ObjectiveTo observe the short-term and long-term efficacy of traditional Chinese medicine （TCM） surgical operations in treating mixed hemorrhoids. MethodsA multi-center retrospective cohort study was conducted， collecting clinical data from 17，831 mixed hemorrhoid surgery patients in 8 top-tier TCM hospitals in Jiangsu Province. Standardized and structured datasets were obtained through artificial intelligence models. Patients who underwent western surgical treatment were categorized into the western surgery group （11,646 cases）， and those receiving TCM surgical operations were categorized into the TCM surgery group （6185 cases）. Propensity score matching （1∶1 matching） was used to balance baseline data between groups. The primary outcome was the one-year recurrence rate， and secondary outcomes included the main symptoms （rectal bleeding， degree of prolapse） and secondary symptoms （anal distension， anal edema， wound secretion and exudation， anal stenosis， residual skin tags， perianal itching， and anal pain） measured on days 7， 28， and 60 after discharge. ResultsAfter matching， 2194 patients were included in each group. Symptom scores showed that at 28 days after discharge， the TCM surgical group had superior improvement in rectal bleeding ［OR=5.786， 95%CI （3.092，10.827）］， degree of prolapse ［OR=4.510， 95%CI （1.649，12.333）］， and anal edema ［OR=3.188， 95%CI （1.295，7.845）］ compared to the western surgical group. At 60 days post-discharge， the TCM group still showed advantages in improving rectal bleeding ［OR=5.237， 95%CI （1.077，25.464）］ and anal pain ［OR=11.697， 95%CI （1.186，115.336）］ （P＜0.05）. Long-term follow-up showed that the one-year recurrence rate in the TCM surgery group was 1.1% （8/726）， while that in the western surgery group was 2.3% （10/444）， with no statistically significant difference between the two groups （P＞0.05）. ConclusionBased on real-world data， TCM surgical treatment for mixed hemorrhoids shows significant short-term symptom improvement， particularly in terms of hemostasis， reducing swelling， and alleviating prolapse of anal masses.

Objective To investigate serum HCV-RNA detection rate in patients with positive hepatitis C virus (HCV) immunoglobulin G (IgG) antibody, and to analyze the related factors of HCV-RNA detection in patients with positive HCV IgG antibody by logistic regression analysis. Methods A retrospective study was conducted on 500 patients with positive HCV IgG antibody. The positive rate of HCV-RNA was counted. Logistic regression analysis was adopted to analyze the related factors of HCV-RNA detection in HCV IgG antibody positive population. Results A total of 317 patients with positive HCV-RNA detection were included in serum HCV-RNA positive group (n=317), and 183 patients with negative HCV-RNA detection were enrolled as serum HCV-RNA negative group (n=183). The diagnosis rate of HCV infection was 63.40% (317/500). Logistic regression analysis showed that abnormal levels of serum ALT, AST, GGT, TBIL, HCV IgG antibody, prothrombin time, and the presence of clinical symptoms were independently correlated with the detection of HCV-RNA in HCV IgG antibody positive individuals (P<0.05). Established 7-factor prediction models and created a nomogram. The chi-square value was 0.586, and P = 0.89 > 0.05. The ROC curve was plotted using pROC, and the area under the ROC curve was 0.912. Conclusion Among the population positive for HCV IgG antibody, the detection rate of serum HCV-RNA is high. Abnormal levels of ALT, AST, GGT, TBIL, IgG antibody, prothrombin time and clinical symptoms are the related factors for the detection of HCV-RNA. These indicators provide a reference for the clinical judgment of the real infection risk of HCV IgG positive individuals.

