ObjectiveTo investigate how Xiaoyao Shukun decoction （XYSKD） regulates the formation and release of neutrophil extracellular traps （NETs） via the phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）/mammalian target of rapamycin （mTOR） signaling pathway， thereby reducing inflammation， inhibiting the excessive proliferation of fibroblasts in pelvic adhesion tissue， decreasing adhesion and fibrosis， and repairing the tissue damage in sequelae of pelvic inflammatory disease （SPID）. MethodsA total of 84 Wistar rats were randomly allocated into seven groups： blank， model， XYSKD （8 mg·kg^-1）， mTOR agonist （10 mg·kg^-1）， mTOR agonist + XYSKD （10 mg·kg^-1+8 mg·kg^-1）， mTOR inhibitor （2 mg·kg^-1）， and mTOR inhibitor + XYSKD （2 mg·kg^-1+8 mg·kg^-1）. The rat model of SPID was constructed by starvation， fatigue， and ascending Escherichia coli infection. After 14 days of drug intervention， the ultrastructure of fibroblasts in the pelvic adhesion tissue was observed by transmission electron microscopy. The general morphology of the uterus， fallopian tube， and ovary was observed by laparotomy. The levels of interleukin-1β （IL-1β）， interleukin-17 （IL-17）， and tumor necrosis factor-α （TNF-α） in the peritoneal flushing fluid were determined by enzyme-linked immunosorbent assay （ELISA）. The expression of myeloperoxidase （MPO） and citrullinated histone 3 （H3） in the fallopian tube was detected by immunofluorescence. Western blot and Real-time quantitative polymerase chain reaction （Real-time PCR） were employed to determine the relative protein and mRNA levels， respectively， of neutrophil elastase （NE）， intercellular adhesion molecule-1 （CD54）， α-smooth muscle actin （α-SMA）， H3， PI3K， and Akt. ResultsCompared with the blank group， the model group presented a large number of collagen fibers in bundles， numerous cytoplasmic folds of fibroblasts， reduced or absent mitochondrial cristae， and disordered and expanded endoplasmic reticulum. By laparotomy， extensive pelvic congestion， connective tissue hyperplasia， thickening and hardening of the tubal end near the uterus， and tubal and ovarian adhesion or cyst were observed in the model group. In addition， the model group showed raised levels of IL-1β， IL-17， and TNF-α in the peritoneal flushing fluid （P<0.01）， increased average fluorescence intensities of MPO and H3 （P<0.01）， and up-regulated protein and mRNA levels of NE， H3， CD54， PI3K， and Akt （P<0.01）. Compared with the model group， the mTOR agonist group showed increased fibroblasts and cytoplasmic folds， absence of mitochondrial cristae， endoplasmic reticulum dilation， and evident collagen fiber hyperplasia. Pelvic adhesions were observed to cause aggravated damage to the uterine， fallopian tube， and ovarian tissues. The levels of IL-1β， IL-17， and TNF-α in the peritoneal lavage fluid elevated （P<0.01） and the average fluorescence intensities of MPO and H3 enhanced （P<0.01） in the mTOR agonist group. In contrast， the XYSKD group and the mTOR inhibitor group showcased decreased fibroblasts and collagen fibers， alleviated mitochondrial crista loss and endoplasmic reticulum dilation， improved morphology and appearance of the uterine， fallopian tube， and ovarian tissues， lowered levels of IL-1β， IL-17， and TNF-α in the peritoneal lavage fluid （P<0.01）， decreased average fluorescence intensities of MPO and H3 （P<0.01）， and down-regulated protein and mRNA levels of NE， H3， CD54， PI3K， and Akt （P<0.05）. Compared with the mTOR agonist group， the mTOR agonist + XYSKD group showed alleviated pathological changes in the pelvic tissue， declined levels of IL-1β， IL-17， and TNF-α （P<0.01）， decreased average fluorescence intensities of MPO and H3 （P<0.01）， and down-regulated protein levels of NE， H3， CD54， α-SMA， p-PI3K/PI3K， and p-Akt/Akt （P<0.01） and mRNA levels of NE， H3， CD54， α-SMA， PI3K， and Akt （P<0.01）. Compared with the mTOR inhibitor group， the mTOR inhibitor + XYSKD group demonstrated reduced pathological severity of the pelvic tissue， reduced levels of IL-1β， IL-17， and TNF-α （P<0.01）， decreased average fluorescence intensities of MPO and H3 （P<0.01）， and down-regulated protein and mRNA levels of NE and CD54 （P<0.05）. ConclusionXYSKD can inhibit the excessive formation and release of NETs via PI3K/Akt/mTOR to ameliorate the inflammatory environment and reduce fibrosis and adhesion of the pelvic tissue， thereby playing a role in the treatment of SPID. It may exert the effects by lowering the levels of IL-1β， IL-17， and TNF-α and down-regulating the expression of NE， H3， CD54， α-SMA， PI3K， and Akt in the pelvic adhesion tissue.

