OBJECTIVE To investigate the protective effect of 2-dodecyl-6-methoxy-2，5-diene-1，4-cyclohexanedione （DMDD）， an active component from Averrhoa carambola root， on myocardial injury in diabetic mice based on the nuclear receptor coactivator 4/ferritin heavy chain 1/autophagy-related protein 8 （NCOA4/FTH1/ATG8） axis. METHODS The successfully modeled diabetic mice were randomly divided into model group and DMDD low-， medium-， and high-dose （12.5， 25， 50 mg/kg） groups， while an additional non-modeled control group was established， with 6 mice in each group. Each group received the corresponding drug solution or an equal volume of normal saline intragastically once daily for 21 consecutive days. After the administration， the levels of fasting blood glucose （FBG）， serum lactate dehydrogenase （LDH）， and creatine kinase isoenzyme MB （CK-MB） were measured. Myocardial pathological changes， degree of fibrosis， and myocardial cell ultrastructure were observed. Myocardial cell death index and NCOA4 protein positive index were detected. The protein expression levels of NCOA4， FTH1， ATG8， solute carrier family 7 member 11 （SLC7A11）， and glutathione peroxidase 4 （GPX4） in cardiac tissue were measured. RESULTS Compared with model group， each DMDD group showed significant alleviation of cardiac pathological injury and varying degrees of improvement in the myocardial cell ultrastructure. The FBG and serum LDH and CK-MB levels， the myocardial cell death index and NCOA4 protein positive index，the protein expression levels of NCOA4， FTH1， and ATG8 in cardiac tissue were significantly decreased （ P ＜0.001）， while the protein expression levels of SLC7A11 and GPX4 were significantly increased （ P ＜0.001）. CONCLUSIONS DMDD can reduce blood glucose levels， alleviate myocardial histopathological injury， and inhibit cell death in diabetic mice. The mechanism is associated with inhibiting excessive activation of the NCOA4/FTH1/ATG8 axis and reducing ferritinophagy.

Guillain-Barre syndrome(GBS)is an autoimmune-mediated peripheral nerve and nerve root disease with its cause not elucidated yet,which may be related to infection,surgery,vaccination,and other factors.With the deepening of understanding of the disease,its electromyographic characteristics have gradually attracted people's attention.This paper summarizes the advances in correlational research on various parameters of electromyography of GBS patients,such as motor and sensory nerve conductions,H reflex,F wave,conduction block,reversible conduction failure,temporal dispersion,sural preservation,and needle electrode electromyography,and analyzes their correlation with inducements and prognosis of GBS,thus being expected to improve understanding of the electromyography in patients with GBS and to provide reference for diagnosis of GBS.

Objective To establish a stable,reliable,and clinically relevant porcine model of endotoxin-induced acute respiratory distress syndrome(ARDS).Methods Ten 8-month-old male Bama minipigs were deeply sedated,followed by invasive mechanical ventilation and electrocardiographic monitoring.Lipopolysaccharide(LPS)was intravenously pumped at 600 μg/(kg·h)for 3 hours,then maintained at 15 μg/(kg·h)thereafter.Dynamic monitoring was performed at five time points after LPS injection(LPS 0,1,3,5,and 8 h),including arterial blood gas analysis and chest computed tomography(CT)scans.Pathological examination of lung tissues obtained via bronchoscopic biopsy(HE staining and transmission electron microscopy)was conducted.These indicators were comprehensively used to evaluate the success of the animal model.Results At 5 hours after LPS administration,8 minipigs developed symptoms such as skin cyanosis,elevated body temperature,and respiratory distress.The oxygenation index decreased to<300 mmHg.Chest CT scans showed diffuse pulmonary infiltrates.Histopathology revealed alveolar edema and hyaline membrane formation.Transmission electron microscopy demonstrated disruption of pulmonary blood-air barrier,depletion of lamellar bodies in type Ⅱ pneumocytes,inflammatory cell infiltration,and exudation of plasma proteins and fibrin.Compared with LPS 0 h,at LPS 8 h,the oxygenation index and arterial blood pH were significantly decreased(P<0.001),while blood lactic acid and serum potassium were significantly increased(P<0.05);serum calcium and base excess were significantly decreased(P<0.05),and the lung injury score based on HE-stained lung sections was significantly increased(P<0.01).Conclusion The porcine ARDS model established by continuous LPS injection can dynamically simulate the pathophysiological characteristics and typical pathological manifestations of clinical septic ARDS,making it an effective tool to study the pathogenesis,prevention,and treatment strategies of septic ARDS.

