Objective To explore whether there is a causal relationship between intestinal flora and esophageal cancer. Methods Summary statistics of intestinal flora and esophageal cancer were obtained from the Genome-wide Association Studies (GWAS) database. Five methods, including inverse variance weighted (IVW), weighted median estimation, Mendelian randomization (MR)-Egger regression, single mode, and weighted mode, were used for analysis, with IVW as the main analysis method. Sensitivity analysis was used to evaluate the reliability of MR results. Results In the IVW method, Oxalobacteraceae [OR=1.001, 95%CI (1.000, 1.002), P=0.023], Faecalibacterium [OR=1.001, 95%CI (1.000, 1.002), P=0.028], Senegalimassilia [OR=1.002, 95%CI (1.000, 1.003), P=0.006] and Veillonella [OR=1.001, 95%CI (1.000, 1.002), P=0.018] were positively correlated with esophageal cancer, while Burkholderiales [OR=0.999, 95%CI (0.998, 1.000), P=0.002], Eubacterium oxidoreducens [OR=0.998, 95%CI (0.997, 0.999), P=0.038], Romboutsia [OR=0.999, 95%CI (0.998, 1.000), P=0.048] and Turicibacter [OR=0.998, 95%CI (0.997, 0.999), P=0.013] were negatively correlated with esophageal cancer. Sensitivity analysis showed no evidence of heterogeneity, horizontal pleiotropy and reverse causality. Conclusion Oxalobacteraceae, Faecalibacterium, Senegalimassilia and Veillonella increase the risk of esophageal cancer, while Burkholderiales, Eubacterium oxidoreducens, Romboutsia and Turicibacter decrease the risk of esophageal cancer. Further studies are needed to explore how these bacteria affect the progression of esophageal cancer.

Objective:To construct a dual performance management model based on data envelopment analysis (DEA),so as to assess the quality of metrological management of medical equipment,and formulate management countermeasures. Methods:The dual performance management model was constructed by adopting data envelopment analysis-banker-charnes-cooper (DEA-BCC). The evaluation indicator system was built from two dimensionalities included input performance and output performance,which can perform comprehensive evaluation meterring performance of equipment,so as to formulate three dimensional measure included improvement of management team,optimization of metrological process,and routine monitor and management for improving metrological management of equipment. A total of 183 used medical equipment of International Peace Maternity & Child Health Hospital of China welfare institute (IPMCH) from 2022 to 2023 were selected. The metrological management of 176 medical equipment from January to December 2022 adopted formulation of management countermeasures on the basis of subjective evaluation to perform management (subjective evaluation),and the metrological management of 177 medical equipment (included 170 equipment that were used in subjective evaluation) from January to December 2023 adopted formulation of management countermeasures on the basis of dual performance evaluation (dual performance evaluation). The self-made online survey questionnaire was used to investigate the recognition degree of 104 operators of clinical department,who used the equipment. Among of them,48 operators received the management method of subjective evaluation,and 56 operators received the dual performance evaluation. The metrological management performance,management effectiveness and clinical recognition degree of the two kinds of management methods for medical equipment were compared. Results:The values of standardized input performance,output performance and comprehensive performance of equipment,which adopted dual performance evaluation management,were respectively 87.74±3.61,97.19±1.70 and 1.11±0.04. Input performance of dual performance evaluation management was lower than that of subjective evaluation management method,and output performance and comprehensive performance of dual performance evaluation management were higher than these of subjective evaluation management method,and the differences of them between two methods were statistically significant (t=4.866,4.457,7.793,P<0.05). The average metrological pass rates of mechanics,thermodynamics,thermology,textiles and medical equipment of medical laboratory of using dual performance evaluation management were (97.99±1.14)％,(97.39±2.08)％,(97.43±1.87)％,(98.06±0.92)％ and (96.77±2.03)％,respectively. All of them were higher than these of using subjective evaluation management method,and the differences of them between two methods were statistically significant (t=4.431,3.232,3.324,4.928,3.352,P<0.05). The satisfaction rates of 56 operators of equipment,who adopted dual performance evaluation management,were respectively 98.21％,94.64％,96.43％,100.00％ and 98.21％ for the management system,metrological frequency,metrological items,metrological effect and service quality of metrological staffs of equipment,which were higher than these of subjective evaluation management method,and the differences of them between two methods were statistically significant (x2=7.240,5.660,6.296,6.128,12.735,P<0.05). Conclusion:The dual performance management model can control the input of metrological management of medical equipment,and enhance the output of metrological management of medical equipment,and promote the operation quality of medical equipment,and improve the level of clinical service of medical equipment.

