Objective To explore the causal relationships of anxiety,depression and neuroticism with recurrent spontaneous abortion(RSA).Methods Genome-wide association study(GWAS)data were used to extract single nucleotide polymorphisms(SNPs)closely related to anxiety,depression and neuroticism as instrumental variables(IVs).Inverse variance weighting(IVW),weighted median estimator(WME),weighted mode(WM)and Mendelian randomization(MR)-Egger regression were employed for MR analysis to evaluate the causal effects of anxiety,depression and neuroticism with RSA,and to analyze heterogeneity,gene pleiotropy and sensitivity.Results A total of 46 SNPs were extracted from GWAS data as IVs(5 anxiety SNPs,9 depression SNPs,and 32 neuroticism SNPs).IVW,WME,WM and MR-Egger regression analysis revealed that the odds ratio(OR)and 95%confidence interval(CI)of anxiety data were 1.07(0.86-1.32),1.10(0.85-1.43),1.14(0.81-1.59)and 1.18(0.53-2.61);those of depression data were 1.11(0.93-1.32),1.05(0.83-1.32),0.96(0.67-1.38)and 0.57(0.25-1.31);those of neuroticism data were 1.01(0.75-1.36),1.07(0.73-1.56),1.02(0.49-2.12)and 2.40(0.46-12.44),but none of the above causal analyses were statistically significant(all P>0.05).After reliability analysis,the Cochran's Q test for heterogeneity evaluation was not significant(P>0.05),the MR-Egger regression intercepts for gene pleiotropy evaluation were all close to 0(P>0.05),and the sensitivity evaluation"Leave-one-out"test also shows that the combined causal effect values are similar.Conclusion There dose not exist causal relationships of anxiety,depression and neuroticism with RSA.The reliability test shows that the results are relatively robust.

Objective Exploring the clinical efficacy of using autologous rib cartilage grafting to reconstruct finger hemiarticular defects.Methods From August 2022 to February 2024,for 6 patients with hemiarticular surface defects in the metacarpophalangeal joints and interphalangeal joints of 8 fingers,costal cartilage was used for joint remodeling and transplantation to reconstruct the hemiarticular surface defects of the fingers.All 8 joint transplants in 6 patients were two-stage surgeries.In the first stage,antibiotic bone cement was used to fill the space-occupying lesions,and in the second stage,costal cartilage joint remodeling was performed to reconstruct the finger joint defects.Postoperative follow-up and assessment of fracture healing according to Paley fracture healing scoring criteria.Outpatient and WeChat follow-up,upper limb function is evaluated according to the upper limb functional assessment standards of the Chinese Medical Association Hand Surgery Society.Record VAS pain score.Results In this group,there were a total of 6 patients with 8 cases of hemiarticular defects.Among them,2 patients had two joint surgical sites,while the remaining 4 patients had a single joint surgical site.There were 2 cases of metacarpophalangeal joint head defects,2 cases of proximal articular surface defects,3 cases of proximal articular head defects,and 1 case of thumb proximal articular head defect.After surgery,8 out of 6 patients'hand wounds healed successfully.All patients were followed up for 6-12 months postoperatively,with an average of 9 months.The VAS pain score(affected finger)for the last follow-up was 0-2 points,with an average of 0.6 points.According to Paley's scoring criteria,all 6 patients had excellent fracture healing.According to the evaluation criteria for upper limb functional assessment of the Chinese Medical Association Hand Surgery Society,3 cases were rated as excellent,3 cases were rated as good,and 2 cases were rated as fair.Conclusion For patients with half joint defects on one side of the finger,rib rib cartilage was used for joint reconstruction,which significantly improved the joint shape and function at the defect site,and reduced joint pain scores.

