ObjectiveTo investigate the feasibility and safety of endoscopic retrograde cholangiopancreatography （ERCP） combined with oral cholangiopancreatography in the treatment of major duodenal papilla gallbladder polyps. MethodsA retrospective analysis was performed for the clinical data of eight patients with choledocholithiasis and gallbladder polyps who underwent ERCP and combined with oral cholangiopancreatography for major duodenal papilla cholecystectomy in Center of Digestive Endoscopy， Jilin People’s Hospital， from May 2022 to June 2024， and related data were collected， including the success rate of surgery， the technical success rate of gallbladder polyp removal， the superselective method of cystic duct， the time of operation， the time of gallbladder polyp removal， and surgical complications. ResultsBoth the success rate of surgery and the technical success rate of gallbladder polyp removal reached 100%， and of all eight patients， three patients used guide wire to enter the gallbladder under direct view， while five patients received oral cholangiopancreatography to directly enter the gallbladder. The time of operation was 51.88±12.34 minutes， and the time of gallbladder polyp removal was 23.13±10.94 minutes. The diameter of gallbladder polyp was 2‍ ‍—‍ ‍8 mm， and pathological examination showed inflammatory polyps in three patients， adenomatous polyps in one patient， and cholesterol polyps in four patients. There were no complications during or after surgery. The patients were followed up for 2‍ ‍—‍ ‍27 months after surgery， and no recurrence of gallbladder polyp was observed. ConclusionOral cholangiopancreatography is technically safe and feasible in endoscopic major duodenal papilla cholecystectomy.

Objective To explore the relevant relationship and specificity between the implicit and explicit loyalty of military cadets in order to provide a theoretical basis and objective indicators for a more comprehensive and objective assessment for individual loyalty.Methods E-Prime 2.0,a classic implicit association paradigm was employed to construct an implicit association loyalty test for 64 military cadets.Simultaneously,an explicit loyalty measurement was conducted using the Chinese Military Personnel Loyalty Scale.Results ① Significant implicit effect was observed in the loyalty assessment of military cadets,indicating a general tendency to perceive higher levels of personal loyalty and lower levels of loyalty to external entities.② Explicit loyalty assessment revealed that the participants had the highest loyalty score towards the Party,the Nation,and the People(4.79±0.34),followed by the loyalty score to their profession(4.38±0.53),and the relatively lower loyalty score towards the unit and leaders(4.03±0.83).Among the 3 dimensions of loyalty,the normative loyalty score ranked highest,while continuance loyalty score took lower.③ There were no correlations among the scores of loyalty to the Party,the Nation,and the People(r=-0.030,P=0.823),to the profession(r=-0.047,P=0.728),to the unit(r=0.050,P=0.710),or to the leaders(r=0.043,P=0.749).Conclusion The implicit effect in the loyalty assessment is significant in military cadets,and there is no significant correlation between explicit and implicit loyalty measurements.Thus,we cannot rely solely on explicit measurements to assess their loyalty attitudes.

Objective To explore the application value of CT texture analysis for evaluating Ki-67 expression in patient with esophageal squamous cell carcinoma.Methods Sixty-one cases of pathologically confirmed esophageal squamous cell carcinoma patients were selected to obtain the Ki-67 protein expression status of the patients'pathological tissues,and the patients were divided into a high-expression group and a low-expression group.All patients underwent plain and enhanced chest CT within two weeks before surgery.Lesions delineation and texture feature extraction of esophageal cancer were obtained via Omni-Kinetics software.The texture parameters included Min Intensity,Max Intensity,Median Intensity,Mean Intensity,Deviation,Skewness,Kurtosis,Entropy,Energy,Correlation,Haralick,short run high grey level emphasis(SRHGLE),short run low grey level emphasis(SRLGLE),long run high grey level emphasis(LRHGLE),long run low grey level emphasis(LRLGLE),Grey Level Nonuniformity,Run Length Nonuniformity.The differences of texture features among different Ki-67 expression groups were compared,and the receiver operating characteristic(ROC)curve was used to analyze the predictive value of Ki-67 expression in patient with esophageal cancer.Results In plain CT images,the SRHGLE and Grey Level Nonuniformity of the high expression group were significantly higher than those of the low expression group(P=0.010,0.002,respectively).In enhanced CT images,the Mean Intensity,Entropy and Grey Level Nonuniformity of the high expression group were significantly higher than those of the low expression group(P=0.026,0.037,0.001,respectively),and SRHGLE and LRHGLE of the high expression group were significantly lower than those of the low expression group(P=0.016,0.010,respectively).The area under the curve(AUC)of texture features in plain CT were 0.676-0.740,and the AUC of combined diagnosis reached 0.770[95%confidence interval(CI):0.645,0.868],and sensitivity and specificity was 0.921,0.565,respectively.In enhanced CT,the AUC of texture features were 0.629-0.750,the AUC of combined diagnosis increased to 0.903(95%CI:0.799,0.964),and sensitivity and specificity was 0.816,0.826,respectively.Conclusion CT texture analysis can early and non-invasively predict Ki-67 expression in patient with esophageal squamous cell carcinoma,it can be used as an imaging marker to evaluate the proliferative activity of esophageal cancer cells,and may provide diagnosis and treatment information for clinical decision-making of esophageal squamous cell carcinoma.

