To evaluate the features of carotid web (CW) by ultrasonography.

A total of 66 patients with CW were retrospectively enrolled from January 2018 to June 2019 at Xuanwu Hospital, Capital Medical University. All patients were examined by both ultrasonography and CTA, and were divided into either a<50% stenosis group (54 cases) or a ≥50% stenosis group (12 cases). The ultrasonographic characteristics of CW, including the length, thickness, direction (forward or backward to the flow), acute angle between the web and carotid wall, and thrombus between the web and carotid wall were compared between the two groups. The stenosis degrees of carotid artery were compared between patients with and without ischemic stroke.

Forty-two (42/66, 63.6%) patients were diagnosed with CW by initial CDFI examination, of whom 21 (21/66, 31.8%) were diagnosed with ulcerative plaque and 3 (3/66, 4.5%) were diagnosed with carotid dissection at first but confirmed by second examination. There were no differences in the web length, thickness, direction, or thrombus detected between the two groups (P>0.05). The angle between the web and carotid wall in the<50% stenosis group was significantly smaller than that of the ≥50% stenosis group (median angel 39o vs 73o, P=0.002), and the percentage of patients with an angle≤ 60o in the<50% stenosis group was significantly higher than that of the ≥50% stenosis group (74.1% vs 41.7%, P=0.042). The diameter of the residual carotid artery at CW location in the<50% stenosis group was significantly larger and peak systolic velocity was significantly higher in the<50% stenosis group than in the≥50% stenosis group (P<0.001). The stenosis degrees of carotid artery were not statistically different between patients with and without ischemic stroke (P=0.321).

Ultrasonography can be used to evaluate the characteristics of carotid web in 2D and color mode. When the angle between the CW and carotid wall is large, the carotid artery stenosis ≥ 50% is more likely to happen, but carotid artery stenosis is not the main cause of ischemic stroke.

The aim of the present study was to evaluate the efficiency of sling exercise, therapeuticultrasound, therapeuticultrasound and sling exercise in patients to alleviate pain and improve lumbar function with lumbar disc herniation.

Individuals were selected from a list of patients being followed at the department of Rehabilitation in the third hospital of Hebei Medical University. 30 patients who were diagnosed with lumbar disc herniation were collected, the diagnoses were established upon medical history, physical examination, and results of imaging studies. The patients were randomly divided into three groups: therapeuticultrasound group received 14 sessions of ultrasonic therapy to the lumbar region, Sling exercise group received 14 sessions of sling exercise, and therapeuticultrasound and sling exercise group received therapeuticultrasound and sling exercise therapy 14 sessions of therapeuticultrasound to the lumbar region,7 sessions per week, 2 weeks. The VAS and ODI were compared with the assessment of the patients before and at the end of the therapy.

At the end of treatment, three groups VAS scores (F=3.069, P=0.043) and ODI scores (t=12.676, P<0.001) was lower than that at the beginning of treatment (P<0.05), at the end of treatment the VAS scores (F=59.400, P<0.001) and of the ODI scores (t=12.737, P<0.001) of ultrasonic and sling exercise therapy group was lower than the other group, the difference is significantly.

All three groups could reduce pain and improve lumbar function, and the ultrasonic and sling exercise therapy was most effective for lumbar disc herniation treatment in the three groups.

To analyze the treatment of different types of traumatic cerebral infarction in children, and explore its pathogenesis in combination with literature so as to improve the cure rate and reduce disability rate.

The clinical data of 42 cases of traumatic cerebral infarction in children were retrospectively analyzed in The Hospital of 81^st Group Army PLA from January 2015 to December 2019. The diagnosis of traumatic cerebral infarction in children was made by CT scan and MRI scan. According to different conditions, children with traumatic cerebral infarction were classified, and different treatment strategies were selected. Children with lacunar infarction were treated with calcium antagonists and neurotrophic drugs, supplemented by hyperbaric oxygen and exercise rehabilitation. The children of focal cerebral infarction and complex cerebral infarction treated by junior dehydrant and hormone also included the calcium antagonist and nutritional nerve drugs. The therapeutic regimen perhaps adjusted by the evolution of the disease. The children of extensive cerebral infarction underwent emergency cranial decompression, and was treated by reducing intracranial pressure and preventing complications after operation. The treatment results and recovery were observed.

