients with bladder cancer treated with this method in our hospital during Feb.and May 2023 were involved.Cutaneous ureterostomy-flap embedding was used in urinary diversion.The stoma-free rate and stenosis rate of stomas within 1 year postoperatively, differences in renal function indicators 1 day before operation and 1 year after operation, urinary diversion-related complications within 6 months postoperatively, including hydronephrosis, urinary tract infections, renal stones were analyzed. [Results] All surgeries were successfully completed.At 1 year postoperatively, renal function indicators showed no significant difference compared to preoperative levels (P>0.05). At 6 months postoperatively, 1 patient developed renal stones, successfully treated with surgery; 2 had urinary tract infection, recovered after antibiotic treatment; 2 had mild unilateral hydronephrosis, alleviated with conservative management.At 1 year postoperatively, the catheter-free rate was 80%(8/10), with no worsening of hydronephrosis or occurrence of ureteral obstruction, and the stent placement duration ranged from 97 to 211 days, average (151.63±42.47) days.The ureteral stent was not removed in 2 patients within 1 year, so the stoma stenosis rate was 20%(2/10). [Conclusion] The application of flap embedding in urinary diversion following radical cystectomy is a simple and safe procedure, with few postoperative complications, high success rate of stent removal, and overall favorable outcomes.

Objective:To investigate the perioperative safety and survival benefits of two-stage operation in the treatment of esophageal malignancies.Methods:This is a retrospective case series study. The clinical data of 70 patients who underwent two-stage operation for esophageal malignancies from January 2015 to January 2023 in the Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine were retrospectively analyzed. There were 58 males and 12 females. The age ( M(IQR)) was 61 (22) years (range: 9 to 79 years), and 51.4% (36/70) of the patients were older than 65 years. All patients underwent the first operation to remove esophageal tumor and the second operation to complete digestive tract reconstruction. The reasons for two-stage operation were summarized, complications and treatment results were recorded, and the prognosis was calculated using Kaplan-Meier curve. Results:The interval between the two stages was 49 (35) days (range: 32 to 82 days). The follow-up perrod was 28(50) months (range: 1 to 69 months). The 30-day fatality rate after the first operation was 4.3% (3/70) and the 30-day fatality rate after the second operation was 0(0/63). The total complication rate of first operation was 55.7% (39/70), the respiratory complication rate was 10.0% (7/70) and the cardiovascular complication rate was 5.7% (4/70) The incidence of anastomotic leakage was 11.1% (9/63). The overall survival rate at 2, 3 and 5 years was 35.7%, 30.0% and 15.7%, respectively.Conclusion:Two-stage operation in the treatment of complex esophageal malignancies is feasible and yields satisfaetory results.

Objective:To investigate the perioperative safety and survival benefits of two-stage operation in the treatment of esophageal malignancies.Methods:This is a retrospective case series study. The clinical data of 70 patients who underwent two-stage operation for esophageal malignancies from January 2015 to January 2023 in the Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine were retrospectively analyzed. There were 58 males and 12 females. The age ( M(IQR)) was 61 (22) years (range: 9 to 79 years), and 51.4% (36/70) of the patients were older than 65 years. All patients underwent the first operation to remove esophageal tumor and the second operation to complete digestive tract reconstruction. The reasons for two-stage operation were summarized, complications and treatment results were recorded, and the prognosis was calculated using Kaplan-Meier curve. Results:The interval between the two stages was 49 (35) days (range: 32 to 82 days). The follow-up perrod was 28(50) months (range: 1 to 69 months). The 30-day fatality rate after the first operation was 4.3% (3/70) and the 30-day fatality rate after the second operation was 0(0/63). The total complication rate of first operation was 55.7% (39/70), the respiratory complication rate was 10.0% (7/70) and the cardiovascular complication rate was 5.7% (4/70) The incidence of anastomotic leakage was 11.1% (9/63). The overall survival rate at 2, 3 and 5 years was 35.7%, 30.0% and 15.7%, respectively.Conclusion:Two-stage operation in the treatment of complex esophageal malignancies is feasible and yields satisfaetory results.

Objective:To retrieve, evaluate and integrate the evidence related to the preparation process for initiating extracorporeal cardiopulmonary resuscitation in hospital, so as to provide reference for clinical implementation of extracorporeal cardiopulmonary resuscitation.Methods:According to the evidence-based nursing method and the 6S evidence model, guidelines, clinical decisions, expert consensus, systematic review and other literatures related to the preparation process for initiating extracorporeal cardiopulmonary resuscitation in hospital were searched from National Guideline Clearinghouse, Scottish Intercollegiate Guidelines Network, National Institute for Health and Care Excellence, and other websites, UpToDate, The Cochrane Library, PubMed, Embase, CNKI, Wanfang and other databases. The retrieval date limit was from the establishment of the database to May 20, 2023. Researchers assessed the quality of the included articles, and extracted and summarized the evidence that met the quality standards.Results:A total of 11 articles were included, including 2 guidelines, 6 expert consensuses, 1 systematic review and 2 quasi-experimental studies. A total of 18 pieces of evidences were summarized from 6 aspects, including medical conditions, team building, materials management, operation mechanism, pre-initiating treatment and initiating judgment.Conclusions:This study summarizes the evidence of preparation process for initiating extracorporeal cardiopulmonary resuscitation in hospital, which can provide reference for promoting the implementation of extracorporeal cardiopulmonary resuscitation. Future studies still need to focus on team building, personnel training and assessment, and optimisation of the management system, so as to improve the efficiency and readiness of treatment.