Objective:To assess the safety and feasibility of selectively preserving the first branch of the right gastro-omental artery using bidirectional dissection in laparoscopic pylorus-preserving gastrectomy (LPPG).Methods:In this retrospective analysis, we studied preoperative, intraoperative, postoperative, and follow-up data of 30 patients with early gastric cancer treated in the Department of Gastric Cancer in Zhejiang Cancer Hospital (28 patients), Department of Gastrointestinal Surgery in Jiaxing Second Hospital (one patient) and Department of Gastrointestinal Surgery in Hangzhou Red Cross Hospital (one patient) who had undergone selective preservation of the first branch of the right gastro-omental artery during LPPG. The main variables studied were as follows: (1) intraoperative preservation of the first branch of the right gastro-omental artery; (2) the overall surgical situation; and (3) postoperative small bowel follow-through and endoscopy findings.Results:LPPG with selective preservation of the right gastro-omental artery vascular branch was achieved in all 30 of the study patients. The mean operation time was (244.3±29.3) minutes and the median intraoperative blood loss 50 (20–200) mL. The median tumor diameter was 1.2 (0.5–3.6) cm and an average of 32.3±11.6 lymph nodes were dissected. The overall median number of positive lymph nodes was 0 (0–6), and of No. 6 lymph nodes 5.1±1.5. Postoperative feeding resumed at an average of 5.2±0.5 days and the postoperative hospital stay averaged 8.4±3.4 days. Pathological stages were as follows: T1a (14 cases), T1b (10 cases), and T2 (6 cases). Small bowel follow-through imaging showed good results in 28 patients 5 days post-surgery, the remaining two exhibiting good results 9 days post-surgery. There were no instances of delayed gastric emptying, and only one patient (3.3%) developed intra-abdominal infection (resolved with conservative treatment).Conclusion:Selective preservation of the right gastro-omental artery during laparoscopic early gastric cancer surgery is a safe and feasible procedure for treating early mid-gastric body cancer with pyloric preservation.

Breast cancer is the worldwide most common malignant tumor in women,and early diagnosis and treatment is the key to improve prognosis.Conventional screening imaging techniques,such as mammography and ultrasonography,have only limited diagnostic efficacy for micro breast cancer.Combining diffuse optical tomography(DOT)and ultrasonography for assessing blood vessel distribution and metabolic level inside the breast lesions,optical tomography image ultrasonography system(OPTIMUS)has unique advantages for diagnosing micro breast cancer with diameter≤1.0 cm.The research progresses of OPTIMUS for diagnosing micro breast cancer were reviewed in this article.

Objectives:To analyze the safety of the assistance of microscope in lumbar interbody decompres-sion,fusion and internal fixation in the treatment of recurrent lumbar disc herniation.Methods:Retrospective analysis was made on 73 patients recurred lumbar disc herniation after percutaneous endoscopic lumbar dis-cectomy(PELD)and underwent a revision surgery of single-segment lumbar decompression and fusion in our hospital from January 1,2020 to April 1,2022.Among the patients,42 received microscope-assisted opera-tion(microscope group),including 31 males and 11 females,aged 53.4±16.4 years;the other 31 received an operation without microscope assistance(conventional group),including 18 males and 13 females,aged 49.6± 11.4 years.There were no significant differences between the two groups in general data such as gender,age and BMI(P＞0.05).Data such as the surgical approach and surgical segment of initial PELD,and operative time,intraoperative bleeding volume,total postoperative drainage volume,postoperative length of stay,dural tears,nerve injury and superficial infection of the revision surgery were collected and compared between the two groups.Results:All the operations were successful.In the microscope group,the operative time was 168.0±33.1min,intraoperative bleeding volume was 125.0±40.2mL,total drainage volume was 379.6±220.6mL and postoperative length of stay was 5.2±1.3d,and dural tears occurred in 2 patients,none nerve injury or superficial wound infection was found.In the conventional group,the operative time was 155.8±29.4min,in-traoperative bleeding volume was 133.9±59.7mL,total drainage volume was 452.2±464.5mL,and postoperative length of stay was 5.0±1.7d,and dural tears occurred in 4 patients,nerve injury was noticed in 1 patient,and none superficial wound infection was found.There was no statistical difference in perioperative and com-plication data between the two groups(P＞0.05).Conclusions:Microscope does not increase the operative time,intraoperative bleeding volume,postoperative length of stay,and the rate of infection,dural tears and nerve injury in the revision surgery after PELD.