The accumulation of fatigue during military operations may lead to decreased operational efficiency and non-combat attrition,which can impact combat effectiveness.On-site monitoring and evaluation of fatigue during military operations,as an important means to keep track of military operations and bring about quick changes in training,underlie the combat effectiveness of military personnel.Focusing on the on-site monitoring and evaluation methods of fatigue during military operations,this paper reviews the determinants of such fatigue as well as on-site monitoring and comprehensive evaluation methods so as to provide reference for accurate and efficient evaluation of fatigue during military operations and for early warning of such fatigue.

In cardiac ablation procedures,the accuracy of catheter positioning determines the authenticity of the cardiac model and the accuracy of the ablation target.This article reviews the literature on catheter positioning in electrophysiology and summarizes the key technologies for catheter positioning,such as magnetic-electric fusion and interference suppression.Addressing the limitations of electric and magnetic positioning individually,the paper elaborates on the rationale for catheter positioning technology based on magnetic-electric fusion.It also outlines the framework of a complex catheter positioning system.Specifically,the magnetoelectric conversion matrix is established first,followed by the optimization of the catheter shape.The interference factors such as magnetic field interference,body movement,respiration,and heartbeat in catheter positioning and their suppression methods are analyzed and discussed in detail.Finally,the development trend of three-dimensional electrophysiology catheter positioning technology is prospected,offering feasible insights for the research on catheter positioning technology based on magnetic-electric fusion.

Acute idiopathic maculopathy(AIM)is an inflammatory lesion of unknown cause that primarily affects the macula. It follows a unique natural course, distinct from other maculopathy, often manifesting as a sudden loss of visual acuity followed by flu-like symptoms that gradually resolve as the disease subsides. A comprehensive understanding of the unique history, multimodal imaging, and a thorough systematic examination are crucial in determining the final diagnosis of AIM. The treatment and prognosis of AIM remain controversial. Meanwhile, it presents similar clinical manifestations and pathological changes to various chorioretinopathy, posing challenges for clinical differentiation. This article provides a review of its pathogenesis, clinical symptoms, multimodal imaging features, diagnosis and differential diagnosis, treatment and prognosis, in order to reduce misdiagnosis and mistreatment while enhancing comprehension of AIM.

Objective:To assess the usage of the robot-assisted core-needle biopsy for the bone tumors, moreover to compare its outcomes with the manual technique.Methods:A retrospective study was conducted from February 2019 to February 2021, the medical records of the patients with bone lesions that had received core-needle biopsy were collected. There were 57 males and 45 females, the age was 45.9 (10~79) years. Eight patients received robot-assisted biopsy, whereas 94 patients underwent C-arm/ CT guided biopsy, the recorded data included operational duration, aspirational direction adjustment, etc. The pathological diagnosis reports of the biopsy specimens and the operational specimens were compared.Results:The diagnosis outcomes included metastases (33 cases), osteosarcoma (12 cases), chondrosarcoma (12 cases), giant cell tumor of bone (12 cases), fibrous dysplasia (7 cases), chronic osteomyelitis (7 cases), lymphoma (4 cases), multiple myeloma (4 cases), chronic fracture (3 cases), chondroblastoma (2 cases), pleomorphic undifferentiated sarcoma (2 cases), leiomyosarcoma (1 case), and Langerhans cell histiocytosis (1 case). Eighty-seven cases (85.29 %) lesions were found in the limbs, whereas 15 cases (14.71%) were in the axial locations. Compared with the manual group, the robot-assisted group had more axial locations: 7/8 vs. 11.70%(11/94), P<0.01; fewer aspirational direction adjustment: (0.4 ± 0.1) times vs. (3.1 ± 1.5) times, P<0.01 ; longer operational duration: (48.8 ± 8.8) min vs. (29.6 ± 6.0) min, P<0.01. There were no statistical differences between the two groups regarding the sex, age, pathological fracture, diagnostic accuracy, open biopsy rate and complications ( P>0.05). Conclusions:The robot-assisted core-needle biopsy is a reliable technique, it helps decrease the operational difficulty. The usage of this technique is recommendable for the bone lesions with great difficulty for biopsy, such as the minimal bone tumors and the lesions in the spine and the pelvis.