ObjectiveTo analyze the distribution characteristics of traditional Chinese medicine （TCM） syndrome elements in different risk populations of heart failure complicated with type 2 diabetes. MethodsClinical data of 675 type 2 diabetes patients were retrospectively collected. Lasso-multivariate Logistic regression was used to construct a clinical prediction nomogram model. Based on this， 441 non-heart failure patients were divided into a low-risk group （325 cases） and a high-risk group （116 cases） according to the median risk score of heart failure complicated with type 2 diabetes. TCM diagnostic information （four diagnostic methods） was collected for both groups， and factor analysis was applied to summarize the distribution of TCM syndrome elements in different risk populations. ResultsLasso-multivariate Logistic regression analysis identified age， disease duration， coronary heart disease， old myocardial infarction， arrhythmia， absolute neutrophil count， activated partial thromboplastin time， and α-hydroxybutyrate dehydrogenase as independent risk factors for heart failure complicated with type 2 diabetes. These were used as final predictive factors to construct the nomogram model. Model validation results showed that the area under the curve （AUC） of the receiver operating characteristic （ROC） curve for the modeling group and validation group were 0.934 and 0.935， respectively. The Hosmer-Lemeshow test （modeling group P = 0.996， validation group P = 0.121） indicated good model discrimination. Decision curve analysis showed that the curves for All and None crossed in the upper right corner， indicating high clinical utility. The low-risk and high-risk groups each obtained 14 common factors. Preliminary analysis revealed that the main disease elements in the low-risk group were qi deficiency （175 cases， 53.85%）， dampness （118 cases， 36.31%）， and heat （118 cases， 36.31%）， with the primary locations in the spleen （125 cases， 38.46%） and lungs （99 cases， 30.46%）. In the high-risk group， the main disease elements were yang deficiency （73 cases， 62.93%）， blood stasis （68 cases， 58.62%）， and heat （49 cases， 42.24%）， with the primary locations in the kidney （84 cases， 72.41%） and heart （70 cases， 60.34%）. ConclusionThe overall disease characteristics in different risk populations of type 2 diabetes patients with heart failure are a combination of deficiency and excess， with deficiency being predominant. Deficiency and heat are present throughout. The low-risk population mainly shows qi deficiency with dampness and heat， related to the spleen and lungs. The high-risk population shows yang deficiency with blood stasis and heat， related to the kidneys and heart.

Coronavirus is the largest RNA virus with known genome so far,among which porcine coronavirus is an important pathogen causing acute diarrhea in piglets.Due to its highly mutable RNA nature,this virus poses a substantial challenge for disease prevention and control,leading to substantial annual economic losses within China's swine industry.The analysis of the mechanism of RNA synthesis of coronaviruses is helpful for understanding the genetic variation of coronaviruses and screening antiviral drugs.At present,more in-depth studies mainly focus on Murine coronavir-us(MHV)and human Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).In order to investigate the replication mechanism of porcine coronaviruses,this article takes MHV,SARS-CoV-2 and other coronaviruses as references to summarises the mechanism of regulating viral rep-lication in the non-coding region of porcine coronaviruses such as Porcine epidemic diarrhea virus(PEDV),Transmissible gastroenteritis virus(TGEV),Porcine deltacoronavirus(PDCoV),and Swine acute diarrhea syndrome coronavirus(SADS-CoV).Placed a specific emphasis on the func-tional roles of conserved motifs and secondary structures within the 5'UTR in facilitating viral rep-lication,elucidated how conserved structures in the 3'UTR regulate the same process.The signifi-cance of the interaction between the non-coding region of the virus and the host were discussed,and variations in the viral 5'UTR and 3'UTR were scrutinized,thereby establishing a solid theoret-ical foundation for the development of antiviral drugs that target UTRs and high titer vaccine can-didate strains.

Objective:To investigate the gut microbiota and metabolic profiles of patients with neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), and to identify potential microbial biomarkers with diagnostic values.Methods:A total of 16 NMOSD patients, 6 MOGAD patients, and 22 age- and sex-matched healthy controls were recruited from Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology since June 2024. Fecal samples were subjected to metagenomic sequencing and untargeted metabolomics. Differential microbes were identified using LEfSe (linear discriminant analysis effect size), and receiver operating characteristic curve analysis was performed to evaluate diagnostic potential. Spearman correlation analysis was used to assess relationships between key microbes, metabolites, and serum antibody titers.Results:Distinct alterations in gut microbiota were observed in both disease groups compared with healthy controls. Ligilactobacillus salivarius was significantly enriched in both NMOSD and MOGAD patients and exhibited robust diagnostic accuracy (area under the curve=0.779 P=0.005). Metabolomics revealed that levels of ethosuximide and lysine-proline were elevated, while free fatty acids (15∶1) and 5, 6-dihydrothymine were reduced in the disease groups. Analysis results indicated that Ligilactobacillus salivarius abundance was positively correlated with aquaporin 4 antibody titers in NMOSD patients ( r=0.522, P=0.046). Conclusions:Patients with NMOSD and MOGAD have characteristic alterations in gut microbial and metabolic profiles.