In 42 cases of traumatic cerebral infarction in children, 35 cases (83.3%) were good recovery, 4 cases (9.5%) were moderate disability, 2 cases (4.8%) were severe disability, 1 case (2.4%) died, and no vegetative state. The good recovery rate of lacunar infarction was 100%, that of focal cerebral infarction was 62.5%, that of mixed cerebral infarction was 60%, and that of extensive cerebral infarction was 50%.

It is of great significance to improve the therapeutic effect and prognosis of children with traumatic cerebral infarction to adopt different treatment schemes for different types of cerebral infarction.

To characterize the patients with supratentorial hypertensive intracerebral hemorrhage (ICH) in the Tibetan Plateau over an altitude of 4000 meters.

A total of 68 cases with supratentorial hypertensive ICH were retrospectively included in Ali Regional People’s Hospital from January 2017 to September 2018. The clinical and laboratory data were collected. A simple linear correlation analysis was applied to analyze the correlation between the amount of bleeding and sex, age, nationality, time from onset , systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum triglyceride (TG), and cholesterol. According to computed tomography (CT) findings, 68 cases were divided into the basal ganglia ICH group (33 cases) and the lobar ICH group (35 cases). The characteristics between two groups were analyzed using t-test or χ² test.

The data of sex, age, nationality, time from onset, SBP, DBP, Hb, TG, and cholesterol of 68 cases on admission did not show any definitive correlation with the hematoma volumes (P＞0.05). The SBP and DBP of patients in the basal ganglia ICH group were significantly higher than that in the lobar ICH group, respectively [(184.9±28.5) mmHg vs (164.6±24.4) mmHg; (113.0±18.1) mmHg vs (103.0±18.4) mmHg] (t=0.499, 0.486; P=0.002, 0.033).

The relevant factors of hematoma volumes in patients with ICH in plateau area were not yet clear. Diastolic and systolic blood pressure of patients in the basal ganglia ICH group was higher than that in those in lobar ICH group.

To compare the efficacy evaluation of electrospun composite biomaterials and a porcine small intestine submucosa mesh for hernia repair.

A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai. Eligible adult patients with primary unilateral reducible groin hernias were randomly assigned (1∶1) to electrospun composite biomaterials (experimental group) or porcine small intestine submucosa (control group) mesh groups. Patients were treated with the tARB technique and assessed at 1,3 and 6 months after the surgery. The primary endpoint was hernia recurrence. The secondary endpoints were postoperative complications including groin pain and operative site infections.

172 patients were assigned to experimental (n=86) and control (n=86) groups. At 6 months follow-up, postoperative complications occurred in 5 patients (5/86, 5.95%) and 2 (2/86, 2.35%) patients in the control and experimental groups, respectively (P>0.05). There was no significant difference in VAS or SVS score between the two groups.

We demonstrate that electrospun composite biomaterial mesh can be used as a ideal choice for inguinal hernia repair. Electrospun composite biomaterial has the characteristics of low recurrence rate, absorbability and long-term comfort.It can be further applied in clinical practice in the future.

Pancreaticoduodenectomy(PD)remains one of the most complicated hepatobiliary operations. The development of minimally invasive surgery for PD has always been an hot spot. Laparoscopic pancreaticoduodenectomy(LPD) has not been widespread carried out due to its difficulty and long learning curve. LPD accounts for 9% of all PD, according to the National Cancer Data base. Compared with laparoscopic surgery, robotic surgery system has significant advantages in the field of minimally invasive PD, including stereotactic amplified vision, filtering hand tremor and simulating the wrist. The article would review the surgical techniques and notes, which could provide clinical reference for other surgeons.

To explore the potential risk factors for mortality within 30 days after orthotopic liver transplantation (OLT) and provide scientific basis for formulating individualized perioperative intervention strategies and predicting postoperative risks.