Objective:To investigate the clinical efficacy of a self-detachable single-J internal stent drainage tube in the laparoscopic primary suture of the common bile duct for hepatolithiasis.Methods:Clinical data of 36 patients with hepatobiliary duct stones who underwent laparoscopic common bile duct primary suture combined with self-detached single J-type internal stent drainage at the First Affiliated Hospital of Xiamen University from April 2022 to April 2025 were retrospectively analyzed, including 17 males and 19 females, aged (54.3±8.7) years. All 36 patients underwent choledochoscopic stone extraction, primary common bile duct suture, and drainage with the self-expelling single-J internal stent. Total bilirubin, aspartate transaminase, and alanine transaminase before and 3 days after operation, as well as operation time, intraoperative blood loss, postoperative hospital stay, postoperative complications (bile leakage, cholangitis, intestinal obstruction, and stent retention), and stent expulsion time were collected.Results:All 36 patients successfully underwent the operation. Total bilirubin, aspartate transaminase, and alanine transaminase 3 days after operation showed significant improvement compared to preoperative levels (all P<0.05). The operation time was (86.5±22.6) min, intraoperative blood loss was 34.2 (13.7, 56.8) ml, and the postoperative hospital stay was (6.6±1.8) days. All single-J internal stents were spontaneously expelled via the anus between 6 and 21 days postoperatively, with the expulsion time of (10.7±2.1) days. No single J-type internal stent drainage tube was displaced into the bile duct in all cases, and there were no complications such as intestinal obstruction, bile leakage, cholangitis, or residual internal stent drainage tube. Conclusion:The self-detachable single-J internal stent drainage tube has been applied in the laparoscopic primary suture of the common bile duct for patients with hepatolithiasis, which demonstrated a good safety and effectiveness.

Objective:To observe the improving effect of acupuncture and Tuina(Chinese therapeutic massage)combined with Ba Duan Jin(Eight-brocade Exercise)on motor function in patients with Parkinson disease(PD)in the early and middle stages.Methods:Seventy patients with early-or middle-stage PD were randomly divided into a control group and an observation group,with 35 patients in each group.The control group was given conventional treatment such as oral levodopa hydrochloride tablets;the observation group was treated with acupuncture,Tuina,and Ba Duan Jin in addition to the control group's treatment.Acupuncture and Tuina were administered twice a week,and Ba Duan Jin was performed five times a week.Each course of treatment lasted 4 weeks,and a total of 3 courses were completed.The changes in the unified Parkinson disease rating scale Ⅲ(UPDRS Ⅲ)score,Berg balance scale(BBS)score,15-meter walking speed,and 6-minute walk distance were compared between the two groups.Results:The total effective rate in the observation group was 93.6%,which was significantly higher than 45.7%in the control group(P<0.01).After 4,8,and 12 weeks of treatment,the UPDRS Ⅲ score in the observation group was significantly lower than the previous score(P<0.05);the BBS score was significantly higher than the previous score(P<0.05),and the 6-minute walk distance also significantly increased compared to the previous result(P<0.05).After 8 and 12 weeks of treatment,the 15-meter walking speed in the observation group was significantly higher than that before treatment and the previous measurement(P<0.05).In comparison with the control group,the observation group showed significantly lower UPDRS Ⅲ scores after 8 and 12 weeks of treatment(P<0.05).Additionally,after 4,8,and 12 weeks of treatment,the observation group had significantly higher BBS scores,15-meter walking speed,and the 6-minute walk distance than the control group(P<0.05).There were no significant differences in the above indicators before and after treatment in the control group(P>0.05).Conclusion:The addition of acupuncture,Tuina,and Ba Duan Jin to Western medication treatment can effectively improve motor function,balance ability,and walking ability in patients with early-or middle-stage PD.

Objective To investigate the relationship between stationing years of personnel on an island and their traditional Chinese medicine(TCM)constitution,thus providing a reference for adjusting the health status of stationed personnel,preventing and treating diseases.Methods Based on The Scale of Constitution in Chinese Medicine Questionnaire,TCM constitution of 734 personnel stationed on an island was investigated.Pearson χ2 method was used for data analysis.Results Of the 734 personnel stationed on an island 345(47.0%)were of the balanced constitution type and 389(53.0%)were of the biased constitution types.Among the people with biased constitution types,composite constitution accounted for 80.5%(313 people)and the simple accounted for the rest(19.5%,76 people).The top three types of the biased were dampness heat(15.2%),qi deficiency(14.0%),and yin deficiency(10.7%).The distribution of TCM constitution types was significantly different in terms of stationing years on the island(P<0.05).There was a significant difference in the balanced type and yin deficiency type between people with stationing time≤2 years and>8 years(P<0.05).There was a significant difference in qi deficiency type and qi depression type between people with stationing time≤2 years and>5 years(P<0.05).Compared to people with stationing time≤2 years,significant difference was found in yang deficiency type in people with stationing time ranging from 2 to 5 years and those with>8 years(P<0.05).There were significant differences in the phlegm dampness type,blood stasis type,and specific diathesis type between people with stationing time≤2 years and people with stationing time ranging from>2～5 years and>8 years(P<0.05).There were significant differences in the dampness heat type between people with stationing time≤2 years and people with stationing time ranging from>5～8 years and>8 years,between pepole with stationing time ranging from>2～5 years and people with stationing time>8 years(P<0.05).Conclusion The dampness heat type,qi deficiency type and yin deficiency type are common biased TCM constitution in personnel stationed on islands.The longer the time spent on islands,the greater the possibility of forming biased constitution.