Objective:To compare the clinical efficacy of a fixed exoskeleton robot with that of an exoskeleton walker in training the balance of stroke survivors in the subacute stage.Methods:Thirty persons with subacute stroke were divided at random into a fixed robot group (15 cases) and a walking robot group (15 cases). In addition to conventional rehabilitation treatment, the fixed robot group underwent daily 20-minute treadmill-based fixed exoskeleton robot training, 5 days a week for 2 weeks. The walking group was trained with an exoskeleton walking robot on the same schedule. Before and after the treatment, the Berg balance scale, the sitting modified functional stretch test (SMFRT), an isokinetic muscle strength test and the modified Barthel index (MBI) were used to evaluate the subjects′ global balance, self-dynamic balance, knee proprioception and ability in the activities of daily living (ADL).Results:After the treatment, both groups′ average Berg score, SMFRT extension difference, proprioceptive absolute error angle in the affected knee and MBI had improved significantly. The average SMFRT extension difference after treatment in the walker group was then significantly better than the fixed robot group′s average. However, the fixed robot group′s proprioception in the affected knee joint was then significantly better, on average, than among the walking robot group.Conclusions:Both fixed exoskeleton robot training and exoskeleton walker training can improve the balance, proprioception and ADL ability after a stroke. The former better improves dynamic balance; the latter better improves proprioception in the affected knee joint.

Objective We aimed to investigate the effects of different non-surgical embryo transfer devices,number of transferred embryos,embryo stage,and embryos obtained from different mouse strains on the efficiency of non-surgical embryo transfer in mice,and to compare the efficiencies of surgical and non-surgical embryo transfer,in order to establish a stable non-surgical embryo transfer technology system.Methods Mouse embryo transfer was carried out using non-surgical method.Results The pregnancy rates using two different non-surgical transfer devices were(75.00±0.00)％and(66.67±14.43)％,and the birth rates were(46.11±6.31)％and(18.89±0.96)％,respectively.Transfer of 10,15,and 20 embryos resulted in pregnancy rates of(66.67±11.55)％,(80.00±0.00)％,and(66.67±23.09)％,and birth rates of(29.33±4.16)％,(38.67±4.81)％,and(17.00±3.46)％,respectively.When blastocysts and morulae were transferred non-surgically,the resulting pregnancy rates were(80.00±0.00)％and(46.67±11.55)％and the birth rates were(38.67±4.81)％and(10.22±2.77)％,respectively.Four strains(C57BL/6J,ICR,genetically modified mice A,genetically modified mice B)were used as donors for non-surgical embryo transfer,with resulting pregnancy rates of(66.67±11.55)％,(80.00±0.00)％,(73.33±11.55)％,and(80.00±0.00)％,and birthrates of(26.67±2.67)％,(38.67±4.81)％,(32.00±3.53)％,and(29.34±2.31)％,respectively.Fifteen pseudo-pregnant mice were transplanted surgically and 15 were transplanted non-surgically,with pregnancy rates of(80.00±0.00)％and(86.67±11.55)％,and birth rates of(38.67±4.81)％and(36.00±5.82)％,respectively.Conclusions Transfer device A resulted in a higher birth rate in this study.The embryo transfer efficiency was higher when 15 embryos were transferred into unilateral uterine horns of pseudo-pregnant 2.5-day recipients.Blastocyst-stage embryo transfer was more efficient than morula-stage transfer.There was no significant difference in efficiency between surgical and non-surgical embryo transfer procedures.