This retrospective study included recipients who underwent OLT at Beijing Chao-Yang Hospital, Capital Medical University. Death within 30 days after surgery was defined as early postoperative mortality, and patients were grouped accordingly. General patient information, preoperative laboratory indicators, and intraoperative data were collected. Receiver operating characteristic (ROC) curves were used to determine the optimal cutoff values for each indicator. Least absolute shrinkage and selection operator (LASSO) regression was applied to screen factors relevant to early postoperative mortality, followed by univariate and multivariate Logistic regression analysis to identify independent risk factors. Restricted cubic spline (RCS) analysis was employed to examine the dose-response relationships between these factors and the risk of early mortality.

A total of 535 OLT recipients were included, among whom 36 (6.7%) experienced early postoperative mortality. Multivariate Logistic regression analysis revealed that intraoperative erythrocyte transfusion >1 650 ml (OR=3.313, 95% CI: 1.397-7.857), intraoperative urine volume≤1 115 ml (OR=3.245, 95% CI: 1.409-7.473), preoperative platelet count≤24.5×10⁹/L (OR=3.437, 95% CI: 1.194-9.895), and preoperative blood glucose≤4.8 mmol/L (OR=2.955, 95% CI: 1.286-6.791) were independent risk factors for early postoperative mortality after OLT. RCS analysis indicated that intraoperative erythrocyte transfusion volume and urine volume showed linear correlations with the risk of early postoperative mortality, while preoperative platelet count exhibited a nonlinear correlation with the risk of early postoperative mortality.

Low preoperative platelet count, preoperative hypoglycemia, high intraoperative erythrocyte transfusion volume, and low intraoperative urine volume are independent risk factors for early postoperative mortality. Preoperative measures should be taken to increase platelet counts above 24.5×10⁹/L, while the optimal range for perioperative blood glucose requires further clarification.

To analyze the risk factors for infectious complications following open hepatectomy in patients with hepatocellular carcinoma (HCC).

Clinical data of 63 patients with HCC who underwent elective open hepatectomy in Guangzhou Eighth People’s Hospital from January 2023 to October 2025 were retrospectively collected. Patients were divided into an infection group (15 patients) and a non-infection group (48 patients) based on the occurrence of postoperative infectious complications. Univariate analysis and multivariate Logistic regression analysis were used to identify independent risk factors.

Among the 63 patients, 15 (23.81%) developed postoperative infectious complications, including intra-abdominal infection in 8 cases (53.33%), surgical site infection in 6 cases (40.00%), and pulmonary infection in 1 case (6.67%). Univariate analysis showed statistically significant differences between the two groups in preoperative serum albumin, total bilirubin, ascites, nutritional risk screening 2002 (NRS 2002) score (NRS-2002≥3 points), and Child-Pugh grade (all P<0.05). Multivariate Logistic regression analysis revealed that low preoperative serum albumin (OR=0.70, 95% CI： 0.56–0.89, P=0.003) and high level of preoperative total bilirubin (OR=1.13, 95% CI： 1.03–1.24, P=0.011) were independent risk factors for infectious complications after open hepatectomy in HCC patients.

Low preoperative serum albumin level and high preoperative total bilirubin level are independent risk factors for infectious complications following open hepatectomy in patients with HCC. Perioperative monitoring and intervention targeting serum albumin and total bilirubin should be strengthened to reduce the risk of postoperative infection.

To investigate the clinical efficacy and safety of single-port laparoscopic-assisted precision breast-conserving surgery (SPE-BCS) in the treatment of early-stage breast cancer by comparing it with conventional open breast-conserving surgery (C-BCS).

The clinical data of female patients with stage Ⅰ–Ⅱ breast cancer who underwent SPE-BCS (60 patients) and C-BCS (80 patients) in Shanghai General Hospital, Shanghai Jiao Tong University, from July 2022 to July 2023 were retrospectively analyzed, including surgical procedures, operative time, intraoperative blood loss, postoperative complications, pathological resection margin status, and oncological outcomes. Postoperative cosmetic outcomes and quality of life were also assessed. The median follow-up time was 30 months.

