Objective To compare the effects of sequential Exoview and Mimics three-dimensional reconstruction with fluorescence method in thoracoscopic pulmonary segmentectomy.Methods The clinical data of 160 patients with lung cancer admitted to our hospital from January 2020 to June 2023 were retrospectively analyzed.Among them,79 patients who underwent thoracoscopic pulmonary segmentectomy with the sequential Exoview three-dimensional reconstruction and fluorescence method before the operation were classified as the Exoview group,and 81 patients who underwent thoracoscopic pulmonary segmentectomy with the sequential Mimics three-dimensional reconstruction and fluorescence method before the operation were classified as the Mimics group.The surgical completion status,the coincidence rate between the number of left and right pulmonary artery branches evaluated before operation and intraoperative findings,reconstruction time,segment display effect,general indicators of operation(operation time,intraoperative blood loss,number of lymph node dissection,thoracic tube placement time,postoperative hospital stay),pulmonary function[forced expiratory volume in one second(FEV1),percentage of forced expiratory volume in one second(FEV1%)]and complications were compared between the two groups.Results All patients in the two groups successfully completed thoracoscopic pulmonary segmentectomy,and indocyanine green was injected once in each group.The operation process was roughly consistent with the preoperative simulation,and no thoracotomy was performed.There was no statistically significant difference in the resection of lung segment between the two groups of patients(P>0.05).The coincidence rate between the number of left and right pulmonary artery branches evaluated before operation and intraoperative findings in the Exoview group was higher than that in the Mimics group(P<0.05).There was no significant difference in the segment display effect between the Exoview group and the Mimics group(P>0.05).The operation time and the reconstruction time in the Exoview group were shorter those that in the Mimics group,and the intraoperative blood loss was less than that in the Mimics group(P<0.05).There was no significant difference in the number of lymph node dissection,the thoracic tube placement time,or the postoperative hospital stay between the two groups(P>0.05).There was no statistically significant difference in FEV1 or FEV1%7 days after surgery compared with those before surgery(P>0.05).The FEV1 and FEV1%of patients in the Mimics group 7 days after surgery were lower than those beforesurgery(P<0.05).There was no statistically significant difference in FEV1 or FEV1%between the Exoview group and the Mimics group before and 7 days after surgery(P>0.05).The total incidence of complications in the Exoview group was 1.27%,compared with 4.94%in the Mimics group,the difference was not statistically significant(P>0.05).Conclusion Both sequential Exoview and Mimics three-dimensional reconstruction with fluorescence method are safe and effective for thoracoscopic pulmonary segmentectomy,while Exoview has more advantages in preoperative assessment of the number of pulmonary artery branches,and it has shorter reconstruction time and operation time,with less impact on lung function.

Objective:To identify risk factors for mortality in patients with cirrhosis and portal hypertension compli-cated by esophagogastric variceal bleeding(EVB)after transjugular intrahepatic portosystemic shunt(TIPS),and to estab-lish a prediction model.Methods:Clinical data of 80 patients who underwent TIPS from March 2022 to March 2024 were retrospectively analyzed.Based on 28-day outcomes,patients were divided into survival(n=65)and death(n=15)groups.Univariate and multivariate logistic regression analyses were used to determine independent predictors,and the model's calibration and discrimination were assessed by the Hosmer-Lemeshow test and ROC curve.Results:Inde-pendent risk factors for death included Child-pugh score(OR=2.653),MELD score(OR=1.924),bleeding volume(OR=1.754),portal vein thrombosis(OR=3.247),and hepatic encephalopathy(OR=2.834).The model demonstrated good cali-bration(Hosmer-Lemeshow χ2=7.142,P=0.521)and discrimination,with an AUC of 0.873(95%CI:0.773-0.939),sensi-tivity of 83.3%,and specificity of 87.7%.Conclusion:Child-pugh score,MELD score,bleeding volume,portal vein thrombosis,and hepatic encephalopathy are independent predictors of post-TIPS mortality in cirrhotic patients with EVB.Emergency TIPS carries higher mortality risk than elective TIPS.The proposed model shows strong predictive perfor-mance and may aid in individualized prognosis assessment and therapeutic decision-making.

High myopia is a refractive abnormality characterized by excessive elongation of the eye axis.The sclera,as an important part of the eye axis regulation,plays a key role in the occurrence and development of high myopia.In this pa-per,based on the domestic and international articles,the pathological changes and related regulatory molecules of the scle-ra in high myopia were systematically summarized from the features of scleral lesions in high myopia and the gene regula-tion and signaling pathways affecting the ultrastructure and mechanical properties of the sclera,thus providing a theoretical basis for the study of the pathological mechanism of high myopia.

