Pancreatic cancer is a severe malignant tumor that poses a significant threat to human health worldwide, with its incidence and mortality rates increasing annually, especially in economically developed regions. The progress of surgical treatment is of great significance in improving the prognosis of pancreatic cancer patients. This article reviews the recent progress in surgical treatment strategies for pancreatic cancer, with a particular emphasis on the multidisciplinary team (MDT) approach, neoadjuvant therapy, conversion therapy, and the assessment of the effectiveness of neoadjuvant/conversion therapy. The MDT approach, by integrating the strengths of multiple disciplines, provides personalized treatment plans for patients, improving the resection rate and survival rate of patients with pancreatic cancer. Neoadjuvant and conversion therapy provide surgical opportunities for patients with advanced pancreatic cancer, improving their prognosis. Additionally, accurate assessment of treatment effects is crucial for determining the timing and method of surgery.

Objective:To evaluate the clinical outcomes of applying an enhanced workflow in robotic-assisted total hip revision arthroplasty.Methods:A retrospective study was conducted to analyze the 25 consecutive patients who had undergone robotic-assisted total hip revision arthroplasty in which an enhanced workflow was applied at Department of Orthopaedic Surgery, Beijing Jishuitan Hospital from September 2021 to October 2024. The cohort consisted of 8 males and 17 females with an age of (64.0±12.8) years. The left side was affected in 18 cases and the right side in 7 cases. The time from initial total hip arthroplasty to revision was (159.6±86.7) months. In all patients, no significant difference was found in the preoperative femoral cortical thickness between the healthy and the affected sides. The enhanced workflow included preoperative CT modeling and planning, intraoperative registration, prosthetic removal and reconstruction, and verification of prosthesis position. A total of 18 patients underwent total hip revision involving both the acetabular and the femoral sides; 6 patients underwent simple acetabular reconstruction with retention of the original femoral stem and replacement of the femoral head; 1 patient underwent femoral revision with retention of the acetabular cup and replacement of the acetabular liner. The operative time, intraoperative blood loss, modified Harris Hip Score (mHHS) and visual analogue scale (VAS) for hip pain at the final follow-up, and follow-up complications were recorded.Results:All patients successfully completed robotic registration during surgery, with no case of intraoperative robotic termination. For the 25 patients, the operative time was (152.2±43.8) minutes, the intraoperative blood loss 600 (400, 1,000) mL, and the follow-up time 12.0 (6.0, 31.5) months. At the final follow-up, their mHHS improved from 66.0 (26.4, 75.6) points preoperatively to 93.5 (80.3, 98.9) points, and their VAS pain score decreased from 5.0 (3.0, 7.0) points preoperatively to 0.0 (0.0, 2.0) point ( P<0.05). Follow-ups revealed no case of reoperation, prosthetic loosening, joint dislocation, periprosthetic infection, or periprosthetic fracture. Conclusion:The enhanced workflow can achieve satisfactory outcomes in robotic-assisted total hip revision for patients with adequate proximal femoral bone stock.

