Objective To introduce the modeling method of pendulum-like modified rat abdominal heart heterotopic transplantation model and evaluate the quality of the model. Methods An operator without transplantation experience performed 15 consecutive models, recorded the time of each step, changes in body weight and modified Stanford scores, and calculated the surgical success rate, postoperative 1-week survival rate and technical success rate. Ultrasound examinations was performed in 1 week postoperatively. Results The times for donor heart acquisition, donor heart processing, recipient preparation and transplantation anastomosis were (14.3±1.4) min, (3.5±0.6) min, (13.6±2.1) min and (38.3±5.2) min respectively. The surgical success rate was 87% (13/15), and the survival rate 1 week after operative was 100% (13/13). The improved Stanford score indicated a technical success rate of 92% (12/13), and the postoperative 1-week ultrasound examination showed that grafts with Stanford scores ≥3 had detectable pulsation and blood flow signals. Conclusions The pendulum-like modified rat abdominal heart heterotopic transplantation improved model further optimizes the operational steps with a high success rate and stable quality, may be chosen as a modeling option for basic research in heart transplantation in the future.

Cysteine protease inhibitor SN(Cystatin SN , CST1), a member of the type 2 cystatins superfamily, regulates tumor biological activities by modulating cysteine protease activity. CST1 is abnormally expressed in digestive system neoplasms, such as esophageal cancer, gastric cancer, hepatocellular carcinoma, colorectal cancer, and pancreatic cancer. CST1 influences tumor cell proliferation, migration, and epithelial-mesenchymal transition (EMT) through signaling pathways including Wnt, STAT3, and PI3K-AKT. Its expression levels significantly correlated with tumor stage, metastasis, and patient prognosis, suggesting its potiential as a novel biomarker for early diagnosis, therapeutic evaluation, and prognosis in digestive system neoplasms. This article systematically reviews the molecular characteristics of CST1, its mechanisms of action in digestive system neoplasms, clinical significance, and explores its potential as a therapeutic target.

The treatment of sacrococcygeal pilonidal disease (SPD) remains challenging due to its high recurrence rate and treatment-related complications. An ideal treatment plan for SPD should be simple to perform, reduce recurrence rates, enable patients to quickly return to normal daily activities, and be associated with a low incidence of complications. Various surgical techniques have been employed for the treatment of SPD, but discrepancies and controversies persist in current clinical practice. Non-surgical treatment is suitable for asymptomatic SPD patients. For patients in the acute abscess phase, drainage is the primary therapeutic goal, with avoidance of midline incisions. Minimally invasive procedures may be considered for patients with localized lesions after weighing the recurrence risk, aiming for faster recovery and better cosmetic outcomes. For recurrent SPD or cases with extensive lesions, excision followed by secondary healing or combined with flap techniques is required to pursue a lower recurrence risk. Based on clinical experience and literature review, this article summarizes the treatment strategies for different types of SPD, providing a reference for clinicians in formulating diagnosis and treatment plans.

The treatment of sacrococcygeal pilonidal disease (SPD) remains challenging due to its high recurrence rate and treatment-related complications. An ideal treatment plan for SPD should be simple to perform, reduce recurrence rates, enable patients to quickly return to normal daily activities, and be associated with a low incidence of complications. Various surgical techniques have been employed for the treatment of SPD, but discrepancies and controversies persist in current clinical practice. Non-surgical treatment is suitable for asymptomatic SPD patients. For patients in the acute abscess phase, drainage is the primary therapeutic goal, with avoidance of midline incisions. Minimally invasive procedures may be considered for patients with localized lesions after weighing the recurrence risk, aiming for faster recovery and better cosmetic outcomes. For recurrent SPD or cases with extensive lesions, excision followed by secondary healing or combined with flap techniques is required to pursue a lower recurrence risk. Based on clinical experience and literature review, this article summarizes the treatment strategies for different types of SPD, providing a reference for clinicians in formulating diagnosis and treatment plans.

A deep learning-based model for automatic diagnosis and classification of adolescent idiopathic scoliosis has been constructed.This model mainly included key points detection and Cobb angle measurement.748 full-length standing spinal X-ray images were retrospectively collected,of which 602 images were used to train and validate the model,and 146 images were used to test the model performance.The results showed that the model had good diagnostic and classification performance,with an accuracy of 94.5%.Compared with experts'measurement,94.9%of its Cobb angle measurement results were within the clinically acceptable range.The average absolute difference was 2.1°,and the consistency was also excellent(r2≥0.9552,P<0.001).In the future,this model could be applied clinically to improve doctors'diagnostic efficiency.