Ergonomic Principle for the Prevention of Work-Related Musculoskeletal Disorders Part 1: General Principles (T/WSJD 14.1-2020) is the first guideline standard for the prevention of work-related musculoskeletal disorders provided to employers and occupational health technical service institutions in China, which covers ergonomic risk factors and their hazard definition, ergonomic prevention principles, risk assessment process, risk control process and risk evaluation principles. The standard specifically clarify the specific types of adverse ergonomic risk factors and control strategies and the standard process of systematic ergonomic risk assessment, providing implementation paths and practical guidance for eliminating/reducing adverse ergonomic risks and enhance workplace environments to prevent work-related musculoskeletal disorders. This paper interprets and analyzes the background of standard establishment, formulation process, fundamental basis, and main content, etc., to provide scientific and accurate technical support for enterprise managers, labours and technical personnel of occupational health institutions to optimize the use of this standard.

Objective:To explore the structural relationship between WMSDs in the upper limbs and various risk factors in the occupational population in China, based on a large sample epidemiological survey and structural equation analysis, and to establish a structural equation model, so as to lay a foundation for the prevention and control of such diseases.Methods:The Chinese version of the Musculoskeletal Disorders Electronic Questionnaire was used to conduct a nationwide survey on the prevalence of WMSDs in the upper extremity. Six factors related to WMSDs in the upper extremity were extracted by the classification standard of adverse ergonomic factors and their source and confirmatory factor analysis, including work organization, work type, upper extremity work posture, individual factors, upper extremity fatigue and upper extremity WMSDs. The structural equation analysis was carried out and the structural equation model was established.Results:The incidence of WMSDs and fatigue in the upper limbs was 24.44% and 43.76%, respectively. The adjusted structural equation model fitting indicators were generally up to the standard (GFI=1.000, AGFI=1.000, RMSEA=0.043, NFI=0.808, TLI=0.784) . The four exogenous latent variables of work organization, work type, upper limb work posture and individual factors were correlated. There was a strong positive correlation between job type and upper limb work posture ( r=0.865) , a moderate positive correlation between work organization and job type and upper limb work posture ( r=0.570, 0.490) , and a weak negative correlation between individual factors and the other three exogenous latent variables. Upper limb work posture and individual factors had direct effects on upper limb WMSDs, and the effect coefficients were 0.10 and 0.06, respectively. Upper limb fatigue played a mediating role between work organization, work type, upper limb work posture and upper limb WMSDs. The effect coefficient was 0.46, and the composition ratios of indirect effects were 100.0%, 100.0%, and 38.3%, respectively. The direct path effect of upper limb work posture, individual factors and upper limb WMSDs was weaker than the mediating path through upper limb fatigue. Conclusion:When carrying out the prevention and control of upper limbWMSDs, it is necessary to comprehensively consider the pathogenesis path of upper limb muscle fatigue and upper limb WMSDs caused by work organization, work type, and upper limb work posture, so as to provide theoretical reference for improving the prevention and control level of such diseases.

Diabetic kidney disease(DKD)is one of the common microvascular complications of diabetes mellitus,and it has become the main cause of chronic kidney disease and end stage renal disease.Traditional Chinese medicine can delay the progress of DKD by inhibiting oxidative stress,improving renal tissue damage,restoring renal function.This paper will summarize the relationship between oxidative stress and DKD and the prevention and treatment of DKD by traditional Chinese medicine,so as to provide reference for clinical drug application,basic research and new drug research and development of DKD.

Diabetic kidney disease(DKD)is one of the common microvascular complications of diabetes mellitus,and it has become the main cause of chronic kidney disease and end stage renal disease.Traditional Chinese medicine can delay the progress of DKD by inhibiting oxidative stress,improving renal tissue damage,restoring renal function.This paper will summarize the relationship between oxidative stress and DKD and the prevention and treatment of DKD by traditional Chinese medicine,so as to provide reference for clinical drug application,basic research and new drug research and development of DKD.

The functional modulation of deep brain structures plays a crucial role in the treatment of psychiatric disorders; however, current approaches primarily rely on invasive techniques such as deep brain stimulation. Temporal Interference (TI) transcranial electrical stimulation is an emerging non-invasive neuromodulation technique capable of precisely regulating the activity of deep brain nuclei, offering an innovative and promising approach for psychiatric disorder treatment. In recent years, studies conducted on healthy individuals and patients with neurological disorders (e.g., Parkinson's disease) have provided preliminary evidence supporting the deep brain modulation capabilities of TI. Meanwhile, multiple registered clinical studies are actively investigating its potential applications in psychiatric treatment. This review systematically summarizes the fundamental principles, neuromodulatory mechanisms, and recent research advances of TI in psychiatric disorders. Additionally, it highlights key scientific issues that need to be addressed to facilitate further basic research and clinical translation in this field.

