Research in abdominal wall mechanics is progressively overcoming the limitations of traditional assessment methods with the application of machine learning and artificial intelligence technologies.By leveraging deep learning algorithms and big data analytics,precise mechanical and predictive models are being established to analyze the stress distribution in abdominal wall muscles under various conditions,facilitating the development of personalized treatment strategies.This approach not only aids in optimizing hernia repair strategies and reducing recurrence risks,but also has the potential to improve patient outcomes.Looking ahead,the continued integration of multidimensional data will further drive systematic research and clinical application in the field of abdominal wall mechanics.

Objective:To explore the relationship between the degree of devascularization and clinical outcomes after interventional embolization and sclerotherapy for peripheral arteriovenous malformations.Method:A retrospective analysis was conducted on the data of 37 patients with peripheral arteriovenous malformations admitted at Department of Cardiovascular Surgery, China-Japan Friendship Hospital from July 2021 to June 2023. All patients received the treatment of "nidus" and/or outflow veins embolization combined with sclerotherapy injection. Two experienced physicians evaluated the degree of devascularization before and after treatment, and conducted a correlation study with clinical outcomes after follow-up.Result:All 37 patients were symptomatic. Swelling and pain accounted for 75.7% of all the cases. Twenty-six patients received only one procedure, 3 patients received re-interventional treatments. The average follow-up time was（13.3±5.0）months. Clinical symptoms were completely relieved in 14 patients, and partial relief in 22 patients. The overall effective rate was 97%. There were 6 patients with degree of de vascularization<50% during procedure, 16 patients with degree of 50%-75%, and 5 patients with degree of 75%-90%, 10 cases with degree over 90%. Patients with devascularization degrees less than 60% can not achieve clinical symptom relief.Conclusions:There is a positive correlation between the degree of devascularization and clinical outcomes in the interventional embolization and sclerotherapy of peripheral arteriovenous malformations, and 60% of the degree of devascularization can serve as the "threshold" for effectiveness of treatment.

Objective:To investigate the effect of carotid endarterectomy(CEA) in the treatment of symptomatic carotid artery near-occlusion(CNO).Methods:Clinical symptoms, imaging examination, treatment and prognosis of 122 symptomatic CNO patients admitted to China-Japan Friendship Hospital from Jan 2014 to Jan 2020 undergoing CEA were retrospectively analyzed. Patients were divided into two groups based on the collapse condition,full collapse group(54 cases) and non-full collapse group(68 cases).Results:The difference was insignificant between the two groups at the 30-day and 12-month occurrence rate of primary endpoints(1.85% vs. 4.41%, P=0.629;7.41% vs. 4.41%, P=0.698).Postoperative re-stenosis occurred in one case in the non-full collapse group 8 months after CEA. Conclusions:CEA can achieve good curative effect for patients with CNO with recurrent symptoms, irrelevant to the existence of distal full collapse. The shunt can prevent intraoperative hypoperfusion and postoperative hyperperfusion.

Objective:To evaluate the efficacy of different carotid artery revascularization strategy in sychronous carotid and coronary artery revascularization.Methods:The clinical data of 53 patients receiving simultaneous carotid and coronary artery revascularization in China-Japan Friendship Hospital from Jan 2014 to Dec 2019 was retrospectively analyzed. The clinical characteristics, imaging examination, treatment and prognosis were collected and reviewed. Patients were divided into CEA group (42 cases) and CAS group (11 cases) according to the carotid artery revascularization method.Results:The mean operative time and blood loss of CEA group were (288.81±43.28) min and (419.05±127.33) ml, respectively. The mean operative time and blood loss of CAS group were (251.82±23.16) min and (318.18±98.16) ml, respectively. The difference of operative time and blood loss between the 2 groups were not significant (all P>0.05). Four minor strokes, 4 transient ischemic attacks (TIA), 2 pulmonary infections and 4 recurrent laryngeal nerve injury were observed in CEA group. Two TIA and 1 re-thoracotomy for hemostasis occurred in CAS group. Conclusions:Both carotid endarterectomy and carotid stenting can achieve good clinical result in synchronous carotid and coronary artery revascularization procedure. The selection of proper carotid artery revascularization method should base on the lesion characteristic and surgeon's experience.

