Objective To compare the effectiveness and safety of transparency cap-assisted endoscopic full-thickness resection(EFTR-C)and endoscopic submucosal excavation(ESE)in the treatment of ≤1.5 cm intracavity growth type gastric stromal tumor.Methods A retrospective analysis was performed on the medi-cal records of 63 patients with ≤1.5 cm intraluminal growth type gastric stromal tumor treated in this hospi-tal from June 2019 to September 2023.The patients were divided into the EFTR-C group(n=33)and ESE group(n=30)according to surgical methods.The general data,operation situation,postoperative situation and follow-up were compared between the two groups.Results There was no statistically significant differ-ence in the intraoperative pneumoperitoneum rate,purse string suture rate,monoblock resection rate,complete resection rate and complication occurrence rate between the two groups(P＞0.05).The operative time,inci-dence rate of intraoperative bleeding,number of titanium clips,postoperative fasting time,postoperative hospi-talization duration and operation costs had statistical difference between the two groups(P＜0.05).Postoper-ative wound healing was good in both groups without recurrence,metastasis and death.Conclusion EFTR-C for the treatment of ≤1.5 cm intracavity growth type gastric stromal tumor has the advantages of simple op-eration,short operation time,low costs and rapid recovery compared with ESE.

The incidence of osteoporotic thoracolumbar vertebral fracture (OTLVF) in the elderly is gradually increasing. The kyphotic deformity caused by various factors has become an important characteristic of OTLVF and has received increasing attention. Its clinical manifestations include pain, delayed nerve damage, sagittal imbalance, etc. Currently, the definition and diagnosis of OTLVF with kyphotic deformity in the elderly are still unclear. Although there are many treatment options, they are controversial. Existing guidelines or consensuses pay little attention to this type of fracture with kyphotic deformity. To this end, the Lumbar Education Working Group of the Spine Branch of the Chinese Medicine Education Association and Editorial Committee of Chinese Journal of Trauma organized the experts in the relevant fields to jointly develop Clinical guidelines for the diagnosis and treatment of osteoporotic thoracolumbar vertebral fractures with kyphotic deformity in the elderly ( version 2024), based on evidence-based medical advancements and the principles of scientificity, practicality, and advanced nature, which provided 18 recommendations to standardize the clinical diagnosis and treatment.

OBJECTIVE: The compatibility of Eucommia ulmoides (Eu) and Psoralea corylifolia (Pc) on the pharmacokinetic (PK) properties in the rat was explored in this study. METHODS: Eu extract, Pc extract and the combined extracts (crude drug ratio was 2:1) was administered by gavage, respectively. Two PK experiments were conducted. In first one, the blood samples were collected via the occuli chorioideae vein to get the PK properties of the components. In second one, the blood samples were simultaneously collected via the internal jugular vein or portal vein at different time points and the concentrations of target ingredients were detected by LC/MS/MS to clear the location where the interaction of Eu and Pc took place in vivo. RESULTS: Eight of 11 ingredients in Eu and Pc extract were determined in rat plasma. The exposure levels of geniposidic acid (GPA), aucubin (AU), geniposide (GP), pinoresinol diglucoside (PDG), psoralen glycosides (PLG) and isopsoralen glycosides (IPLG) were decreased 1/5-2/3 after administration of combined extracts. Comparing to the combined administration, the exposure of GPA and AU in plasma of single Eu administration collected via the portal vein were decreased 1/3-2/3, and the values of AUC_0-24h and AUC_0-∞ of GP collected from the portal vein or internal jugular vein were double increased. The other components' parameters were not significantly changed. CONCLUSION In summary, the Pc and Eu combined administration could affect the exposure of the main components of Eu extract in rats due to the changed intestinal absorption. The research on the compatibility of Pc and Eu was helpful to guide the clinical administration of Eu and Pc simultaneously.

Abstract： Objective　To retrospectively analyze the investigation and disposal of the COVID-19 outbreak caused by the transmission of the Omicron variant in infected imported cases, and provide basis for COVID-19 outbreak management. Methods　The description epidemiological method was used to describe the COVID-19 outbreak in Sanya City from March 31 to April 15, 2022. The propagation chain was mapped and the experience gained and shortcomings identified in emergency responses were analyzed. Results　The outbreak resulted in 95 reported locally transmitted COVID-19 cases with a incubation period M(P25, P75) of 4 (3, 5) d. In the 95 cases, the proportion of cases detected through close contact screening, centralized isolation, community screening, control area screening, active treatment (examination), and key population screening were 33.68%, 22.11%, 18.95%, 12.63%, 6.32%, 4.21% and 2.11%, respectively. The epidemic spread for 6 generations, causing 5 clusters of outbreaks and 12 cases of cluster disease. The epidemic affected 12 villages/neighborhood committees, 1 bar, 1 hospital, 1 small clinic, 1 farmer's market, 1 large shopping mall and 1 restaurant in 2 districts of Sanya City. The result of gene sequencing was Omicron variant BA.1.1. Through the immediate launch of emergency plans, nucleic acid and antigen testing, controlling close contact between infected persons and close contacts, suspending indoor business sites, central urban control, and temporary suspension, COVID-19 was controlled within 16 days. Conclusions　The transmission chain of this outbreak was clear and was caused by imported cases. Strengthening the management of the pass, doing a good job in information sharing and docking, timely screening for cases, screening, pushing, controlling high-risk groups, and implementing comprehensive control measures, can effectively prevent the spread of the epidemic, providing a reference for the control of epidemic situations in relevant scenarios.