AIM To investigate the effects of Yunpi Tongchang Formula on intestinal mucosal barrier damage in rats with opioid-induced constipation(OIC)of Spleen-Kidney Yang Deficiency Syndrome.METHODS In contrast to the 10 rats of the blank group,the 50 rats of the modeling group were induced into models of OIC of Spleen-Kidney Yang Deficiency Pattern by 7 days consecutive administration of both subcutaneous loperamide injection and alternating gavage of activated carbon ice water and vinegar.Following successful modeling,rats were randomly allocated into the model group,the mosapride citrate tablet group(1.35 mg/kg),and the high-dose,medium-dose,and low-dose Yunpi Tongchang Formula groups(15.12,7.56,3.78 g/kg),with 8 mice in each group.Upon the completion of the 14 days treatment,the rats had their TCM Syndrome scores assessed;their fecal water content,initial black stool excretion time,and small intestine propulsion rate measured;their colon tissue morphology observed by HE staining;their serum levels of IL-6,TNF-α,and IL-1β detected by ELISA;their expressions of occludin and zonula occludens-1(ZO-1)in colon tissues detected by immunohistochemistry;their mRNA expressions of MyD88,TLR4 and NF-κB p65 in the colon tissues detected by RT-qPCR;and their protein expressions of MyD88,TLR4 and NF-κB p65 in the colon tissues detected by Western blot.RESULTS Compared to the blank group,the model group had higher TCM Syndrome scores(P＜0.01);lower fecal water content and small intestine propulsion rate(P＜0.05,P＜0.01);longer initial black stool excretion time(P＜0.01);more mucosal edema in colon tissue,obvious inflammatory infiltration,and glandular disorder;increased serum levels of IL-6,TNF-α and IL-1 β(P＜0.05);decreased colon expressions of ZO-1 and occludin(P＜0.01);and increased mRNA and protein expressions of TLR4,MyD88 and NF-κB p65(P＜0.01).Compared to the model group,both the medium-dose Yunpi Tongchang Formula group and the mosapride citrate tablet group demonstrated effectively reduced TCM syndrome scores(P＜0.01);increased fecal water content and small intestine propulsion rate(P＜0.05,P＜0.01);and shorter initial black stool excretion time(P＜0.01);improved colon mucosal edema and inflammatory infiltration;decreased serum levels of IL-6,TNF-α and IL-1β(P＜0.01);upregulated protein expressions of ZO-1 and occludin(P＜0.01);and downregulated mRNA and protein expressions of TLR4,MyD88 and NF-κB p65(P＜0.05,P＜0.01).CONCLUSION Yunpi Tongchang Formula significantly ameliorates constipation symptoms in OIC rat models of Spleen-Kidney Yang Deficiency Syndrome because of its efficacy in attenuating intestinal inflammation and preserving the integrity of intestinal epithelial barrier structure,with its mechanistic action in downregulating TLR4/MyD88/NF-κB signaling pathway activation.

Purpose: The aim of this study was to investigate the feasibility of an intelligent handheld ultrasound (US) device for assisting non-expert general practitioners (GPs) in detecting carotid plaques (CPs) in community populations. Methods: This prospective parallel controlled trial recruited 111 consecutive community residents. All of them underwent examinations by non-expert GPs and specialist doctors using handheld US devices (setting A, setting B, and setting C). The results of setting C with specialist doctors were considered the gold standard. Carotid intima-media thickness (CIMT) and the features of CPs were measured and recorded. The diagnostic performance of GPs in distinguishing CPs was evaluated using a receiver operating characteristic curve. Inter-observer agreement was compared using the intragroup correlation coefficient (ICC). Questionnaires were completed to evaluate clinical benefits. Results: Among the 111 community residents, 80, 96, and 112 CPs were detected in settings A, B, and C, respectively. Setting B exhibited better diagnostic performance than setting A for detecting CPs (area under the curve, 0.856 vs. 0.749; P<0.01). Setting B had better consistency with setting C than setting A in CIMT measurement and the assessment of CPs (ICC, 0.731 to 0.923). Moreover, measurements in setting B required less time than the other two settings (44.59 seconds vs. 108.87 seconds vs. 126.13 seconds, both P<0.01). Conclusion Using an intelligent handheld US device, GPs can perform CP screening and achieve a diagnostic capability comparable to that of specialist doctors.