Objective:To explore the efficacy and surgical seletion or timing for elderly patients(≥85 years) with inguinal hernia.Methods:A retrospective analysis was conducted on clinical data of 323 patients aged ≥ 85 years who underwent surgical treatment for inguinal hernia admitted to the Department of General Surgery of East China Hospital Affiliated to Fudan University from Jan 2020 to Dec 2024.There were 308 males (95.36%) and 15 females (4.64%), with an average age of (87.83 ± 1.91) years. The ASA classification included 15 cases of grade Ⅰ, 209 cases of grade Ⅱ, 97 cases of grade Ⅲ, and 2 cases of grade Ⅳ.Results:Among the 323 patients, there were 20 bilateral hernia cases and 303 unilateral cases. Ninety-seven cases were of scrotal hernia. Surgical methods included 11 TAPP cases, 10 TEP cases, 297 Lichtenstein cases, 3 open suture repair and 2 laparoscopic suture repair. Four cases underwent intestinal resection and in two cases enterostomy was performed. The median follow-up after surgery was 3 months. Hernia recurrence was found in 2 cases, seroma in 14 cases, chronic pain in 2 cases, SSI in 11 cases, intestinal obstruction in 1 case, urinary retention in 3 cases, pulmonary infection in 9 cases, urinary tract infection in 2 cases, cardiovascular and cerebrovascular accidents in 2 cases. The incidence of postoperative complications in the emergency group was significantly higher than that in the elective group. Three deaths occurred within 30 days after surgery, all of which were in the emergency group.Conclusions:Selective inguinal hernia repair is safe and effective for over 85 year old patients with inguinal hernia. The incidence of emergency surgical complications and mortality is significantly increased. Lichtenstein surgery under local anesthesia or regional block anesthesia is the preferred method.

Objective:To explore the effect of integrating clinical situational mode into experimental teaching of Pathogenic Biology,integrate early clinical concept into experimental teaching,and enhance students'ability to analyze and solve clinical problems,so as to improve the quality of teaching.Methods:A total of 179 students from class 7 to 12 of grade 2022 majoring in clinical medicine of a medical college were enrolled as the research subjects.Among them,88 students from class 7 to 9 were selected as the control group and comprehensive experimental content teaching according to the traditional teaching mode were carried out.A total of 91 students from class 10 to 12 were selected as the experimental group and experimental teaching system of Pathogenic Biology focusing on clinical case analysis and discussion,comprehensive experimental development,and diagnosis and treatment of infectious diseases were carried out.The results of process evaluation and summative evaluation were compared between the two groups,and the effect of integrating clinical situation mode into experimental teaching on improving the learning ability of students in the experimental group was evaluated in the form of a questionnaire survey.Results:Academic performances of process evaluation and summative evaluation in the experimental group were higher than those in the control group(P＜0.01).The integration of clinical situational mode into Pathogenic Biology significantly improved students'learning interest,theoretical comprehension,and cultivation of"early clinical"thinking.Conclusion:The integration of clinical situational mode into Pathogenic Biology experiment course can effectively motivated students'learning enthusiasm and cultivate high-quality medical talents with innovative ability and clinical thinking.

Sarcopenia is an age-related skeletal muscle degenerative disease.Physiologically aging mice are the most commonly used animal model for studying sarcopenia.As sarcopenia is characterized by decreased skeletal muscle mass and reduced muscle strength,exercise performance as a reflection of muscle function is widely used to evaluate sarcopenia.Methods of evaluating the motor function of sarcopenia mouse models are generally designed based on muscle endurance,muscle strength,coordination,and balance.The method include tests such as treadmill exhaustion,voluntary wheel use,grip strength,horse grid,bars and balance beam tests.By collating recent publications,we have systematically summarized the method used for evaluating motor function,including the tests'principles,procedures,evaluation indexes,advantages,and disadvantages.We then propose an operational program for evaluating the sarcopenia phenotype,which will be of help to researchers wishing to choose evaluation method appropriate to their specific research purposes.Further innovative technology for assessing motor function that could be instructive in the evaluation of skeletal muscle function and diagnosis of sarcopenia is summarized.

Objective:To explore the effect of integrating clinical situational mode into experimental teaching of Pathogenic Biology,integrate early clinical concept into experimental teaching,and enhance students'ability to analyze and solve clinical problems,so as to improve the quality of teaching.Methods:A total of 179 students from class 7 to 12 of grade 2022 majoring in clinical medicine of a medical college were enrolled as the research subjects.Among them,88 students from class 7 to 9 were selected as the control group and comprehensive experimental content teaching according to the traditional teaching mode were carried out.A total of 91 students from class 10 to 12 were selected as the experimental group and experimental teaching system of Pathogenic Biology focusing on clinical case analysis and discussion,comprehensive experimental development,and diagnosis and treatment of infectious diseases were carried out.The results of process evaluation and summative evaluation were compared between the two groups,and the effect of integrating clinical situation mode into experimental teaching on improving the learning ability of students in the experimental group was evaluated in the form of a questionnaire survey.Results:Academic performances of process evaluation and summative evaluation in the experimental group were higher than those in the control group(P＜0.01).The integration of clinical situational mode into Pathogenic Biology significantly improved students'learning interest,theoretical comprehension,and cultivation of"early clinical"thinking.Conclusion:The integration of clinical situational mode into Pathogenic Biology experiment course can effectively motivated students'learning enthusiasm and cultivate high-quality medical talents with innovative ability and clinical thinking.