Baseline characteristics were similar between the two groups. The SPE-BCS group had slightly shorter operative time and less intraoperative blood loss than the C-BCS group. Both groups had negative surgical margins and similar postoperative complication rates. Six months after surgery, patients in the SPE-BCS group had higher cosmetic satisfaction and higher BREAST-Q scores, indicating less postoperative pain and better chest wall comfort. During the follow-up, no local recurrence or distant metastasis occurred in either group.

SPE-BCS offers advantages such as smaller incisions, improved cosmetic results, avoiding heat damage while maintaining oncological efficacy. It is a feasible and safe alternative to C-BCS. With the widespread adoption of this technique and a shortened learning curve, this procedure is expected to become a new surgical procedure in breast-conserving treatment for early-stage breast cancer.

To construct an implementation model for the structured integration of medical humanities general education into residency training, tailored to clinical scenarios in general surgery, to verify its application effects, and to analyze the internal mechanism through which it enhances the comprehensive professional competency of resident physicians.

A quasi-experimental study design was employed. A total of 136 resident physicians who rotated in the Department of General Surgery at the First Affiliated Hospital of Sun Yat-sen University from July 2020 to June 2023 were selected as research subjects. They were non-randomly divided (based on rotation batches) into an observation group (n=60) and a control group (n=76). The observation group underwent a 5-month humanities-integrated teaching intervention based on a three-dimensional framework of “Curriculum-Scenario-Feedback” on the basis of conventional residency training, while the control group received conventional general surgery residency training. The teaching effects were comprehensively evaluated from multiple dimensions through end-of-rotation assessments, reflective journal text analysis, scenario simulation assessments, and specialized questionnaires.

The scores of the observation group in professional theory, skill operation, and case presentation were 8.9%, 8.4%, and 8.2%, higher than those of the control group respectively, with all differences statistically significant (P<0.001). The observation group scored significantly higher than the control group in the affective response and critical analysis dimensions of reflective journals, the information giving and shared decision-making items in scenario simulations, as well as in all dimensions of cognitive understanding, affective identification, behavioral intention, and teaching satisfaction (all P<0.05).

The structured integration model constructed in this study can effectively and synergistically enhance the clinical professional competence and medical humanities literacy of general surgery resident physicians. Its core mechanism involves: reducing cognitive load through systematic curriculum integration, strengthening the internalization of humanistic affect through learning communities, and promoting the transformation of humanistic behaviors via a formative evaluation closed-loop. This provides a practical plan for implementing evaluable and replicable medical humanities education within the surgical residency training system.

Pancreatic cancer presents significant challenges due to low early diagnosis rates, ineffective drug treatments, and drug resistance, innovative foundational therapies for pancreatic cancer still face numerous obstacles in transitioning from trials to widespread clinical application. This article systematically outlines the key challenges across multiple dimensions, including molecular subtypes of pancreatic cancer, tumor microenvironment, preclinical models, early detection, treatment strategies, and research translation. It proposes potential breakthrough directions: early screening and improved diagnostic efficiency; personalized treatment plans based on genetic profiling of patients; development of more relevant preclinical research models; optimization of multimodal treatment strategies; and enhanced efficiency in translating basic research to clinical applications. Among these areas, the lag in early screening along with insufficient precision in personalized treatment, represent the core focal points for current breakthroughs. Promoting collaborative innovation across four key dimensions of “model systems, diagnostic tools, treatment strategies, and clinical trial design”, can bring hope for prolonging the survival of patients with pancreatic cancer.

Cholangiocarcinoma (CCA) is a highly malignant tumour of the biliary tract system, characterised by its aggressive nature, poor prognosis, and complex pathogenesis. In recent years, particularly with the advancements in high-throughput sequencing technology, the role of changes in the biliary tract microbiota in the occurrence, development, and diagnosis of CCA has garnered significant attention. This review examines the specific changes in the biliary tract microbiota associated with CCA, underlying the mechanisms by which alterations in the biliary tract microbiota drive the development and progression of CCA, and the potential value of biliary tract microbiota intervention in the prevention and treatment of CCA. The aim is to explore new directions for the prevention and treatment strategies of CCA.