Objective:To summarize the initial experience of 5G-ultra-long-distance robotic hepatectomy.Methods:This is a retrospective case series study. The clinical information from 5 cases of 5G ultra-long-distance robot-assisted hepatectomy performed was collected from June 2023 to October 2024, in collaboration between Sir Run Run Shaw Hospital, Zhejiang University School of Medicine in Hangzhou and Alaer Hospital, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine in Alaer, located 4 600 km apart. The patients comprised 1 male and 4 females, aged from 36 to 59 years, with an average age of 48 years. Their body mass index ranged from 20.4 to 30.9 kg/m2, with an average of 24.62 kg/m2. Preoperatively, 5 patients were diagnosed with liver disease requiring hepatectomy. The operations used 5G ultra-remote four-arm endoscopic robot surgery system. The remote control room was located in Sir Run Run Shaw Hospital (Hangzhou, Zhejiang), and the robot operating room was located in Alaer Hospital (Alaer, Xinjiang). The wired network relied on 60 Mb/s high-speed public Internet special line (China Telecom). In order to ensure the security of data transmission, the system implemented a double-layer encryption strategy for the wired network, and carried out strict debugging and verification for both the wired and wireless networks. Perioperative data and information on network performance were collected for 5 patients.Results:The surgical duration of the 5 cases of 5G ultra-long-distance robot-assisted hepatectomy ranged from 49 to 342 minutes, with an average of 184 minutes. Intraoperative blood loss varied from 5 to 800 ml, averaging 183 ml. Network performance was evaluated during the surgery, revealing an average network latency of 108.2 ms, with no significant lag or delay observed during any of the procedures. All patients recovered smoothly, with a postoperative hospital stay ranging from 5 to 10 days, averaging 7.2 days. Postoperative complications included 1 case of hypoproteinemia and 1 case of pleural effusion. Pathological examination confirmed that all cases suffered benign liver diseases (three patients with hepatic hemangioma, one with regenerative nodule in cirrhosis, and one with hepatolithiasis and choledocholithiasis).Conclusion:The preliminary exploration of clinical practice indicated that 5G-ultra-long-distance robot-assisted surgery is feasible for hepatectomy, with no severe complications affecting patients′ recovery.

Objective:To investigate the feasibility of transcatheter edge-to-edge repair (TEER) using a short-clip strategy for patients with moderate-to-severe or greater degenerative mitral regurgitation caused by commissural prolapse.Methods:This retrospective study included patients with severe mitral regurgitation secondary to commissural prolapse who underwent TEER at the Second Affiliated Hospital of Zhejiang University School of Medicine between September 2022 and July 2024. Preoperative clinical and imaging data, intraoperative details, procedural outcomes, and 1-month postoperative follow-up results were collected.Results:A total of 19 patients were enrolled, aged (74.1±6.1) years, including 12 males. Among them, 10 patients had external commissural prolapse, and 9 patients had internal commissural prolapse. Preoperatively, all patients exhibited severe mitral regurgitation (4+), with an effective regurgitant orifice area of (0.55±0.17) cm2, left atrial volume of (104.77±36.57) ml, left ventricular end-diastolic volume of (102.29±32.47) ml, left ventricular end-diastolic dimension of (5.34±0.59) mm, and prolapse width of (1.18±0.34) cm. All procedures utilized short clips (NTR or NTW clips) to target the prolapsed commissural region and were completed successfully without intraoperative complications. At 1-month follow-up, no mortality, stroke, single-leaflet device attachment, myocardial infarction, or unplanned mitral reintervention occurred. Mitral regurgitation severity improved to ≤2+ in all patients, with left atrial volume of (74.49±33.83) ml, left ventricular end-diastolic volume of (85.90±18.05) ml, and left ventricular end-diastolic dimension of (4.93±0.37) mm (all P<0.05). Conclusion:The short-clip strategy, focusing on precise clip placement at the commissural interface, is feasible and effective for TEER in patients with severe mitral regurgitation due to commissural prolapse.