Objective To explore differentially expressed proteins in the serum exosomes of acute myeloid leukemia(AML)patients and healthy controls by using the proteomics method,and provide new biomarker for the diagnosis and treatment of AML.Methods A total of 76 AML patients diagnosed and treated in the First People's Hospital of Honghe State from November 2022 to June 2024 were selected as the experimental group,and 60 healthy physical examination participants were selected as the control group.Tandem Mass Tag(TMT)labeled proteomics was used to identify the differences in protein expression in serum exosomes between the experimental and control groups,and the identified differentially expressed proteins were subjected to bioinformatics analysis.Western-Blot was used to verify the differentially expressed proteins.Results Comparedwith healthy controls,146 aberrantly expressed proteinswere detected in serum exosomes of AML patients,of which 89 were up-regulated and 57 were down-regulated.Among them,Alpha-1-antichymotrypsin(α1-ACT),Angiogenin(ANG),Vitronectin(VIT),Clusterin(Clu),Fibronectin(FN),Keratin type I cytoskeletal-18(KRT18),and actinin alpha4(ACTN4)showed changed significantly.Gene ontology(GO)and Kyoto encyclopedia of genes and genomes(KEGG)enrichment analysis indicated that differentially expresseproteins were involved in biological processes such as neutrophil immunity,neutrophil degranulation,neutrophil activation immune response,and protein activation cascade,significantly enriched in 25 biological pathways including complement and coagulation cascades,extracellular matrix(ECM)-receptor interaction,and hypoxia-inducible factor-1(HIF-1)signaling pathways.Western-blot validation results showed that compared with the control group,the expression levels of ANG,Clu and FN in the serum exosomes of AML patients were significantly increased,while the expression level of ACTN4 was significantly decreased,with statistically significant differences(t=-11.854～18.569,all P<0.05).The expression levels of ANG and FN were correlated with white blood cell count(F=8.888,7.818,all P<0.05)and cytogenetics(F=8.619,7.983,P<0.05).The expression level of Clu protein was correlated with white blood cell count(F=2.571,P<0.05),but not significantly associated with cytogenetics(F=1.886,P>0.05).ANG,FN and Clu showed no significant correlation with FAB classification(F=0.175,0.434,0.042,all P>0.05).Conclusion The expression of exosomal proteins in the serum of AML patients compared to healthy individuals are significant differences,which may serve as serological markers for the diagnosis and treatment of AML.

Objective To achieve non-invasive and precise prediction of mean arterial pressure(MAP)based on a fully convolutional neural network(FCNN).Methods A high-precision blood pressure data acquisition system compliant with international metrological standards was used in conjunction with the'gold standard'auscultation method to collect blood pressure and pulse waveform data from patients.True MAP values were derived via Gaussian fitting of pulse waveform data,constructing a traceable dataset.The FCNN was applied to this dataset to develop a novel MAP prediction method.Additionally,the predictive accuracy of the FCNN was compared with linear regression and conventional empirical formulas.Results The mean squared errors(MSE)for MAP prediction using the FCNN,linear regression,and empirical formulas were 19.76,21.40,and 30.97,respectively.The coefficients of determination(R2)were 0.90,0.89,and 0.84,and the prediction accuracies were 0.90,0.89,and 0.85,respectively.Conclusions By using systolic blood pressure,diastolic blood pressure,age,and arm circumference as input parameters,the FCNN-based MAP prediction method significantly reduces the bias of empirical formulas.This approach not only improves the accuracy of hemodynamic boundary condition acquisition but also contributes to refining the metrological traceability system of non-invasive blood pressure measurement.

Objective To achieve non-invasive and precise prediction of mean arterial pressure(MAP)based on a fully convolutional neural network(FCNN).Methods A high-precision blood pressure data acquisition system compliant with international metrological standards was used in conjunction with the'gold standard'auscultation method to collect blood pressure and pulse waveform data from patients.True MAP values were derived via Gaussian fitting of pulse waveform data,constructing a traceable dataset.The FCNN was applied to this dataset to develop a novel MAP prediction method.Additionally,the predictive accuracy of the FCNN was compared with linear regression and conventional empirical formulas.Results The mean squared errors(MSE)for MAP prediction using the FCNN,linear regression,and empirical formulas were 19.76,21.40,and 30.97,respectively.The coefficients of determination(R2)were 0.90,0.89,and 0.84,and the prediction accuracies were 0.90,0.89,and 0.85,respectively.Conclusions By using systolic blood pressure,diastolic blood pressure,age,and arm circumference as input parameters,the FCNN-based MAP prediction method significantly reduces the bias of empirical formulas.This approach not only improves the accuracy of hemodynamic boundary condition acquisition but also contributes to refining the metrological traceability system of non-invasive blood pressure measurement.