This review provides a comprehensive overview of multimodal prehabilitation in elderly patients with gastrointestinal cancer, highlighting recent advances and variations in clinical outcomes. The principal components of multimodal prehabilitation—including exercise training, nutritional optimization, psychological support, and comorbidity management—are systematically summarized. Evidence from randomized controlled trials demonstrates considerable heterogeneity in prehabilitation efficacy among elderly adults, largely attributable to differences in baseline physiological function and comorbid conditions. A multidimensional assessment framework is proposed to facilitate population stratification and the development of tailored prehabilitation strategies for distinct patient subgroups. Furthermore, the emerging role of artificial intelligence in individualized assessment and risk prediction is discussed, offering new perspectives for implementing precision prehabilitation in geriatric oncology.

Gastric cancer represents one of the most common malignant tumors worldwide and leading cause of cancer-related mortality. The emergence of immune checkpoint inhibitors (ICIs) has markedly influenced the therapeutic landscape of gastric cancer in recent years. Programmed cell death protein-1 and ligand 1 (PD-1/PD-L1) inhibitors not only demonstrate significant survival benefits in the first-line treatment of advanced gastric cancer, but also provide new strategies for perioperative management of locally advanced gastric cancer. This artical aims to outline the application of ICIs in first-line and perioperative treatment of gastric cancer, and to discuss key issues including mechanisms of resistance, management of immune-related adverse events, and heterogeneity of the tumor microenvironment. These insights may shed light on novel immunotherapeutic strategies, optimization of combination regimens, and advancement of precision and individualized treatment approaches.

The evolution of hernia repair surgery has been closely tied to advancements in materials science. Synthetic, non-absorbable meshes were widely applied and had achieved favorable clinical outcomes by significantly reducing recurrence rate. However, due to their inherent material properties, their permanent implantation is associated with specific complications, including foreign body sensation, chronic pain, adhesions to surrounding tissues, and mesh infection. Biological meshes, owing to their degradable nature, may significantly reduce the risk of these complications. The advantages of biological meshes include excellent biocompatibility, degradability, the capacity to induce tissue regeneration, and a favorable profile against infection. Nevertheless, their clinical application was limited by high costs, potential immune-mediated adverse reactions, and ongoing debate regarding their mechanical strength and long-term efficacy. This article provides a systematic review of the application of biological meshes in hernia repair, elaborating on their respective advantages and limitations in inguinal hernia, ventral hernia, hiatal hernia, and parastomal hernia repair. With the development of material technology and completion of multi-center, large-sample, long-term follow-up clinical trials, the application of biological meshes in hernia repair is expected to become more standardized. They will provide a new foundation for the precision management of hernia repair.

Enhanced recovery after surgery (ERAS) significantly improves patient outcomes by optimizing perioperative management strategies. As a core component of ERAS, multimodal analgesia (MMA) integrates analgesic agents and techniques with different mechanisms of action to achieve effective postoperative pain control while reducing opioid consumption and opioid-related adverse effects. This article systematically reviews the specific applications and clinical value of MMA across various surgical specialties, including abdominal, orthopedic, and thoracic surgeries. Current challenges—such as insufficiently individualized analgesic strategies and uneven implementation of advanced techniques—are analyzed, and future directions based on precision medicine, novel analgesic agents, and intelligent technologies are discussed. Clinical practice demonstrates that MMA facilitates early postoperative recovery through optimized analgesic regimens and represents critical foundation for the successful implementation of ERAS.

To investigate the association between five-time chair stand test (CST) performance and the risk of incident chronic lung disease (CLD) in middle-aged and older adults, and to explore its clinical significance for early risk identification in community populations.

Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS). A total of 10, 371 participants aged ≥45 years at baseline (2011) who were free of CLD and had complete data on key variables were included, with follow-up waves in 2013, 2015, 2018, and 2020. Participants were categorized into an abnormal CST group (n=4 668, male CST>7.5 s, female CST>9.5 s) and a normal CST group (n=5 703, male CST ≤7.5 s, female CST ≤9.5 s). Kaplan-Meier curves and log-rank tests were used to compare cumulative CLD incidence between groups, and Cox proportional hazards models were employed to estimate hazard ratios (HR) and 95% confidence intervals (CI).