As an important and fundamental resource of scientific research,laboratory animals have become essential tools for the continuous advancements in life sciences,medical research,drug development,and other fields.With the development of related laws and regulations,the welfare of laboratory animals is increasingly valued by the general public and international research communities alike.To ensure the welfare of laboratory animals,the ethical review and conduct of laboratory animal practitioners should be standardized,incorporating and adapting advanced international practices with those in China.This article primarily outlines the process for reviewing and approving animal use protocols,along with the standards for evaluation,with the aim of providing a reference for researchers writing animal use protocols and for International Animal Care and Use Committee members conducting ethical reviews of laboratory animal welfare.

Objective We aimed to investigate the effects of different non-surgical embryo transfer devices,number of transferred embryos,embryo stage,and embryos obtained from different mouse strains on the efficiency of non-surgical embryo transfer in mice,and to compare the efficiencies of surgical and non-surgical embryo transfer,in order to establish a stable non-surgical embryo transfer technology system.Methods Mouse embryo transfer was carried out using non-surgical method.Results The pregnancy rates using two different non-surgical transfer devices were(75.00±0.00)％and(66.67±14.43)％,and the birth rates were(46.11±6.31)％and(18.89±0.96)％,respectively.Transfer of 10,15,and 20 embryos resulted in pregnancy rates of(66.67±11.55)％,(80.00±0.00)％,and(66.67±23.09)％,and birth rates of(29.33±4.16)％,(38.67±4.81)％,and(17.00±3.46)％,respectively.When blastocysts and morulae were transferred non-surgically,the resulting pregnancy rates were(80.00±0.00)％and(46.67±11.55)％and the birth rates were(38.67±4.81)％and(10.22±2.77)％,respectively.Four strains(C57BL/6J,ICR,genetically modified mice A,genetically modified mice B)were used as donors for non-surgical embryo transfer,with resulting pregnancy rates of(66.67±11.55)％,(80.00±0.00)％,(73.33±11.55)％,and(80.00±0.00)％,and birthrates of(26.67±2.67)％,(38.67±4.81)％,(32.00±3.53)％,and(29.34±2.31)％,respectively.Fifteen pseudo-pregnant mice were transplanted surgically and 15 were transplanted non-surgically,with pregnancy rates of(80.00±0.00)％and(86.67±11.55)％,and birth rates of(38.67±4.81)％and(36.00±5.82)％,respectively.Conclusions Transfer device A resulted in a higher birth rate in this study.The embryo transfer efficiency was higher when 15 embryos were transferred into unilateral uterine horns of pseudo-pregnant 2.5-day recipients.Blastocyst-stage embryo transfer was more efficient than morula-stage transfer.There was no significant difference in efficiency between surgical and non-surgical embryo transfer procedures.

As an important and fundamental resource of scientific research,laboratory animals have become essential tools for the continuous advancements in life sciences,medical research,drug development,and other fields.With the development of related laws and regulations,the welfare of laboratory animals is increasingly valued by the general public and international research communities alike.To ensure the welfare of laboratory animals,the ethical review and conduct of laboratory animal practitioners should be standardized,incorporating and adapting advanced international practices with those in China.This article primarily outlines the process for reviewing and approving animal use protocols,along with the standards for evaluation,with the aim of providing a reference for researchers writing animal use protocols and for International Animal Care and Use Committee members conducting ethical reviews of laboratory animal welfare.

Objective To investigate the composition ratios and trends of different etiologies after liver biopsy for patients with unexplained liver diseases.Methods A retrospective analysis was performed for the etiology of 960 patients with unexplained liver diseases who were hospitalized and underwent liver biopsy in The Third Affiliated Hospital of Sun Yat-Sen University from January 2011 to December 2020,and the etiologies were categorized by year and age group.The chi-square test was used for comparison of categorical data between multiple groups,and the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups.Results There was a tendency of increase in the overall composition ratio of unexplained liver diseases over the past decade.The leading diagnosis after liver biopsy was autoimmune liver disease(AILD)in 306 patients(31.9%),followed by nonalcoholic fatty liver disease(NAFLD)in 95 patients(9.9%)and drug-induced liver disease(DILI)in 82 patients(8.5%),and there were still 320 patients with undetermined causes(33.3%).There were significant differences in sex ratio and median age distribution between the patients with different etiologies(sex ratio:χ2=155.36,P<0.001;median age distribution:H=182.48,P<0.001).AILD had been the leading etiology in 2011-2020,and there was a tendency of reduction in the composition ratio of AILD(χ2=24.40,P<0.001).NAFLD accounted for the highest proportion of 17.6%in the adolescent stage,while AILD accounted for the highest proportion of 17.8%,47.3%,and 56.3%,respectively,in the young,middle-aged,and elderly stages.Conclusion There is a tendency of increase in the composition ratio of unexplained liver diseases in patients undergoing liver biopsy,with AILD being the main disease diagnosed after liver biopsy,followed by NAFLD and DILI,but one-third of the patients still have an unclear etiological diagnosis.