Objective A deep learning-based method for evaluating the quality of pediatric pelvic X-ray images is proposed to construct a diagnostic model and verify its clinical feasibility.Methods Three thousand two hundred and forty-seven children with anteroposteric pelvic radiographs are retrospectively collected and randomly divided into training datasets,validation datasets and test datasets.Artificial intelligence model is conducted to evaluate the reliability of quality control model.Results The diagnostic accuracy,area under ROC curve,sensitivity and specificity of the model are 99.4%,0.993,98.6%and 100.0%,respectively.The 95%consistency limit of the pelvic tilt index of the model is-0.052-0.072.The 95%consistency threshold of pelvic rotation index is-0.088-0.055.Conclusion This is the first attempt to apply AI algorithm to the quality assessment of children's pelvic radiographs,and has significantly improved the diagnosis and treatment status of DDH in children.

Objective:To investigate the effect of behavioral lifestyle on the CT values of urinary tract stones, as well as the relationship between behavioral lifestyle and the therapeutic effect of extracorporeal shock wave lithotripsy (ESWL).Methods:A total of 265 patients with urinary tract stones who underwent ESWL treatment at Affiliated Hospital of Jining Medical University from January 2019 to June 2023 were selected. According to the CT values of the stones, the subjects were divided into high CT value group (CT value > 1 000 HU, n=106) and low CT value group (CT value ≤ 1 000 HU, n=159). A retrospective survey was conducted to assess the patients' behavioral lifestyles, and general data, CT values, number of lithotripsy sessions, lithotripsy time, lithotripsy efficiency, and incidence of complications were compared between the two groups. SPSS 22.0 software was used for statistical analysis. The χ2 test and t-test were used for group comparisons, and Pearson correlation analysis was used to examine the relationship between stone CT values and different behavioral lifestyles. Results:The high CT value group had lower average daily water intake((1 242±347)mL vs (1 784±376)mL), average daily fresh fruit intake((135±43)g vs (196±51)g), and average daily exercise time((18±12)min vs (32±14)min) compared with the low CT value group( t=-11.850, -9.926, -8.434, all P<0.01). In contrast, the high CT value group had higher average daily salt intake((8.3±2.2)g vs (6.5±1.7)g) and average daily animal protein intake ((72±18)g vs (54±16)g) compared with the low CT value group ( t=7.495, 8.531, both P<0.01). The high CT value group required more lithotripsy sessions and longer lithotripsy time than the low CT value group ( t=6.192, 7.507, both P<0.05), while lithotripsy efficiency was lower than the low CT value group ( χ2=33.181, P<0.01). The incidence of complications was higher in the high CT value group compared to the low CT value group ( χ2=3.915, P=0.048), with statistically significant differences. Conclusion:Appropriate water intake, diet, and exercise habits are beneficial in reducing stone CT values, improving the efficacy of ESWL treatment, and decreasing the incidence of complications.

Objective To explore the clinical effect of reconstructing distal radioulnar ligament with al-lograft tendon under wrist arthroscopy in the treatment of chronic PalmerⅠD type triangular fibrocarti-lage complex injury complicated with distal radioulnar joint instability.Methods Clinical data of 15 pa-tients with chronic PalmerⅠD type triangular fibrocartilage complex injury and admitted to our hospital between January 2017 to January 2020 were retrospectively analyzed.All of them were treated with wrist arthroscopic allograft tendon reconstruction of distal radioulnar ligament.During the postoperative follow-up,the wrist range of motion and grip strength were evaluated,while the wrist pain and wrist function were assessed using the visual analogue scale(VAS)and modified Mayo score.Results All pa-tients were followed up twelve to twenty-four months,with an average of(18.15±2.20)months.The postoperative VAS score was(2.56±0.69),significantly better than the preoperative one(6.78±1.24)(P<0.05).Moreover,the postoperative ratio of grip strength between the affected and the healthy hand was(76.18±9.72)%,significantly better than that of(50.18±6.79)%(P<0.05),with increased grip strength.Meanwhile,the postoperative rotational motion of wrist joint[(151.09±12.38)°]improved significantly compared with that before operation[(142.87±10.19)°](P<0.05).According to the modi-fied Mayo score,8 cases were excellent,6 cases were good,and 1 case was fair,reaching an excel-lent and good rate of 93.33%.Conclusion Wrist arthroscopic reconstruction of distal radioulnar liga-ment with allograft tendon is effective in the treatment of chronic PalmerⅠD type triangular fibrocarti-lage complex injury with lower radioulnar joint instability,relieving pain and promoting grip strength and rotational motion.