Sarcopenia is an age-related skeletal muscle degenerative disease.Physiologically aging mice are the most commonly used animal model for studying sarcopenia.As sarcopenia is characterized by decreased skeletal muscle mass and reduced muscle strength,exercise performance as a reflection of muscle function is widely used to evaluate sarcopenia.Methods of evaluating the motor function of sarcopenia mouse models are generally designed based on muscle endurance,muscle strength,coordination,and balance.The method include tests such as treadmill exhaustion,voluntary wheel use,grip strength,horse grid,bars and balance beam tests.By collating recent publications,we have systematically summarized the method used for evaluating motor function,including the tests'principles,procedures,evaluation indexes,advantages,and disadvantages.We then propose an operational program for evaluating the sarcopenia phenotype,which will be of help to researchers wishing to choose evaluation method appropriate to their specific research purposes.Further innovative technology for assessing motor function that could be instructive in the evaluation of skeletal muscle function and diagnosis of sarcopenia is summarized.

Objective To explore differentially expressed proteins in the serum exosomes of acute myeloid leukemia(AML)patients and healthy controls by using the proteomics method,and provide new biomarker for the diagnosis and treatment of AML.Methods A total of 76 AML patients diagnosed and treated in the First People's Hospital of Honghe State from November 2022 to June 2024 were selected as the experimental group,and 60 healthy physical examination participants were selected as the control group.Tandem Mass Tag(TMT)labeled proteomics was used to identify the differences in protein expression in serum exosomes between the experimental and control groups,and the identified differentially expressed proteins were subjected to bioinformatics analysis.Western-Blot was used to verify the differentially expressed proteins.Results Comparedwith healthy controls,146 aberrantly expressed proteinswere detected in serum exosomes of AML patients,of which 89 were up-regulated and 57 were down-regulated.Among them,Alpha-1-antichymotrypsin(α1-ACT),Angiogenin(ANG),Vitronectin(VIT),Clusterin(Clu),Fibronectin(FN),Keratin type I cytoskeletal-18(KRT18),and actinin alpha4(ACTN4)showed changed significantly.Gene ontology(GO)and Kyoto encyclopedia of genes and genomes(KEGG)enrichment analysis indicated that differentially expresseproteins were involved in biological processes such as neutrophil immunity,neutrophil degranulation,neutrophil activation immune response,and protein activation cascade,significantly enriched in 25 biological pathways including complement and coagulation cascades,extracellular matrix(ECM)-receptor interaction,and hypoxia-inducible factor-1(HIF-1)signaling pathways.Western-blot validation results showed that compared with the control group,the expression levels of ANG,Clu and FN in the serum exosomes of AML patients were significantly increased,while the expression level of ACTN4 was significantly decreased,with statistically significant differences(t=-11.854～18.569,all P<0.05).The expression levels of ANG and FN were correlated with white blood cell count(F=8.888,7.818,all P<0.05)and cytogenetics(F=8.619,7.983,P<0.05).The expression level of Clu protein was correlated with white blood cell count(F=2.571,P<0.05),but not significantly associated with cytogenetics(F=1.886,P>0.05).ANG,FN and Clu showed no significant correlation with FAB classification(F=0.175,0.434,0.042,all P>0.05).Conclusion The expression of exosomal proteins in the serum of AML patients compared to healthy individuals are significant differences,which may serve as serological markers for the diagnosis and treatment of AML.

Objective:To explore the efficacy and surgical seletion or timing for elderly patients(≥85 years) with inguinal hernia.Methods:A retrospective analysis was conducted on clinical data of 323 patients aged ≥ 85 years who underwent surgical treatment for inguinal hernia admitted to the Department of General Surgery of East China Hospital Affiliated to Fudan University from Jan 2020 to Dec 2024.There were 308 males (95.36%) and 15 females (4.64%), with an average age of (87.83 ± 1.91) years. The ASA classification included 15 cases of grade Ⅰ, 209 cases of grade Ⅱ, 97 cases of grade Ⅲ, and 2 cases of grade Ⅳ.Results:Among the 323 patients, there were 20 bilateral hernia cases and 303 unilateral cases. Ninety-seven cases were of scrotal hernia. Surgical methods included 11 TAPP cases, 10 TEP cases, 297 Lichtenstein cases, 3 open suture repair and 2 laparoscopic suture repair. Four cases underwent intestinal resection and in two cases enterostomy was performed. The median follow-up after surgery was 3 months. Hernia recurrence was found in 2 cases, seroma in 14 cases, chronic pain in 2 cases, SSI in 11 cases, intestinal obstruction in 1 case, urinary retention in 3 cases, pulmonary infection in 9 cases, urinary tract infection in 2 cases, cardiovascular and cerebrovascular accidents in 2 cases. The incidence of postoperative complications in the emergency group was significantly higher than that in the elective group. Three deaths occurred within 30 days after surgery, all of which were in the emergency group.Conclusions:Selective inguinal hernia repair is safe and effective for over 85 year old patients with inguinal hernia. The incidence of emergency surgical complications and mortality is significantly increased. Lichtenstein surgery under local anesthesia or regional block anesthesia is the preferred method.