Objective To investigate the composition ratios and trends of different etiologies after liver biopsy for patients with unexplained liver diseases.Methods A retrospective analysis was performed for the etiology of 960 patients with unexplained liver diseases who were hospitalized and underwent liver biopsy in The Third Affiliated Hospital of Sun Yat-Sen University from January 2011 to December 2020,and the etiologies were categorized by year and age group.The chi-square test was used for comparison of categorical data between multiple groups,and the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups.Results There was a tendency of increase in the overall composition ratio of unexplained liver diseases over the past decade.The leading diagnosis after liver biopsy was autoimmune liver disease(AILD)in 306 patients(31.9%),followed by nonalcoholic fatty liver disease(NAFLD)in 95 patients(9.9%)and drug-induced liver disease(DILI)in 82 patients(8.5%),and there were still 320 patients with undetermined causes(33.3%).There were significant differences in sex ratio and median age distribution between the patients with different etiologies(sex ratio:χ2=155.36,P<0.001;median age distribution:H=182.48,P<0.001).AILD had been the leading etiology in 2011-2020,and there was a tendency of reduction in the composition ratio of AILD(χ2=24.40,P<0.001).NAFLD accounted for the highest proportion of 17.6%in the adolescent stage,while AILD accounted for the highest proportion of 17.8%,47.3%,and 56.3%,respectively,in the young,middle-aged,and elderly stages.Conclusion There is a tendency of increase in the composition ratio of unexplained liver diseases in patients undergoing liver biopsy,with AILD being the main disease diagnosed after liver biopsy,followed by NAFLD and DILI,but one-third of the patients still have an unclear etiological diagnosis.

Objective:To observe and analyze the abnormal gait characteristics and lower limb kinematic chain in patients with bilateral moderate-to-severe hallux valgus(HV)during adaptive walking.Method:From September 2022 to August 2023,33 patients with moderate-and-severe HV were selected from the department of arthrology,Wangjing Hospital,Chinese Academy of Traditional Chinese Medicine and en-rolled in the observation group.A group of 29 healthy subjects were matched and enrolled in the control group.DC-G-150-F2 three-dimensional gait analysis system was used to collect gait characteristics and lower limb motion chain of two groups during a 10m adaptive walking test.Temporal-spatial gait parameters and ki-nematic changes in the hip,knee,and ankle joints were observed and analyzed.Result:The gait time-space parameters of left and right support phase,total double support phase,left lateral foot deviation angle,step length,stride length and pace in the observation group were significantly lower than those in the control group(P＜0.05).In contrast,the time-space parameters of left and right swing phase and stride frequency in the observation group were significantly higher than those in the control group(P＜0.05).The two groups had no significant difference in right lateral foot deviation angle and step width(P＞0.05).The range of flexion and extension of the right hip joint,rotation of the left hip joint,rotation of the left and right knee joint and flexion and extension of the left and right ankle joint in the observation group were significantly lower than those in the control group(P＜0.05).There were no significant differences be-tween the two groups in the range of motion of left hip flexion and extension,right hip rotation,left versus right hip spreading,left versus right knee flexion and extension,and left versus right ankle rotation(P＞0.05).However,the range of motion of right hip rotation and right knee flexion and extension was lower than that of the control subjects(P=0.084,P=0.093).Conclusion:Gait changes in patients with bilateral moderate-to-severe bunions are characterized by shortened sin-gle and double support phases,prolonged swing phase,increased step frequency,reduced step length and stride length,and a"broken stride and slow catching up"walking pattern.The range of motion of each lower limb joint in the sagittal plane and horizontal plane is reduced,resulting in a rigid and twisted state through-out the lower limb kinematic chain.