During follow-up, 1, 601 out of 10, 371 participants developed incident CLD, including 870 cases (18.64%) in the abnormal CST group and 731 cases (12.82%) in the normal CST group. Compared with the normal group, the abnormal group was older and had higher proportions of females, rural residents, unmarried individuals, those with lower educational levels, and those with hypertension, diabetes, heart disease, stroke, and related medication use (all P<0.05). Receiver operating characteristic (ROC) analysis showed that for males, the area under the curve (AUC) of CST for predicting incident CLD was 0.588 (95%CI: 0.567~0.610), with an optimal cut-off value of 7.5 s, sensitivity of 68.35%, and specificity of 44.96%; for females, the AUC was 0.583 (95%CI: 0.561~0.604), with an optimal cut-off value of 9.5 s, sensitivity of 41.33%, and specificity of 71.50%. Kaplan-Meier curves demonstrated that the abnormal CST group had a significantly lower event-free survival rate than the normal group (log-rank P<0.001). Cox regression showed that in the unadjusted model, abnormal CST was associated with an increased risk of incident CLD (HR=1.509, 95%CI: 1.368~1.665, P<0.001); after adjusting for demographic factors, lifestyle, comorbidities, and medication use, the association remained robust (HR=1.559, 95%CI: 1.402~1.733, P<0.001).

Baseline CST abnormality is a predictor of increased risk of incident CLD in middle-aged and older adults. It holds clinical significance for population-level risk stratification and early community-based identification.

To investigate the risk of acute exacerbations and all-cause readmission in patients with pre-chronic obstructive pulmonary disease (COPD).

A total of 127 patients with chronic airway diseases admitted to our hospital from October 2021 to October 2023 were selected. Among them, 49 patients with chronic respiratory symptoms and post-bronchodilator forced expiratory volume in 1 second (FEV₁)/forced vital capacity (FVC) ≥ 0.7 were assigned to the observation group, and 78 patients with post-bronchodilator FEV₁/FVC<0.7 were assigned to the control group. Clinical data, chest imaging findings, laboratory results, and treatment details were collected. Acute exacerbation events and all-cause readmissions were recorded during follow-up. A Cox proportional hazards model was used to analyze the association between lung function classification and acute exacerbations as well as all-cause readmission within 12 months after discharge.

Compared with the control group, the observation group had lower COPD assessment test (CAT) scores [(17.28±5.67) vs. (19.75±6.03), P=0.021], higher arterial partial pressure of oxygen (PaO₂) [(84.16±14.88) mmHg vs. (77.85±16.24) mmHg, P=0.025], and lower arterial partial pressure of carbon dioxide (PaCO₂) [(41.08±9.45) mmHg vs. (44.92±11.53) mmHg, P=0.044]. The observation group also had lower usage rates of glucocorticoids [30(61.22%) vs. 62(79.49%), P=0.022], inhaled bronchodilators [28(57.14%) vs. 59(75.64%), P=0.025], methylxanthines [26(53.06%) vs. 59(75.64%), P=0.007], and antibiotics [36(73.47%) vs. 70(89.74%), P=0.012]. No significant differences were found in chest imaging or laboratory indicators between the two groups (P>0.05). During follow-up, the observation group had 6 cases of acute exacerbation (12.24%, 95%CI: 8.55~18.65) and the control group had 15 cases (19.25%, 95%CI: 14.70~23.48) (P<0.05); the observation group had 5 cases of all-cause readmission (10.20%, 95%CI: 9.80~13.89) and the control group had 12 cases (15.38%, 95%CI: 14.12~16.75) (P<0.05). Multivariate Cox regression analysis showed that FEV₁/FVC<0.7 was a risk factor for acute exacerbation (HR=1.925, 95%CI: 1.138~3.102, P<0.001) and all-cause readmission (HR=2.488, 95%CI: 1.685~3.615, P<0.001) within 12 months after discharge.

Patients with pre-COPD have a risk of acute exacerbations and readmission. Patients with confirmed COPD have definite airflow limitation, and their medium-term risks of acute exacerbation and readmission are higher than those of pre-COPD patients. Clinical attention should be paid to standardized follow-up, risk factor control, and dynamic monitoring of lung function in pre-COPD patients to reduce the risk of adverse outcomes.