Objective Exploring the clinical efficacy of using autologous rib cartilage grafting to reconstruct finger hemiarticular defects.Methods From August 2022 to February 2024,for 6 patients with hemiarticular surface defects in the metacarpophalangeal joints and interphalangeal joints of 8 fingers,costal cartilage was used for joint remodeling and transplantation to reconstruct the hemiarticular surface defects of the fingers.All 8 joint transplants in 6 patients were two-stage surgeries.In the first stage,antibiotic bone cement was used to fill the space-occupying lesions,and in the second stage,costal cartilage joint remodeling was performed to reconstruct the finger joint defects.Postoperative follow-up and assessment of fracture healing according to Paley fracture healing scoring criteria.Outpatient and WeChat follow-up,upper limb function is evaluated according to the upper limb functional assessment standards of the Chinese Medical Association Hand Surgery Society.Record VAS pain score.Results In this group,there were a total of 6 patients with 8 cases of hemiarticular defects.Among them,2 patients had two joint surgical sites,while the remaining 4 patients had a single joint surgical site.There were 2 cases of metacarpophalangeal joint head defects,2 cases of proximal articular surface defects,3 cases of proximal articular head defects,and 1 case of thumb proximal articular head defect.After surgery,8 out of 6 patients'hand wounds healed successfully.All patients were followed up for 6-12 months postoperatively,with an average of 9 months.The VAS pain score(affected finger)for the last follow-up was 0-2 points,with an average of 0.6 points.According to Paley's scoring criteria,all 6 patients had excellent fracture healing.According to the evaluation criteria for upper limb functional assessment of the Chinese Medical Association Hand Surgery Society,3 cases were rated as excellent,3 cases were rated as good,and 2 cases were rated as fair.Conclusion For patients with half joint defects on one side of the finger,rib rib cartilage was used for joint reconstruction,which significantly improved the joint shape and function at the defect site,and reduced joint pain scores.

Objective:To explore the short-term efficacy on 3D printing assisted reconstruction of traumatic digit joint defects using rib and costo-osteochondral autograft.Methods:From August 2022 to July 2023, 7 patients with open digit joint defects had undergone emergency primary debridement and fracture fixation in the Department of Orthopaedics, 988th Hospital of the Joint Logistics Support Force of PLA. Patients with more phalangeal defects that could not be aligned were treated with antibiotic bone cement filling in the emergency surgery. In the second stage surgery, bone cement was removed and transfer of rib cartilage graft was performed to reconstruct the digit joint defect. According to a 1∶1 3D printed hand templates, rib cartilage grafts were crafted to the shape of digit joints, and then spliced together the digit joints and bone defects for fixation. Follow-up X-ray examinations were taken and assessment of the healing status of rib and fractures of phalangeal and metacarpophalangeal bones were carried out according to the Paley fracture healing score. At the outpatient follow-up, assessment of transferred joint movement and evaluation of upper limb function were conducted according to the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association. Visual Analogue Scale (VAS) pain scores were evaluated from the affected digits and donor sites.Results:After reconstructive surgery, all 7 patients had primary healing of the wounds of hand. One patient had fat liquefaction at the donor site, and the rest had primary donor site healing. One patient received further surgery for extensor tendon repair after rib cartilage grafting due to the digital extensor tendon injury. All 7 patients were included in postoperative follow-up for 6-11 months, with an average of 9 months. All patients had excellent fracture healing according to the Paley fracture healing score. At the final follow-up, the extension and flexion of the digit joints were found at 40°-80° (average 56.2°) for proximal interphalangeal joints (4 patients), and 10° in extension and 85° in flexion for metacarpophalangeal joint (1 patient). The range of motion of the thumb interphalangeal joint (2 patients) was 20°-35° (average 27.5°). Hand function was assessed according to Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association and it was found that 3 patients were in excellent, 3 in good and 1 in fair.Conclusion:This study focused on the treatment of traumatic digit joint defects by transfer of individually crafted rib cartilages in reconstruction of the defected digit joint. It significantly improves the appearance and function of the defected digit joints, especially suitable for the irregular defects of phalangeal bones.

Pancreatic metastases originating in colon cancer are very rare clinically, and there are few reports on their imaging manifestations. In this paper, it improves the diagnosis of the disease by reporting a case of pancreatic head metastases and focusing on the appearance of contrast-enhanced ultrasound.