Objective:To evaluate the clinical outcomes of applying an enhanced workflow in robotic-assisted total hip revision arthroplasty.Methods:A retrospective study was conducted to analyze the 25 consecutive patients who had undergone robotic-assisted total hip revision arthroplasty in which an enhanced workflow was applied at Department of Orthopaedic Surgery, Beijing Jishuitan Hospital from September 2021 to October 2024. The cohort consisted of 8 males and 17 females with an age of (64.0±12.8) years. The left side was affected in 18 cases and the right side in 7 cases. The time from initial total hip arthroplasty to revision was (159.6±86.7) months. In all patients, no significant difference was found in the preoperative femoral cortical thickness between the healthy and the affected sides. The enhanced workflow included preoperative CT modeling and planning, intraoperative registration, prosthetic removal and reconstruction, and verification of prosthesis position. A total of 18 patients underwent total hip revision involving both the acetabular and the femoral sides; 6 patients underwent simple acetabular reconstruction with retention of the original femoral stem and replacement of the femoral head; 1 patient underwent femoral revision with retention of the acetabular cup and replacement of the acetabular liner. The operative time, intraoperative blood loss, modified Harris Hip Score (mHHS) and visual analogue scale (VAS) for hip pain at the final follow-up, and follow-up complications were recorded.Results:All patients successfully completed robotic registration during surgery, with no case of intraoperative robotic termination. For the 25 patients, the operative time was (152.2±43.8) minutes, the intraoperative blood loss 600 (400, 1,000) mL, and the follow-up time 12.0 (6.0, 31.5) months. At the final follow-up, their mHHS improved from 66.0 (26.4, 75.6) points preoperatively to 93.5 (80.3, 98.9) points, and their VAS pain score decreased from 5.0 (3.0, 7.0) points preoperatively to 0.0 (0.0, 2.0) point ( P<0.05). Follow-ups revealed no case of reoperation, prosthetic loosening, joint dislocation, periprosthetic infection, or periprosthetic fracture. Conclusion:The enhanced workflow can achieve satisfactory outcomes in robotic-assisted total hip revision for patients with adequate proximal femoral bone stock.

Pancreatic cancer is a severe malignant tumor that poses a significant threat to human health worldwide, with its incidence and mortality rates increasing annually, especially in economically developed regions. The progress of surgical treatment is of great significance in improving the prognosis of pancreatic cancer patients. This article reviews the recent progress in surgical treatment strategies for pancreatic cancer, with a particular emphasis on the multidisciplinary team (MDT) approach, neoadjuvant therapy, conversion therapy, and the assessment of the effectiveness of neoadjuvant/conversion therapy. The MDT approach, by integrating the strengths of multiple disciplines, provides personalized treatment plans for patients, improving the resection rate and survival rate of patients with pancreatic cancer. Neoadjuvant and conversion therapy provide surgical opportunities for patients with advanced pancreatic cancer, improving their prognosis. Additionally, accurate assessment of treatment effects is crucial for determining the timing and method of surgery.

Objective To explore the network structure of anxiety,depression and sleep among individuals under long-term high-altitude exposure.Methods A total of 303 subjects who had resided at high altitudes for more than 6 months on end were selected.The insomnia severity index(ISI),patient health questionnaire(PHQ-9),and generalized anxiety disorder scale(GAD-7)were employed to assess insomnia,depression and anxiety before network analysis was conducted to identify the central and bridge nodes in the symptom network.Results The incidence of moderate or severe depression,anxiety and insomnia were 38.9％[95％confidence interval(CI):33.4％-44.5％],23.1％(95％CI:18.3％-27.9％),and 18.5％(95％CI:14.1％-22.9％),respectively."Noticeability of sleep problems by others"had the highest expected influence centrality,followed by"sleep maintenance""uncontrollable worry""restlessness"and"sleep problems".Five bridge symptoms were identified:"sad mood""sleep problems""restlessness""feeling afraid"and"trouble relaxing".Conclusion Sleep-related symptoms play a crucial role in the overall network structure,serving as both central and bridge nodes.Additionally,the"feeling down or depressed"acts as a bridge node and holds importance in the comorbidity network of anxiety and depression.Targeting these key symptoms through intervention and prevention strategies may improve the psychological well-being of individuals with long-term residence in high-altitude regions.