Objective To investigate the current status and awareness of pharmaceutical services in hospitals in Guizhou province and to provide a reference for exploring and carrying out pharmaceutical service fees.Methods The questionnaire was designed by the"wjx.cn"website.Three kinds of questionnaires were designed for pharmacists,doctors,nurses,and patients as the research objects,with corresponding differences in some questions,and promoted on WeChat,Dingxiangyuan,and other network platforms.Results A total of 655 questionnaires were collected,and 639 valid questionnaires were recovered,with an effective recovery rate of 97.56%.324 pharmacists(50.70%),82 doctors and nurses(12.83%),233 patients(36.46%)were surveyed.The average approval score of these three groups of respondents on pharmaceutical service fees was 4.67,4.23,and 4.22,respectively(full score:5).Conclusions Overall,pharmacists'professional services have received support from medical staff and patients.However,patients'pharmaceutical service projects currently focus on dispensing services.The recognition of pharmacists'work and the public's awareness of pharmaceutical services can be improved by enhancing the professional ability of pharmacists,strengthening publicity and guidance,and exploring"Internet+pharmaceutical services",etc.,to promote the sustainable development of pharmaceutical services.

OBJECTIVE To explore the role of Yes-associated protein(YAP)in epidermal stem cell(EPSC)differentiation after ionizing radiation(IR).METHODS ① A punch was used to induce skin injuries on the back of mice.The IR group received localized irradiation with 60 Co γ-rays,while the normal control group did not.Samples were collected at 0,1,3,6,9,and 12 d for RNA and protein extraction.Western blotting was used to detect changes in YAP protein expressions during wound healing.Real-time quantitative polymerase chain reaction(RT-qPCR)was performed to assess the mRNA levels of Yap and its downstream target genes,connective tissue growth factor(Ctgf),and cysteine-rich protein 61(Cyr61).② EPSCs were exposed to 60 Co γ at a dose of 4 or 8 Gy,while the control group was not irradiated.Cells were collected to detect the levels of YAP protein via Western blotting.Cells were collected at 4,12,24,and 36 h post-IR to assess the levels of YAP mRNA by RT-qPCR.③ Short hairpin RNA(shRNA)was used to establish stable YAP knockdown cell lines,and the knockdown efficiency of sh YAP was verified by Western blotting.RT-qPCR was then performed to detect the impact of YAP knockdown on mRNA levels of K1 and K10 after IR.RESULTS① Compared with the control group,the YAP protein level in the IR group during wound healing was significantly reduced(P<0.05,P<0.01),so were the mRNA levels of Yap and its downstream target genes Ctgf and Cyr61(P<0.05,P<0.01).② Compared to the cell control group,the mRNA and protein levels of YAP in the IR group cells were significantly reduced(P<0.01).③ In the sh YAP cells,the YAP protein level was significantly reduced(P<0.01).Furthermore,the mRNA levels of K1 and K10 were significantly decreased after IR in sh YAP cells(P<0.01).CONCLUSION YAP can regulate EPSC differentiation in wound healing after IR.

Objective:To investigate the expression of trefoil factor 3 (TFF3) in gastric cancer and its regulation mechanism on the gastric cancer cells proliferation.Methods:The differences in the expression levels of TFF3 in 66 cases of gastric cancer were detected by RT-PCR and immunohistochemical method. SGC-7901 cells were cultured stably. Through the expression of TFF3 gene in silent cells infected with gv248 lentivirus vector (SGC-7901/KD group) and the setting up of control group (SGC-7901/NC group), CCK-8 method, flow cytometry and Transwell method were used to detect the changes of cell activity. SGC-7901/KD or SGC-7901/NC cells were injected into the right armpit of 20 BALB/C nude mice respectively. The expression of VEGF in tumor was detected by immunohistochemical method and Western blot method.Results:The expression level of TFF3 mRNA in gastric cancer tissues (15.31±2.18) was significantly higher than that in adjacent tissues (4.58±1.69) ( P < 0.05). After infection with recombinant lectin virus, the expression level of TFF3 gene in SGC-7901/KD cells was 0.08±0.006, significantly lower than that in the other two groups. After 5 days of culture, the OD value of cells in SGC-7901/KD group was 1.28±0.05, significantly lower than that in SGC-7901/NC group (1.78±0.08). The number of cell colonies formed was also significantly reduced, and the colonies were smaller. Compared with the control group, the proportion and apoptosis rate of SGC-7901/KD cells in G0/G1 phase were significantly higher, while the proportion of cells in G2/M phase was significantly lower. The results of scratch healing test showed that the distance between wound edges of SGC-7901/KD cells was significantly shorter than that of SGC-7901/NC cells. Western blot analysis showed that the relative expression level of VEGF protein in SGC-7901/KD cells (0.98±0.05) was significantly lower than that in SGC-7901/NC cells (2.87±0.17) ( P < 0.05). Compared with SGC7901/NC group, after 2 weeks of injection of SGC-7901/KD cells, the tumor volume of mice was (184.4±50.2) mm 3, significantly smaller than that of SGC7901/NC group (326.8±76.9) mm 3 ( P < 0.05). The expression of VEGF protein in SGC7901/KD group was significantly lower than that in control group ( P < 0.05) . Conclusion:In gastric cancer cells, TFF3 gene silencing can inhibit the growth of gastric cancer cells by inhibiting the expression of VEGF, which is expected to become a new molecular target.