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 investigate the clinical value of trabecular metal augments in revision surgery for Paprosky typeⅢcomplicated acetabular bone defects, and evaluate the effectiveness in intraoperative stability, the acetabular rotation center reconstruction, and hip function improvement.

A retrospective analysis was conducted on patients with Paprosky typeⅢacetabular bone defects who underwent revision surgery at Zhejiang Provincial Hospital of Traditional Chinese Medicine between January 2016 and December 2022. Inclusion criteria: age≥18 years; total hip arthroplasty history requiring acetabular revision due to prosthetic loosening or osteolysis; radiographic confirmation of Paprosky typeⅢacetabular bone defects; complete follow-up data with a follow-up duration of at least 12 months. Exclusion criteria: active infection or unresolved previous periprosthetic joint infection; severe comorbidities precluding surgical tolerance; pathological fractures or tumor-related bone defects; incomplete clinical or radiographic data. A total of six patients were enrolled. Among them, three patients with typeⅢA defects underwent reconstruction using trabecular metal augments combined with a porous tantalum metal cup, while three patients with typeⅢB defects were treated with a cage combined with an augment. The vertical and horizontal offsets of the hip center relative to the anatomical hip center were measured, and implant stability was evaluated based on radiographic findings. Intraoperative blood loss, operative time, perioperative complications, and domain-specific Harris hip scores before surgery and at the final follow-up were recorded to assess clinical efficacy and safety. Statistical analysis was performed using paired t tests or the Wilcoxon signed-rank test as appropriate. Difference was considered statistically significant if P<0.05.

All the patients completed the follow-up. At the final follow-up, implant position remained stable, with no evidence of dislocation, screw breakage, or obvious migration, and radiographic findings indicated satisfactory osseointegration. The total Harris score increased from the (54.2±4.2) before operation to (86.9±3.0) at the final follow-up (t=12.18, P<0.01). Pain scores improved from (15.5±5.7) to (40.0±3.2) (t=9.36, P<0.01), and function scores improved from (31.8±5.3) to (39.0±4.5) (t=3.74, P<0.05). The vertical offset of the hip center decreased from (20.1±3.7) mm before operation to (6.9±2.5) mm at the final follow-up (t=8.47, P<0.01), while the horizontal offset decreased from (10.8±2.9) mm to (4.7±2.0) mm (t=6.92, P<0.01).

Augment provides effective mechanical support and favorable osseointegration in revision surgery for Paprosky typeⅢ complex acetabular defects, enabling subtype-specific reconstruction strategies across different Paprosky Ⅲ subtypes. Short- to mid-term follow-up outcomes were satisfactory.

To analyze the impact of a perioperative blood management program based on multidisciplinary collaboration on blood loss and blood transfusion rate during total knee arthroplasty (TKA).

Patients who underwent TKA in the First Affiliated Hospital of Harbin Medical University from March 2022 to February 2024 were selected. After the inclusion criteria (primary TKA for end-stage knee disease, preoperative hemoglobin≤100 g/L, normal coagulation function) and exclusion criteria (bilateral TKA, tranexamic acid allergy or contraindication, high risk or history of thrombosis, severe cardiovascular and cerebrovascular diseases) screening, 86 patients were finally enrolled the study. According to the random number table method, the participants were divided into the control group (given routine blood management scheme) and the observation group (perioperative blood management scheme based on multidisciplinary collaboration), with 43 cases in each group. T test, chi square test and other statistical methods were used to analyze and compare the intraoperative blood loss, blood transfusion rate, operation time, hemoglobin (Hb) and complications between the two groups, as well as the satisfaction of the two groups.

The intraoperative blood loss and perioperative blood transfusion volume in the observation group were less than those in the control group, the blood transfusion rate was lower than that in the control group, and the operation time was shorter than that in the control group (t=6.197, 12.742, 5.988, χ²=4.440), and the differences were statistically significant (all P<0.05). On the third day after the operation, Hb levels of both groups decreased compared with those before the operation, while Hb level of the observation group was higher than that of the control group, and the difference was statistically significant (t=3.339, P< 0.05). The total incidence of complications in the observation group was lower than that in the control group, the average length of hospital stay was shorter than that in the control group, and the patient satisfaction score was higher than that in the control group (χ²=4.440, t=2.917, 5.747), and the differences between the two groups were statistically significant (all P<0.05).