Objective:To analyze the epidemic characteristics and periodicity of hemorrhagic fever with renal syndrome (HFRS) in Jingzhou City, Hubei Province, and provide a basis for scientific prevention and control of HFRS in Jingzhou City.Methods:Retrospective analysis was used to collect HFRS case data and population data of Jingzhou City and 8 counties (cities, districts) within its jurisdiction, including Shashi District, Jingzhou District, Gongan County, Jianli City, Jiangling County, Shishou City, Honghu City, and Songzi City from 1962 to 2020, from the Archives of the Jingzhou Center for Disease Control and Prevention and the Infectious Disease Report Information Management System of the China Disease Control and Prevention Information System; and the epidemic characteristics of HFRS was analyzed in Jingzhou City and 8 counties (cities, districts) within its jurisdiction. The periodicity of HFRS onset was determined using wavelet analysis.Results:From 1962 to 2020, 18 936 HFRS cases were reported in Jingzhou City, with an average incidence rate of 5.95/100 000. There were a total of three epidemic peaks, namely from 1972 to 1973 (24.82/100 000, 24.84/100 000), 1983 (60.08/100 000), and 1995 (14.57/100 000). According to different regions, the high incidence areas of HFRS showed a phased transfer trend: from the 1960s to the 1970s, the Jiangbei area (Honghu City, Jianli City) was the highest incidence area; in the 1980s and 1990s, the high incidence areas were transferred to Jiangnan area (Songzi City, Shishou City, and Gongan County); after 2005, high incidence areas were relocated to Jiangbei area (Honghu City, Jianli City, Jiangling County). The wavelet analysis results showed that there were 12.30 and 21.77 years of HFRS epidemic cycles in Jingzhou City before 2000 ( P < 0.05); among them, the periodicity of Shashi District, Gongan County, Jiangling County, Shishou City, and Honghu City was relatively consistent with that of Jingzhou City, with epidemic cycles of about 12 or 22 years ( P < 0.05). Conclusions:Jingzhou City is currently at the peak of a 22-year epidemic cycle of HFRS, with Jiangbei area as the high incidence areas. The 12-year epidemic cycle in Jingzhou City has ended after 2000.

The application of robots in thoracic surgery is mainly based on the da Vinci general surgery robot. With the popularization of artificial intelligence (AI) application scenarios, the combination of AI and robots is more closely, and there is a strong clinical demand and huge application space for the development of specialized disease-specific robotic systems for thoracic surgery. This article aims to systematically describe the history of the rise of specialized surgical robots and the status of the localization of surgical robots in China, propose the concept of applying AI to the research and development of integrated specialized disease-specific robots in thoracic surgery, and clarify the ethics and prospects that intelligent specialized disease-specific surgical robots will face.

Exosomes are widely distributed in various body fluids. They are extracellular vesicles with a diameter of 30-100nm that contain a variety of biologically active substances. They play an important role in a variety of biological processes such as tumor invasion, migration and immune escape. With the progress of research, exosomes derived from bladder cancer have shown great potential in the early diagnosis and treatment of bladder cancer. This article reviews the main biological characteristics of exosomes and their new developments in the diagnosis and treatment of bladder cancer.

OBJECTIVE：To analyze the metabolites of tetrahydroxystilbene glucoside （THSG）and speculate its metabolism pathway in rats. METHODS ：Male SD rats were randomly divided into plasma group （n＝3），urine group （n＝3），bile group （n＝3），and tissue group （n＝9）. Each group was given single dose of THSG 200 mg/kg intragastrically. Plasma samples 10，30 min and 1，1.5，2，4 h after medication ，the unrine 0-6 h after medication ，the bile 0-4 h after medication ，the tissue of heart ， liver，spleen，lung，kidney and stomach 30 min and 1，2 h after medication （3 at each time point ）were collected respectively.After precipitated with methanol ，the metabolites of samples were analyzed and identified by UHPLC-Q-Exactive Orbitrap MS and mass loss filtration （MDF）. Its metabolism pathway was speculated. RESULTS：In the blood ，urine，bile，heart，liver，spleen， lung，kidney，stomach samples ，6，7，11，1，5，1，3，4，4 metabolites were detected ，including two phase Ⅰ（hydrolysis， hydrogenation and hydroxylation ）metabolites，18 phase Ⅱ（glucuronic acid binding and sulfation ）metabolites. There were 12 glucuronic acid binding products. CONCLUSIONS：Most of the metabolites of THSG are found in bile ，mainly glucuronic acid binding products of phase Ⅱ metabolite THSG ； main metabolic pathways involve glucose hydrolysis ， hydrogenation， hydroxylation，glucuronic acid binding and sulfation.