Asian ginseng mostly appeared in herbal medical books in the late Qing Dynasty and the early Republic of China.In modern literature,it is believed that this drug is alias of vigorously cultivated ginseng,Talinum paniculatum(Jacq.)Gaertn.,Pananis Japonici Rhizoma,Arctii Fructus and other drugs,and the origin is confused.This article made a textual research on the name,origin,producing areas,processing,property and taste,and efficacy.It is concluded that the Asian ginseng was earlier included in the Ben Cao Gang Mu Shi Yi in the Qing Dynasty,and was named Asian ginseng because it was produced in Japan.The original plant is Panax ginseng C.A.Meyer,which is a kind of Araliaceae plant.It takes Yunzhou,Huijin and Xinzhou of Japan as the true land,and is also cultivated in Northeast China.Asian ginseng medicinal materials are made by processing techniques such as net whiskers,boiling,cooling,and exposure to dryness.They are warm in property,sweet and slightly bitter in taste.They are good at tonifying qi and generating fluid,and can treat all deficiency syndromes of fluid and qi.In the Qing Dynasty,they were often used as Ginseng Radix et Rhizoma.The identification of false was also attached for distinguishing.

Objective:To analyze the feasibility and safety of laparoscopic radical resection of hilar cholangiocarcinoma (HCCA).Methods:Clinical data of 72 patients with HCCA undergoing radical resection at the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Xi'an Jiaotong University from January 2019 to January 2022 were retrospectively analyzed, including 36 males and 36 females, aged 57(47, 63) years old. According to surgical approach, patients were divided into the laparoscopic group ( n=39) and open group ( n=33). The surgical safety, tumor radicality, postoperative recovery, complications and survival time were compared between the two groups. Results:Operative time was comparable between the two groups [(6.4±2.6) h vs. (6.3±2.4) h, P>0.05], while the intraoperative blood loss was lower in the laparoscopic group [(531.9±273.3) ml vs. (674.6±330.0) ml]. Data were also comparable between the two groups in terms of R0 resection rate [92.3% (36/39) vs. 93.9% (31/33)], the number of lymph node dissection (7.7±2.6 vs. 7.6±2.4), and the incidence of postoperative complications [20.5% (8/39) vs. 18.2% (6/33)] (all P>0.05). However, the laparoscopic group was superior to the open group in terms of postoperative analgesia time [(2.0±0.7)d vs. (2.8±0.9)d], postoperative resumption of feeding time [(1.6±0.5)d vs. (3.9±0.9)d], and postoperative hospitalization time [(8.6±1.5)d vs. (12.8±2.2)d] ( t=4.04, 8.23, 9.47, respectively, all P<0.001). Postoperative cumulative survival was comparable between the two groups ( χ2=0.50, P=0.480). Conclusion:Laparoscopic radical resection of HCCA has similar efficacy to open surgery and has the advantage of less invasiveness and enhanced recovery.

With the intensify of aging population,accurate assessment of brain health becomes more and more important.Brain age can reflect brain health and cognitive function.Based on different algorithms,modal data and central datasets,imaging is helpful for predicting brain age.The progresses of imaging researches for predicting brain age were reviewed in this article.

Objective To investigate the effects of the estrogen synthesis inhibitor letrozole on the composition,diversity,and abundance of the intestinal microbiota in rats with polycystic ovary syndrome(PCOS).Methods A rat model of PCOS was induced using the estrogen synthesis inhibitor letrozole.The gut microbiota structures of normal and PCOS rats were analyzed 16S rRNA sequencing.Results At the phylum level,rats in the PCOS group had a lower abundance of Firmicutes(73.29%±5.34%vs.77.17%±4.01%)and a higher abundance of Bacteroidetes(23.85%±6.22%vs.17.21%±6.90%)compared with the normal group.At the genus level,the abundances of Rochella(5.61%±3.20%vs.16.13%±6.20%)and Zurichella(1.75%±2.23%vs.9.98%±7.34%)were lower in the PCOS group than in the normal group,but the abundances of Lactobacillus(18.83%±11.50%vs.15.88%±7.06%),Prevotella(4.58%±1.09%vs.0.46%±0.15%),and Ruminococcus(2.97%±1.56%vs.1.16%±0.60%)were increased.Analysis of Kyoto Encyclopedia of Genes and Genomes signaling pathways of the differentially expressed bacteria showed that signaling pathways related to bile acid biosynthesis in the intestine were changed in the PCOS rat model.Conclusions The structure of intestinal flora in PCOS rat model constructed by intragastric administration of letrozole is significantly disordered,which may be related to the signaling pathways related to bile acid biosynthesis.