The multidisciplinary blood management program, through precise hemostasis techniques, dynamic monitoring and precise execution by the nursing team, and anemia pretreatment, can reduce blood loss and blood transfusion requirements in patients with total knee arthroplasty (TKA). Nursing plays a crucial role in carrying out medical orders, warning of complications and promoting early rehabilitation, thereby accelerating the rehabilitation process and enhancing patient satisfaction.

To evaluate the stiffness of peri-knee muscles in patients with knee osteoarthritis (KOA) using shear wave elastography (SWE) and to analyze its correlation with knee joint function.

This study was conducted at Henan Provincial Luoyang Orthopedic Hospital (Henan Provincial Orthopedic Hospital). Participants included KOA patients and healthy controls. KOA diagnosis was based on the Chinese Guideline for Diagnosis and Treatment of Osteoarthritis (2024 edition) with Kellgren-Lawrence gradesⅠtoⅢ; individuals with conditions or medication history potentially affecting lower limb muscles were excluded. Healthy control group had no relevant history and no strenuous exercise, alcohol, or caffeine intake 48 h prior. Propensity score matching (PSM) was used to balance the two groups. Shear wave elastography was used to assess the elastic modulus, reflecting muscle stiffness, of the quadriceps (vastus medialis, rectus femoris, vastus lateralis), hamstrings (semimembranosus, semitendinosus, biceps femoris long head), and gastrocnemius (medial/lateral heads). KOA patients were assessed using the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and knee range of motion (ROM). Pearson or Spearman correlation analysis was performed between muscle stiffness and WOMAC scores/knee ROM.

Compared with healthy group, KOA patients showed increased stiffness in the rectus femoris (Z=–2.45, P=0.014), semimembranosus (Z=–2.15, P=0.032), semitendinosus (Z=–3.97, P<0.001), and biceps femoris long head (Z=–2.49, P=0.013), and the differences were statistically significant. After correction, correlation analysis in KOA patients showed that hamstring stiffness was positively correlated with total WOMAC score and its subscales (pain, stiffness, physical function) and negatively correlated with knee ROM. Specifically, semimembranosus stiffness correlated positively with total WOMAC (r=0.596), pain (r=0.463), stiffness (r=0.478), and physical function (r=0.632) (all P<0.01), and negatively with ROM (r=–0.641, P<0.001). Semitendinosus stiffness correlated positively with total WOMAC (r=0.437), pain (r=0.451), stiffness (r=0.458), and physical function (r=0.420) (all P<0.05), and negatively with ROM (r=–0.507, P<0.01). Biceps femoris long head stiffness correlated positively with total WOMAC (r=0.585), pain (r=0.587), stiffness (r=0.510), and physical function (r=0.547) (all P<0.001), and negatively with ROM (r=–0.485, P<0.01).

Increased hamstring stiffness is associated with worse knee function and reduced ROM in KOA. Targeted intervention on these specific muscles may represent a novel strategy for improving knee function in KOA patients.

To study the mechanical characteristics of the meniscus after ramp injury using the method of finite element analysis and provide a reference for clinical management.

A detailed finite element model of the knee joint bone, cartilage, meniscus, and major ligaments (patellar ligament, anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament, and lateral collateral ligament) was constructed by combining computed tomography and magnetic resonance imaging, of based on which a knee model of meniscal ramp injuries was constructed built, covering the four types of injuries in the Thaunat classification (type Ⅱ to type Ⅴ). A vertical load (650 N) and an anterior load (134 N) were applied to simulate the force patterns at different knee flexion angles (0°, 30°, 60°, 90°) to evaluate the stresses and displacements at the meniscal ramp injury.