Objective:To explore the position and length of anchor placement during the repair of anterior talofibular ligament (ATFL) in adolescents with unclosed epiphyseal plates by measuring the relevant data in three-dimensional CT.Methods:A total of 100 three-dimensional CT images of adolescent patients with unclosed epiphyseal plates were collected from the database of the Radiology Center of Renhe Hospital Affiliated to China Three Gorges University from January 1, 2017 to January 1, 2024. There were 69 males and 31 females, aged 12.38±0.90 years (range, 11-14 years), 47 on the left side and 53 on the right side, with a height of 155.72±5.84 cm (range, 145-175 cm), a weight of 48.02±5.93 kg (range, 40-72 kg), and a body mass index (BMI) of 19.77±1.61 kg/m 2 (range, 17.69-24.91 kg/m 2). The built-in measurement tool of the picture archiving and communication system (PACS) was used to measure the angle (α) between the direction of the nail placement and the longitudinal axis of the fibula, the distance between the nail placement point and the posterior edge of the fibula ( d), and the height from the nail placement point to the level of the fibula tip ( h) to evaluate the position and length of the anchor placement. Results:In adolescent patients, α was 47.50°±3.28° (range, 40.00°-56.00°), d was 17.12±1.80 mm (range, 11.70-21.90 mm), and h was 5.21±1.17 mm (range, 3.40-7.90 mm). The α, d and h of male patients were 47.48°±3.13° (range, 42.00°-56.00°), 17.49±1.54 mm (range, 14.45-21.90 mm) and 5.25±1.07 mm (range, 3.70-7.90 mm), respectively. Those of female patients were 47.55°±3.66° (range, 40.00°-53.00°), 16.30±2.07 mm (range, 11.65-20.30 mm) and 5.07±1.56 mm (range, 3.40-7.00 mm), respectively. There was a significant difference in d between male and female patients ( t=3.193, P=0.002), but there was no significant difference in α and h ( t=0.098, P=0.922; t=0.296, P=0.770). Conclusions:The safe range of anchor placement during ATFL anatomical repair in adolescents with unclosed epiphyseal plates is about 3.40-7.90 mm above the tip of fibula and 56°-90° with the longitudinal axis of fibula. Male patients with unclosed epiphyseal plates should choose anchors with a length of 14 mm and shorter, while females should choose anchors with a length of 10.8 mm.

Objective To analyze the risk factors of left atrial appendage(LAA)thrombosis in elderly patients with NVAF.Methods A total of 210 NVAF patients admitted to our hospital from January 2019 to June 2023 were enrolled in this study.Transesophageal echocardiography was applied used to detect the LAA thrombus,and then according to the presence or absence of thrombus,the patients were divided into a thrombus group(n=42)and a non-thrombus group(n=168).The indicators of routine blood test within 48 h of admission and the characteristics of LAA were recorded.Multivariate logistic regression analysis was performed to identify the risk factors related to the occurrence of LAA thrombus.Results The thrombus group exhibited sig-nificantly larger proportions of diabetes and nonparoxysmal AF,higher total bilirubin,increased left ventricular end-systolic diameter and left ventricular end-diastolic diameter values,and elevat-ed ratio of complex LAA,but lower INR and left ventricular ejection fraction value than the non-thrombus group(P＜0.05,P＜0.01).After adjusting for confounding factors,multivariate logistic regression analysis showed that diabetes(OR=3.585,95％CI:1.003-12.808,P=0.049)and complex LAA(OR=5.572,95％CI:2.101-14.777,P=0.001)were independent risk factors for LAA thrombosis.Conclusion LAA morphology and diabetes are independent risk factors for the occurrence of LAA thrombus in NVAF patients.

Public hospitals serve as the core pillar of the healthcare service system,and their economic responsibility au-dits exhibit dual attributes of serving public welfare and maintaining professional management.These audits are characterized by unique audit targets,extensive coverage,diverse methods,and high result utilization.This study focuses on the economic respon-sibility audits in public hospitals,aiming to enhance oversight quality and efficiency.It systematically analyzes the implementa-tion of audit timelines,the construction of evaluation systems,the application of audit methods,and the utilization of audit re-sults,revealing current challenges and development trends in auditing practices.To address these issues,we propose a standard-ized"quaternity"framework,including normalizing mid-term audits,standardizing evaluation systems,innovating digital-intelli-gent audits,and establishing closed-loop mechanisms for result utilization.This framework aims to provide new insights for advan-cing the standardization,intellectualization,and value optimization of economic responsibility audits in public hospitals,ultimate-ly improving supervisory efficacy in audits and supporting high-quality hospital development.