Objective:To assess the safety and feasibility of selectively preserving the first branch of the right gastro-omental artery using bidirectional dissection in laparoscopic pylorus-preserving gastrectomy (LPPG).Methods:In this retrospective analysis, we studied preoperative, intraoperative, postoperative, and follow-up data of 30 patients with early gastric cancer treated in the Department of Gastric Cancer in Zhejiang Cancer Hospital (28 patients), Department of Gastrointestinal Surgery in Jiaxing Second Hospital (one patient) and Department of Gastrointestinal Surgery in Hangzhou Red Cross Hospital (one patient) who had undergone selective preservation of the first branch of the right gastro-omental artery during LPPG. The main variables studied were as follows: (1) intraoperative preservation of the first branch of the right gastro-omental artery; (2) the overall surgical situation; and (3) postoperative small bowel follow-through and endoscopy findings.Results:LPPG with selective preservation of the right gastro-omental artery vascular branch was achieved in all 30 of the study patients. The mean operation time was (244.3±29.3) minutes and the median intraoperative blood loss 50 (20–200) mL. The median tumor diameter was 1.2 (0.5–3.6) cm and an average of 32.3±11.6 lymph nodes were dissected. The overall median number of positive lymph nodes was 0 (0–6), and of No. 6 lymph nodes 5.1±1.5. Postoperative feeding resumed at an average of 5.2±0.5 days and the postoperative hospital stay averaged 8.4±3.4 days. Pathological stages were as follows: T1a (14 cases), T1b (10 cases), and T2 (6 cases). Small bowel follow-through imaging showed good results in 28 patients 5 days post-surgery, the remaining two exhibiting good results 9 days post-surgery. There were no instances of delayed gastric emptying, and only one patient (3.3%) developed intra-abdominal infection (resolved with conservative treatment).Conclusion:Selective preservation of the right gastro-omental artery during laparoscopic early gastric cancer surgery is a safe and feasible procedure for treating early mid-gastric body cancer with pyloric preservation.

Purpose Using conventional ultrasound,3D energy Doppler and shear wave elastography to develop one multi-modal ultrasound-based prediction model for placental insufficiency of second trimester.Materials and Methods A prospective analysis was conducted by reviewing 209 pregnant women with anterior wall placenta who underwent multi-modal ultrasound examination in the Affiliated Renhe Hospital of China Three Gorges University from April 2021 to April 2022,and all participants were divided into 118 cases in the normal group and 91 cases in the placental insufficiency group based on clinical diagnosis.Their placental function was evaluated through hemodynamics[blood flow parameters of umbilical artery(UA),uterine artery(Ut A)and cerebral placental rate(CPR)],blood stream perfusion[vascular index(VI),blood flow index(FI)and vaso-blood flow index(VFI)]and mechanical tissue properties[mean of elasticity modulus(Emean)].Logistic regression analysis was performed on the indicators with statistically significant differences between groups,establishing a prediction model of placental insufficiency and evaluating its efficacy.Results There were statistically significant differences in Ut A blood flow parameters,CPR,VI,VFI and Emean between the two groups(t=-12.74,-10.28,-11.01,7.02,7.00,-11.97,all with P<0.05).In regression analysis,Ut A-RI(≥0.65),CPR(≤1.53)and Emean(≥4.14 KPa)were found to be the independent risk factors,of which Emean had the greatest diagnostic efficacy(area under the curve,AUC=0.904).The AUC of the prediction model established by combining the three parameters was 0.945,with a sensitivity of 87.91%and a specificity of 94.92%,which has significantly higher diagnostic efficacy than that of a single parameter.Conclusion The prediction model based on the multi-modal ultrasound parameters has certain predictive value and high specificity for placental insufficiency of second trimester and can guide early clinical intervention to improve perinatal outcomes.