Objective:To explore the feasibility, efficacy and limitation of robot-assisted laparoscopic surgery in the treatment of adrenal tumors in children.Methods:The clinical data of 5 children with adrenal tumors treated with robot-assisted laparoscopic surgery in Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science & Technology from October 2020 to March 2021 were retrospectively analyzed. All patients were males aged between 2 years and 4 months to 13 years and 1 month (median: 7 years and 7 months). One case had left adrenal adenomas and 4 cases had right adrenal adenomas.The maximum diameter of tumors was 3.0-6.0 cm (median: 4.8 cm).Results:Robot-assisted laparoscopic adrenalectomy was performed successfully on all 5 patients.The ope-ration time was 215-325 min (median: 275 min). The intraoperative bleeding was 10-50 mL (median: 28 mL). The indwelling time of the drainage tube after surgery was 3-5 days (median: 4 days). The postoperative hospital stay was 9-13 days (median: 11 days). The hospitalization cost was 51 268-58 157 yuan (median: 53 485 yuan). No complications occurred during or after the operation.Postoperative pathological tests suggested adrenal cortex adenocarcinoma in 1 case, pheochromocytoma in 1 case, gangliocytoma in 2 cases, and ganglioneuroblastoma in 1 case.Conclusions:Robot-assisted laparoscopic surgery is safe and feasible in children with adrenal tumors, but there are some limitations.This approach needs to be verified by further clinical research.

Objective To investigate the imaging characteristics of renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion. Methods We retrospectively analyzed the clinical and imaging data of five children with Xp11.2 tRCC confirmed by surgery and pathology in our hospital from January 2015 to December 2020. Four cases underwent CT plain scan and contrast-enhanced examination, and one case underwent MRI plain scan, contrast-enhanced examination and DWI examination. We observed and analyzed the location, size, shape, boundary, composition, enhancement pattern and degree, the relation with the renal hilum and adjacent large vessels, and the metastasis of the tumor. Results All cases were cortical-medullary type. Four cases were solid/cystic-solid lesions, iso- or slightly hyper-density on CT scans with calcification and necrosis, in which a few with bleeding or cystic lesions. Enhanced scanning primarily showed mild to moderate enhancement, and enhancement of pseudocapsule was seen during the delayed phase. One case was cystic lesion, the cystic fluid presented as hypo-density on CT, and T1 hypo-intensity and T2 hyper-intensity, as well as restricted diffusion on DWI. No enhancement was found in the cystic part after enhancement. There were irregular and thickened cystic wall and septum, and mural nodules on enhanced MRI. Conclusion Several characteristics of Xp11.2 tRCC in children could be drawn. Punctate and patchy calcifications in or around the solid/cystic-solid lesions and delayed "pseudocapsule sign" are typical. The possibility of Xp11.2 tRCC should be considered when there are irregular and thickened cystic wall and septum and the enhancement of mural nodules.

Objective To explore the effect of angiogenesis in carotid atherosclerotic plaque.Methods From Jan 2016 to Aug 2016,Carotid artery plaque was abtained in 52 cases after carotid endarterectomy at the Department of Cardiovascular Surgery of China-Japan Friendship Hospital.Patients were divided into symptomatic group and asymptomatic group.Specimens were stained with HE and Movat,and the density,size,distribution and morphology of neovascularization were counted.Results The density of neovascularization in the symptomatic group and the asymptomatic group were 5.27 ± 0.46 and 2.30 ±0.29,respectively (P ＜ 0.001),the average cross-sectional area of neovascularization in the symptomatic group was (2.26±0.21) mm2 and (1.00 ±0.48) mm2 in the asymptomatic group (P=0.02).In the distribution,the symptomatic group and the asymptomatic group were 3.37 ± 0.46/ mm2,1.32 ±0.16/mm2 in basal part,3.71 ±0.42/mm2,1.56 ±0.20/mm2 in the shoulder part,3.48 ±0.44/mm2,1.55 ± 0.21/ mm2 in the fibrous cap,respectively (P ＜ 0.001).Conclusion The density and cross-sectional area of neovascularization in the symptomatic group were larger than those in the asymptomatic group,irregular branching vessels were dominant.