A 79-year male presenting with abdominal distension, diarrhea, edema and oliguria, which soon progressed to acute renal failure, was admitted in Xiamen Branch of Zhongshan Hospital. The diagnosis of atypical hemolytic uremic syndrome (aHUS) was confirmed after admission. The hematological parameters and renal function were improved after prompt hemodialysis, plasma exchange, plasma and immunoglobulin transfusion. The patient experienced multiple recurrences of aHUS within 1 year, but achieved long-term remission with regular use of eculizumab. The reported cases of aHUS were searched from Wanfang Data Knowledge Service Platform and CNKI Database from January 2000 to January 2024, and 64 non-pregnant adult aHUS cases were retrieved from literature. The analysis of 65 cases showed a male-to-female ratio was 1.2∶1 and an average age of 34.8 years ranging from 20 to 86 years. Common clinical manifestations included fever (24 cases, 36.9%), renal dysfunction (27 cases, 41.5%), and neurological symptoms (15 cases, 23.1%). Additionally, 40 cases (61.5%)had concomitant hypertension. Among the 65 patients, 36 (55.4%) received hemodialysis, 31 (47.7%) underwent plasma exchange or plasma transfusion, 29 (44.6%) were treated with glucocorticoids, and only 3 (4.6%) were treated with eculizumab. In terms of treatment outcomes, 29.2% (19 cases)of the patients achieved complete renal function recovery, 46.2% (30 cases)developed end-stage renal disease, and 4 patients died. aHUS presents with a variety of clinical manifestations involving multiple systems. Plasma exchange remains the primary treatment method at present. Early and accurate diagnosis, prompt and effective treatment can significantly improve patient prognosis.

Objective:To explore indications for replantation of proximal proper digital artery and establishing extrinsic arterial perfusion pressure in the treatment of special type of severed digits with avulsion over 12.0 hours of warm ischemia, and to analyse the factors that affected the survival rate of the replanted digits.Methods:From September 2014 to January 2022, 8 patients with severed digits and prolonged warm ischemia were treated by transposition of adjacent digital artery together with the technique of extrinsic arterial perfusion pressure in the Department of Wrist and Hand Surgery, the Orthopaedic Hospital in Sichuan Province. During the operation, the defected proximal proper digital artery was reconstructed and repaired with vein graft, one side of the digital artery was repaired with an inverted "Y" vein graft, and one side of "Y" vein was bridged and anastomosed to repair the original digital artery. On the other side, the adjacent proximal proper digital arteries were transpositioned and anastomosed to gain an extrinsic arterial perfusion pressure, which increased the distal haemodynamic and reconstituted the blood supply. Of the 8 patients (9 severed digits) : 1 had severed index and middle fingers, 2 had severed index fingers, 4 had severed thumbs and 1 had severed little finger. All the patients were males, aged 16-63 years old, at 37.6 years old in average. Warm ischemia time of the severed digits were 12.3-20.6 hours, with 17.4 hours in average. The survival rate of replanted digits was observed after surgery. Postoperative follow-ups were conducted through telephone or WeChat reviews.Results:Follow-up time was 6-26 months, at 8.3 months in average. Retrospective analysis was performed. Vascular compromises occurred in 3 patients 4 digits (arterial insufficiency in 1 digit, venous congestion in 3 digits), skin necrosis occurred in 1 patient (1 digit) and digit necrosis in 1 patient (1 digit). Overall, 8 of the 9 replanted digits survived. According to the Replantation Function Evaluation Standard of Hand Surgery Association of Chinese Medical Association, the digit function after replantation was evaluated at excellent in 6 digits, good in 1 digit and poor in 1 digit.Conclusion:For a severed digit with an ischemia time over 12.0 hours, the survival rate can be improved by transposition of an adjacent digital artery to provided extrinsic arterial perfusion pressure.