Objective:To explore the application and effect of artificial intelligence technology in perinatal management of gestational diabetes mellitus.Methods:240 pregnant women with gestational diabetes diagnosed during 24-26 weeks of pregnancy in Changsha Maternal and Child Health Hospital were prospectively selected and randomly divided into control group (120 cases) and observation group (120 cases). The control group used the traditional management mode for nutritional management, and the observation group used AI technology for nutritional management. The weight gain, blood glucose control level, insulin use, pregnancy complications, pregnancy outcome and other indicators of the two groups were compared.Results:(1) Monitoring indicators during pregnancy: there was no significant difference in weight gain between the two groups ( P>0.05). The proportion of weight gain in the appropriate range in the observation group was significantly higher than that in the control group ( P<0.05); The prevalence of full-term anemia, insulin use rate and the incidence of blood glucose exceeding the control standard in the observation group were significantly higher than those in the control group (all P<0.05). (2) Pregnancy outcome: there was no significant difference in the incidence of gestational hypertension, cesarean section, fetal growth restriction, premature delivery and neonatal hypoglycemia between the two groups (all P>0.05); The incidence of conversion to cesarean section, macrosomia, neonatal blood glucose <2.6 mmol/L, mild asphyxia and admission to neurosurgical intensive care unit (NICU) in the observation group were significantly higher than those in the control group (all P<0.05). Conclusions:Application of AI technology to nutritional management of gestational diabetes can better control the maternal perinatal weight gain and blood glucose level, reduce the incidence of anemia in the third trimester of pregnancy, the incidence of macrosomia, the use of insulin and the rate of conversion to cesarean section, and improve the neonatal outcome.

Objective: To compare the therapeutic effect of different drug in the treatment of schizophrenia in acute stage. Methods: From November 2014 to June 2017, 105 patients with acute schizophrenia admitted in Department of Psychiatry of Taiyuan Psychiatric Hospital and Department of Psychiatry of Jiuzhou Dermatological Hospital of Taiyuan were selected in the study.Seventy-five patients were from the Department of Psychiatry, Taiyuan Psychiatric Hospital.Thirty patients were from the Department of Psychiatry, Jiuzhou Dermatology Hospital.The patients were divided into three groups by random number method, with 35 cases in each group.A group was given amisulpride.B group was given olanzapine.C group was given ziprasidone.The PANSS score (positive symptoms, negative symptoms, mental pathological score), curative effect (cured, significantly improved, invalid), adverse events (EPS, akathisia, nausea, rapid heart beat, blurred vision, orthostatic dizziness, weight gain, total adverse events) in the three groups were observed. Results: After treatment for 2 weeks, the positive symptoms.negative symptoms, mental pathological score in the three groups were significantly decreased (all P<0.05). The positive symptoms.negative symptoms, mental pathological score at corresponding period had no statistically significant differences among the three groups (all P>0.05). There was no statistically significant difference in therapeutic effect among the three groups (P>0.05). The occurrence of EPS of C group was significantly lower than that of B group [14.29%(5/35) vs.40.00%(14/35), χ²=5.851, P<0.05]. The incidence rate of adverse events of C group was significantly lower than that of A group and B group (χ²=5.833, 4.690, all P<0.05). However, there was no statistically significant difference in the occurrence of adverse events between A group and B group(P>0.05). Conclusion Amisulpride, olanzapine and ziprasidone in the treatment of acute phase of schizophrenia has good early reaction control and late curative effect.The adverse events of ziprasidone is significantly less than the other two drugs.But patients adopt which kind of drugs also need to formulate specific solutions according to individual circumstance.

Objective: To investigate the effects of traditional Chinese medicine Baoyuanhuoxue Granula on the state of senile type Ⅱdiabetes before thrombus.Methods: 60 cases of selected senile type Ⅱdiabetes patients were divided into two groups,trial group(treatment with routine western medicine added Baoyuanhuoxue Granula;30 cases) and control group(treatment with simple western medicine; 30 cases).After two months,the changes of expression rate of blood viscosity, nail fold microcirculation and platelet aggregation,D-D,CD-62p and PAC-1 of patients in two groups before and after treatment were observed.Results: Baoyuanhuoxue Granula can reduce the expression rate of blood viscosity,platelet aggregation,D-D,CD-62p and PAC-1 obviously,and can improve nail fold microcirculation.Conclusion: Baoyuanhuoxue Granula can improve the state of senile type Ⅱdiabetes before thrombus.