OBJECTIVE：To inves tigate the application effect and safety of modified compound polyethylene glycol electrolyte powder（SF-PEG）in intestinal preparation method for patients with constipation undergoing colonoscopy. METHODS ：From Jan. 2020 to Aug. 2020，160 patients with constipation undergoing colonoscopy in anorectal department of the affiliated hospital of North Sichuan Medical College were randomly divided into observation group and control group ，with 80 cases in each group. The patients in the control group took 2 boxes of SF-PEG （mixed into 3 000 mL warm water ）orally at 3：00 a.m. on the day of examination，and finished within 2 hours. The patients in the observation group took 1 box of SF-PEG （mixed into 1 500 mL warm water）at 20：00 the night before the examination and 5：00 in the morning of the day of examination ，and drank it within 1 hour；1 bottle of Dimethylsiloxane powder （mixed into 75 mL warm water ）was taken orally at 7：00 a.m. on the inspection day. The satisfaction of intestinal preparation ，intestinal bubble score ，operation time of colonoscopy ，detection of polyps ，tolerance rate ， acceptance rate of repeating intestinal preparation of patients and incidence of adverse reactions were compared between the two groups. RESULTS ：The patients of 2 groups successfully completed bowel preparation and colonoscopy. The intestinal preparation total satisfaction rate ，intestinal bubble satisfaction rate ，polyp detection rate ，tolerance rate and repeating intestinal preparation acceptance rate of patients of observation group were significantly higher than control group （P＜0.05），while the incidence of nausea and vomiting and total incidence of adverse reactions were significantly lower than control group （P＜0.05），and the operation time of colonoscopy was significantly shorter than control group （P＜0.05）. CONCLUSIONS ：Oral administration of SF-PEG in batches combined with Dimethylsiloxane powder for bowel preparation in patients with constipation before colonoscopy have the advantages of high satisfaction with bowel preparation ，less intestinal bubbles ，short operation time ，high detection rate of polyps，high tolerance rate of patients ，high acceptance rate of repeating intestinal preparation and less adverse reactions. It is a safe and effect method for intestinal preparation.

We retrieved the PDTC patient medical record in our center who have received multi-disciplinary comprehensive treatment in March 2019. By reviewing his treatment process, we hope to improve the recognition of this disease and provide reference for individualized programs.

To systematically analyze the status of the standardization of basic public health services, the project of basic public health service equalization and the first round of national pilot projects of the standardization of basic public services are carried out to provide support for the promotion of the standardization and equalization of basic public health services. The information about above-mentioned three aspects related to national basic public health services were collected, and a systematic comparison of standardization of basic public health services with the 14 specifications in the National Basic Public Health Service Specification ( the 3 th Edition ) and the 51 pilot projects in the Notice of Carrying Out the Pilot Work of National Basic Public Service Standardization was conducted. The current public health standards are basically in line with the requirement of the resident health record management service specifications. However, the public health standards related to public health projects in other 13 service specifications and national basic public health service standardization pilot projects are incomplete or absent. The current public health standards cannot fully meet the requirements of the implementation of national basic public health services. In the process of promoting the equalization of basic public health service, it is urgent to develop targeted public health standards in related fields.

Objective:To systematically analyze the basic characteristics and contents of the current health standards for infectious disease, environmental health, school health and disinfection in the context of COVID-19 prevention and control, and provide support for the further optimization of epidemic prevention and control guidelines and reference for the revision and improvement of related health standards.Methods:Public health standards used in COVID-19 prevention and control were selected for a systematic comparison with "The Plan of COVID19 Prevention and Control (the 6 th Edition)" and other epidemic prevention and control guidelines from the perspectives of application scope and technical elements. Results:The current standards of public health are with scientificity, timeliness and feasibility. The application scope and technical elements of the current public health standards basically meet the needs of the prevention and control of COVID-19 epidemic, but the public health standardization system still needs improvement, and some public health standards need to be revised.Conclusions:The implementation of current public health standards can provide strong technical support for the prevention and control of COVID-19 epidemic. The experience obtained from COVID-19 epidemic prevention and control might promote the further improvement of the health standardization system.