OBJECTIVE：To establ ish the fingerprint of Sojae Semen Nigrum and content determination method of 5 kinds of isoflavones，so as to provide reference for controlling its quality better. METHODS ：HPLC method was adopted to establish the fingerprint and detect the contents of 5 kinds of isoflavones. The determination was performed on Phenomenex C 18 column with mobile phase consisted of acetonitrile- 0.12％ formic acid solution （gradient elution ）at the flow rate of 1 mL/min. The detection wavelength was set at 260 nm；the column temperature was 30 ℃ and sample size was 10 μL. Using daidzin as reference，HPLC fingerprints of 12 batches of samples were determined. The similarity of 12 batches of samples was evaluated by TCM Chromatographic Fingerprint Similarity Evaluation System （2012A） to confirm common peak. Cluster analysis and principal component analysis were performed by using SPSS 20.0 software and SIMCA 13.0 software. RESULTS ：There were 19 common peaks in HPLC fingerprints of 12 batches of samples ，the similarity of which was higher than 0.94. Totally 5 components were identified，such as daidzin ，glycitin，genistin，daidzein，genistein. Cluster analysis showed that 12 batches of Sojae Semen Nigrum were clustered into 2 categories，i.e. S 1-S3 clustered into one category ，and S 4-S12 clustered into the other category. By principal component analysis ，the contribution rates of two principle components were 53.261％ and 40.715％；accumulative contribution rate was 93.976％. The linear range of above 5 components were 5.97-191.00 µg/mL（r＝0.999 9），1.05-33.46 µg/mL（r＝0.999 9）， 8.93-285.61 µg/mL（r＝0.999 5），0.82-26.33 µg/mL（r＝0.999 9），0.93-29.64 µg/mL（r＝0.999 7），respectively. The limits of quantitation were 0.881 1，0.611 6，0.078 6，0.243 3，0.511 6 μg/mL，respectively. The limits of detection were 0.264 3，0.244 7， 0.021 4，0.124 8，0.106 7 μg/mL，respectively. RSDs of precision ，stability，reproducibility and durability tests were all lower than 5％. Recoveries were 95.15％-96.56％（RSD＝0.51％，n＝6），98.52％-103.45％（RSD＝1.88％，n＝6），95.37％-97.91％ （RSD＝0.95％，n＝6），99.75％-102.00％（RSD＝0.78％，n＝6），100.26％-103.65％（RSD＝1.21％，n＝6）. Among 12 batches of Sojae Semen Nigrum ，the contents of above 5 components were 0.178 3-0.265 9，0.021 7-0.096 2，0.288 5-0.597 2，0.014 1- 0.058 8，0.012 9-0.082 9 mg/g. CONCLUSIONS ：Established HPLC fingerprint and content determination method of 5 kinds of isoflavones can be used for quality control of Sojea Semen Nigrum. The Isoflavone components are similar ，but the contents are different among Sojae Semen Nigrum from different producing areas.

Objective:To compare the skin disinfection effect in different marking methods.Methods:From June 2015 to August 2018, samples of 200 healthy volunteers were collected in the operating room of a hospital. Using self-matching design, a blank control area A was set up in the upper abdomen of every volunteer, and sterile markers were used to mark areas B, C, D and E. Areas B and C were directly marked on the abdominal skin (solid line of area B, dashed line of area C) , and areas D and E were marked after the skin was disinfected first (solid line of area D, dashed line of area E) . After disinfection, specimens were collected in areas A, B, C, D, and E for bacterial culture and the disinfection effect was monitored.Results:A total of 1 000 samples were collected from 200 healthy volunteers. Among them, 39 bacterial cultures were positive and the number of colonies detected in the positive samples was 1 to 6 cfu/cm 2. The positive rate of skin bacterial culture in the marked area of solid line was higher than that in marked area of dashed line. The differences in the positive rates of bacterial culture in different areas were statistically significant ( Q=51.87, P< 0.01) . Further pairwise comparison showed that the differences between the areas B and C that were first drawn lines and then disinfected and area A were statistically significant (χ 2=20.05, 9.09, P< 0.05) . However, there was no statistically significant difference between areas D and E that were first disinfected and then drawn lines and area A ( P>0.05) . The detection rate of bacteria in area B was higher than that in area C, and the difference was statistically significant (χ 2=7.97, P<0.05) . The detection rate of bacteria in area D was higher than that in area E, but the difference was not statistically significant ( P> 0.05) . Conclusions:Marking and disinfecting the skin at the surgical site will have an effect on the skin disinfection effect. It is recommended that the skin at the surgical site be disinfected first and then marked, and the method of dashed line marking should be adopted.