The angle of flexion increased, the changes in displacement and stress at the meniscal tear were more significant in the finite element models of type Ⅳ and V ramp injuries compared to type Ⅱand Ⅲ meniscal ramp injuries. When the knee flexed at 60°, the maximum stress at the type Ⅳ and Ⅴ meniscal ramp injuries was approximately 3.5 to 4.2 times higher than that of the intact meniscus, and the displacements at the injuries were nearly four to five times higher than those of the intact meniscus. When the knee flexed at 90°, the maximum stress and displacements at the ramp injury were approximately 2.4 to 2.9 and 3.5 to 3.9 times higher than those of the intact meniscus for type Ⅳ and type Ⅴ menisci, respectively. The meniscus was most stressed in the 60° flexion condition in these two subtypes of ramp injury. Except for 60° and 90° of flexion and internal rotation, no remarkable difference existed between the Ⅳ and Ⅴ meniscal ramp injury models and the intact meniscus.

When the knee is stable and the tear length is less than two centimetres, type Ⅱand Ⅲ meniscal ramp injuries can be treated non-operatively, while surgical repair may be chosen for type Ⅳ and Ⅴ meniscal ramp injuries .

Osteoarthritis (OA), as a whole-joint degenerative disease, is difficult to reverse cartilage degeneration through traditional treatments. Mesenchymal stem cell-derived exosomes (MSC-Exo) have shown great potential due to their stability, low immunogenicity, and targeted delivery ability. MSC-Exo can delay the progression of OA by regulating the metabolic balance of chondrocytes, enhancing cartilage matrix production, and macrophage polarization, and inhibiting the inflammatory cascade reaction. In recent years, research on engineered exosomes has made breakthroughs, such as optimizing the drug-loading capacity and therapeutic effect of exosomes through targeted peptide modification or nanotechnology, providing new ideas for OA treatment. However, the clinical translation of MSC-Exo still faces many challenges, including the standardization of preparation methods, in-depth analysis of mechanisms of action, and the lack of clinical research data. This article reviewed the application prospects and challenges of MSC-Exo in OA treatment.

Osteoarthritis is a common joint disease characterized by cartilage damage and chronic inflammation, significantly affecting the quality of life of patients. Recent studies suggest that neutrophils, as important immune cells, play a critical role in the pathogenesis of osteoarthritis. Neutrophils are involved not only in inflammatory responses but may also influence the cartilage repair process. However, current research on the role of neutrophils in osteoarthritis still requires further investigation. This review aimed to summarize the role of neutrophils in osteoarthritis and its underlying mechanisms, and assess the therapeutic potential of targeting neutrophils, providing new insights and directions for future research and treatment.

Osteonecrosis of the femoral head (ONFH) represents a debilitating progressive disorder driven by multifactorial etiologies that impair osseous vascularization and trigger osteocyte death, with no definitive therapeutic intervention currently established. Pathological progression involves apoptotic cascades within osteocytic networks and trabecular microarchitectural deterioration, culminating in catastrophic biomechanical failure of the femoral head through subchondral collapse and articular cartilage disintegration. Contemporary management prioritizes early-stage joint preservation strategies to decelerate disease advancement and avert structural collapse. Core decompression (CD), while serving as the cornerstone surgical modality for necrotic debridement, paradoxically destabilizes subchondral mechanical integrity, thereby potentiating collapse acceleration. To mitigate this iatrogenic risk, CD is increasingly augmented with osteoconductive grafts or synthetic bone substitutes to simultaneously reconstitute load-bearing frameworks and stimulate endogenous osteogenesis. Modern synthetic bone scaffolds have gained prominence in ONFH therapy due to their exceptional biocompatibility, osteogenic potential, and scalable manufacturing. Recent paradigm shifts in material design transcend conventional paradigms of biocompatibility and passive osteoconduction, instead prioritizing convergent engineering approaches that synchronize osteoimmunomodulatory precision with biomechanical resilience. This strategic integration aims to orchestrate a harmonious equilibrium between immunometabolic bone niche modulation and structural reinforcement. The present review critically evaluated state of the art innovations in bioengineered bone substitutes for ONFH, offering evidence-based perspectives to refine clinical translation and material optimization.