Objective To study the seropositive ratio of the antibody to aquporin 4 (AQP4-IgG) and myelin oligodendrocytes glycoprotein antibody(MOG-IgG)in patients with autoimmune-associated central nervous system (CNS) diseases. Meanwhile, epidemiology and clinical manifestation and diagnosis,laboratory examination and magnetic resonance imaging(MRI)of AQP4-IgG seropositive and MOG-IgG seropositive patients are described. Methods 2068 patients serum samples were collected and enrolled in the multi-center research. The methodology of cell-mediated immunofluorescence staining was used to detect serum AQP4-IgG and MOG-IgG. Clinic medical records were collected and characteristics of epidemiology and manifestation were compared. Results 681 patients were AQP4-IgG seropositive and 110 patients were MOG-IgG seropositive. The female/male ratio and age of onset of patients with AQP4-IgG seropositive(616 female and 65 male,female:male=9.50:1.00;Age of onset=41.7±14.9)were significantly higher than that of patients with MOG-IgG (57 female and 53 male, female:male=1.08:1.00, P<0.0001; Age of onset=27.0 ±17.7, P<0.0001). The optic neuritis was significantly higher in patients with AQP4-IgG seropositive and patients with MOG-IgG seropositive (38.4% vs.53.5%, P<0.05).Among patients with AQP4-IgG seropositive, 42.14% conformed the diagnostic criteria of neuromyelitis optica (NMO),which was higher than that of patients with MOG-IgG seropositive (13.64%, P<0.0001). Laboratory examination showed that there was no significant difference in cerebrospinal fluid protein levels between patients with AQP4-IgG seropositive and those with MOG-IgG seropositive.MRI imaging suggested that AQP4-IgG positive patients were more common in cervical thoracic spinal cord lesions, while MOG-IgG positive patients were more involved in thoracolumbar spinal cord. The study also found that these two groups of patients could be comorbid with other autoimmune antibodies. Conclusions This multi-center research has revealed that patients with AQP4-IgG seropositive and those with MOG-IgG seropositive display differences in epidemiology,clinic manifestations and diagnosis,laboratory examination and MRI imaging. AQP4-IgG and MOG IgG auto-antibody detection are necessary for clinic diagnosis and differential diagnosis.

Objective To evaluate diagnostic method and treatment strategy for free floating thrombus in carotid artery.Methods From Ju12016 to Oct 2017,7 patients with free floating thrombus in carotid artery was diagnosed at our department.The medical history,symptoms,diagnosis,treatment strategy and prognosis of those patients were analyzed retrospectively.Results Among 7 patients,4 were symptomatic;4 patients were concomitant with severe carotid artery stenosis and 3 with mild to moderate stenosis.3 received carotid endarterectomy and patch angioplasty.4 received carotid artery stenting with distal cerebral protection divice.There was no perioperative and 30-day stroke,myocardial infarction,death or hyperperfusion syndrome occurred.The 12-month follow up showed no restenosis,no free floating thrombus recurrence and no ischemic cerebrovascular event.Conclusion Free floating filling defect in carotid artery is a typical sign for unstable plaque.Both carotid endarterectomy and carotid artery stenting can be used for the treatment of free floating thrombus.

Objective To evaluate the feasibility and safety of simultaneous carotid endarterectomy (CEA) and carotid stenting (CAS) for bilateral carotid stenosis.Methods From Jan 2012 to Aug 2014,8 patients underwent simultaneous CEA and CAS.The surgical plan was based on clinical features and imaging findings.CEA before CAS was done in 5 patients,CAS before CEA was done in 3 patients.One patient also underwent simultaneous coronary artery bypass grafting due to unstable angina.Results Operation success rate was 100％.Intraoperative carotid shunts,patches and embolic protection devices were used in all patients.One patient developed post-procedural hyperperfusion syndrome and returned to normal after symptomatic treatment.The remaining patients recovered uneventfully,there were no cerebrovascular accident,nerve injury or wound complications.Follow-up period was 18-48 months,follow-up rate was 100％.During the follow-up,all patients were relatively stable,no re-stenosis,death or cardiovascular events.Conclusions Through thorough evaluation,careful preparation,and strict management,simultaneous CEA and CAS is a technically feasible and safe treatment strategy for bilateral carotid stenosis.