Objective To explore the potential cross-sectional categories of health promotion behaviors in patients after PCI and analyze their influencing factors,so as to provide a reference for formulating targeted interventions to improve health promotion behaviors in patients after PCI.Methods A total of 242 patients who underwent PCI surgery in the Department of Cardiovascular Medicine of a tertiary hospital in Sichuan Province from February to May 2024 were selected by convenience sampling method.The general information questionnaire,the health promotion lifestyle scale,the health literacy scale for patients with chronic diseases,and the perceived social support scale were used to conduct the survey.The potential profile analysis of health promotion behaviors in patients after PCI was carried out,and the influencing factors were explored by univariate analysis and multiple logistic regression analysis.Results A total of 230 patients after PCI completed the study.The results of potential profile analysis showed that the health promotion behaviors of patients after PCI could be divided into three potential profiles:"low health promotion-poor behavior group"(n=71,30.9%),"medium health promotion behavior group"(n=53,23.0%),and"high health promotion-positive behavior group"(n=106,46.1%).Logistic regression analysis showed that medical payment methods,the number of chronic diseases,whether they had received chronic disease-related knowledge guidance,health literacy,and social support were the influencing factors of the potential profile of health promotion behaviors of patients after PCI(all P<0.05).Conclusion The health promotion behaviors of patients after PCI have obvious categorical characteristics.Nursing staff should formulate personalized intervention strategies according to the characteristics and influencing factors of each category,improve the health literacy and comprehension of social support of patients after PCI,and then improve their health promotion behaviors.

Objective To analyze the MRI artifact of the inner ear structure in patients with peripheral vertigo acquired by using 3D fast imaging employing steady state acquisition(3D FIESTA-C)and 3D fast spin echo(3D-Cube T2).Methods Data of 63 patients with peripheral vertigo treated in the Department of Otolaryngology,The First Affiliated Hospital of Xi'an Jiaotong University,from October 2023 to June 2024 were filtered for analysis.The patients consisted of 16 males and 47 females,aged 18 to 60 years old.Two senior radiologists independently evaluated the quality of the acquired images through the two MRI sequences.Kappa test was used to evaluate the consistency of the two radiologists' subjective judgments,and Wilcoxon signed-rank test was used to compare the image quality between each sequence.The accuracy of 3D FIESTA-C,3D-Cube T2 and combination of the two sequences was calculated in the presentation of inner ear structure.Results The overall image quality of 3D-Cube T2 was better than that of 3D FIESTA-C(Z=-11.670,P＜0.001),and the accuracy of 3D FIESTA-C combined with 3D-Cube T2 was superior to that of each sequence in demonstrating the semicircular canals.The demonstration accuracy of horizontal semicircular canal among three scan protocols was statistically different(P＜0.001).Conclusion 3D FIESTA-C has the advantage in detecting horizontal semicircular canal,and 3D-Cube T2 always provides high quality images of upper semicircular canal.Compared with each scanning sequence,3D FIESTA-C combined with 3D-Cube T2 can effectively avoid misdiagnosis or missed diagnosis of semicircular canal structures in the patients with peripheral vertigo.

Peritoneal dialysis (PD) is a crucial renal replacement therapy for end-stage renal disease (ESRD), offering significant advantages as high flexibility, hemodynamic stability, and high cost-effectiveness. However, prolonged exposure to intra-abdominal dialysate may predispose to the mechanical complication of abdominal external hernia. Abdominal external hernia may lead to various adverse clinical outcomes. In severe cases, it can progress to incarceration or even rupture, ultimately necessitating discontinuation of the therapy. The authors systematically review PD-associated abdominal external hernias, including their clinical landscape, risk factors, surgical treatment strategies and prognostic determinants. They also assess the effects of hernia repair on residual renal function, aiming to provide references for clinical decision-making.