Objective:To investigate the incidence of venous thromboembolism (VTE) in patients with esophageal cancer (EC).Methods:The retrospective cohort study was conducted. The clinicopathological data of 8 458 EC patients who were admitted to Sichuan Cancer Hospital from January 2017 to December 2021 were collected. There were 6 923 males and 1 535 females, aged (64±9)years. There were 3 187 patients undergoing surgical treatment, and 5 271 cases undergoing non-surgical treatment. Observation indicators: (1) incidence of VTE in EC patients; (2) treatment and outcomes of patients with VTE. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was analyzed using the nonparameter rank sum test. Count data were expressed as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Comparison of ordinal data was analyzed using the nonparameter rank sum test. Results:(1) Incidence of VTE in EC patients. Of 8 458 EC patients, 175 cases developed VTE, with an incidence rate of 2.069%(175/8 458). Among 175 VTE patients, there were 164 cases of deep venous thrombosis (DVT), 4 cases of pulmonary embolism (PE), 7 cases of DVT and PE. There were 59 surgical patients and 116 non-surgical patients. There was no significant difference in thrombus type between surgical and non-surgical EC patients with VTE ( χ2=1.95, P>0.05). Of 3 187 surgical patients, the incidence of VTE was 1.851%(59/3 187), including an incidence of 0.157%(5/3 187) of PE. PE accounted for 8.475%(5/59) of surgical patients with VTE. Of 5 271 non-surgical patients, the incidence of VTE was 2.201%(116/5 271), including an incidence of 0.114%(6/5 271) of PE. PE accounted for 5.172%(6/116) of non-surgical patients with VTE. There was no significant difference in the incidence of VTE or PE between surgical patients and non-surgical patients ( χ2=1.20, 0.05, P>0.05). (2) Treatment and outcomes of patients with VTE. Among 175 EC patients with VTE, 163 cases underwent drug treatment, and 12 cases did not receive treatment. Among 163 cases with drug therapy, 158 cases underwent anticoagulant therapy, 5 cases were treated with thrombolysis. All the 163 patients were improved and discharged from hospital. Conclusions:The incidence of VTE in patients with EC is relatively low, as 2.069%. There is no significant difference in the incidence of VTE or thrombus type between surgical EC patients and non-surgical EC patients.

A pulse and respiration synchronous detection system is designed to explore the changes of physiological signals in different situations.The system obtains the corresponding signal through STM32 control pulse and respiratory acquisition circuit,calculates and displays real-time parameters such as heart rate and respiratory rate,and transmits the data to the upper computer for storage in the database.The experimental test results show that the system can monitor pulse and respiratory waveform in different situations,and the waveform is in good condition.Compared with medical pulse oximeter,the error of measured heart rate and blood oxygen concentration is less than 3%,and the error of respiratory rate is less than 5%compared with the actual value,which verifies the accuracy of system signal acquisition.The system is small in size,low in cost,and comfortable to wear,and can be applied in experimental research related to pulse and respiratory signals.

With the large-scale application of Helicobacter pylori (Hp) eradication therapy, the decline in the infection rate of the population will lead to a decrease in the occurrence of Hp-related gastric cancer. In other words, the proportion of Hp-negative gastric cancer will also increase significantly, and esophago-gastric junction carcinoma, which is not closely related to Hp infection, will also become a new focus in the prevention and treatment of gastric cancer in the future. Image enhanced endoscopy is a type of endoscopic technique that has developed rapidly in recent years, and has played an important role in the diagnosis of early gastric cancer and esophageal cancer. However, there are still many unsolved questions about whether this technology is also valuable for esophago-gastric junction carcinoma. The authors intend to review the current progress of image enhanced endoscopy in diagnosis and treatment of esophago-gastric junction carcinoma from the perspective of endoscopists.

With the large-scale application of Helicobacter pylori (Hp) eradication therapy, the decline in the infection rate of the population will lead to a decrease in the occurrence of Hp-related gastric cancer. In other words, the proportion of Hp-negative gastric cancer will also increase significantly, and esophago-gastric junction carcinoma, which is not closely related to Hp infection, will also become a new focus in the prevention and treatment of gastric cancer in the future. Image enhanced endoscopy is a type of endoscopic technique that has developed rapidly in recent years, and has played an important role in the diagnosis of early gastric cancer and esophageal cancer. However, there are still many unsolved questions about whether this technology is also valuable for esophago-gastric junction carcinoma. The authors intend to review the current progress of image enhanced endoscopy in diagnosis and treatment of esophago-gastric junction carcinoma from the perspective of endoscopists.