Steroid-induced osteonecrosis of the femoral head (SONFH) is a non-traumatic osteonecrotic disorder characterized by persistent disruption of the bone marrow microenvironment, a process that cannot be fully explained by vascular insufficiency or bone tissue necrosis alone. Emerging evidence has identified marrow adipogenic lineage precursors (MALPs) as a bone marrow-specific mesenchymal cell subpopulation that plays a critical role in regulating marrow homeostasis, vascular remodeling, and bone turnover. However, the functional significance and pathological involvement of MALPs in SONFH remain insufficiently defined.This review integrated recent advances in MALP biology with the traditional Chinese medicine (TCM) theory of Wei deficiency-blood stasis-marrow atrophy, and systematically analyze the potential stage-dependent roles of MALPs in the initiation and progression of SONFH from the perspective of global bone marrow microenvironmental imbalance. Available evidence suggests that during Wei deficiency stage, long-term or high-dose glucocorticoid use may induce abnormal expansion of MALPs, accompanied by impaired marrow homeostatic regulation. During the blood stasis stage, MALPs participate in vascular regulation through the secretion of angiogenic factors, while their functional dysregulation disrupts microcirculatory reconstruction and markedly promotes osteoclastogenesis in a receptor activator of nuclear ractor kappa B ligand (RANKL)-dependent manner, thereby amplifying the coupling between vascular dysfunction and excessive bone resorption. In the marrow atrophy stage, MALPs undergo further fate shifts toward adipocytes and myofibroblasts, resulting in sustained loss of regulatory and reparative capacity, progressive exhaustion of marrow regenerative potential, and ultimately irreversible vascular compromise and structural bone damage.Collectively, MALPs should not be regarded merely as adipogenesis-related cells in SONFH, but rather as central regulatory nodes that dynamically participate in bone marrow microenvironmental remodeling across disease stages. Wei deficiency-blood stasis-marrow atrophy theory provides a coherent conceptual framework for understanding the stage-specific functional transitions of MALPs in SONFH. Further investigation into MALP plasticity and microenvironmental regulatory functions may offer novel mechanistic insights and support the optimization of TCM -based therapeutic strategies for SONFH.

This review aimed to sort out the current development status of imaging examination techniques for early knee degenerative disease (knee osteoarthritis) and the integrated application of these techniques with artificial intelligence deep learning technology, so as to provide references for the optimization of clinical diagnosis and relevant academic research. By searching two English literature databases, relevant research literatures were collected using appropriate keywords; after excluding duplicate, low-relevance, and low-quality literatures, 46 high-quality literatures were finally selected for systematic analysis. Clinically common imaging examination techniques each have their own characteristics and can help detect some lesion features in the early stage of the disease, while some novel imaging techniques can capture subtle changes of lesions more accurately. The combination of deep learning technology with these imaging examinations has exhibited good performance in automatically identifying lesion locations, judging disease severity, and predicting disease progression trends, which significantly improves the efficiency and accuracy of diagnosis. However, the related technologies currently still have problems such as insufficient generalization ability and the need for improved standardization. Imaging examination techniques for early knee degenerative disease are continuously developing, and their integration with deep learning provides a new path for precise and efficient disease assessment in clinical practice. In the future, it is necessary to further optimize the stability and clinical adaptability of the technologies to promote their wider application in clinical practice.

To investigate the detection rate of the duodenal papilla using detachable string magnetically controlled capsule endoscopy technology, and to predict the risk of bile duct intubation during endoscopic retrograde cholangiopancreatography (ERCP) by observing the morphology of the duodenal papilla.

A retrospective analysis was conducted on the detection rate of duodenal papilla in 20 patients who underwent ERCP with complete ds-MCE examination before surgery and were admitted to the Fifth Affiliated Hospital of Zunyi Medical University(Zhuhai)from January 2022 to October 2022. Analyze the detection rate of duodenal papilla by this examination and observe its papilla morphology to predict the risk of selective biliary catheterization.

The detection rate of ds-MCE duodenal papilla was 70% (14/20); 11 cases of Type I and 3 cases of Type IV morphology; All patients underwent ERCP, with good selective intubation and an average time of 2.93 minutes.No postoperative pancreatitis or hyperamylasemia occurred.

ds-MCE can improve the detection rate of duodenal papilla and further observe papilla morphology to predict the risk of bile duct catheterization during ERCP.

To evaluate the efficacy and prognosis of endoscopic submucosal resection with ligation (ESMR-L) and endoscopic submucosal dissection (ESD) for the treatment of G1 rectal neuroendocrine tumors (R-NETs).

In this case- control study, 108 patients with G1 stage R-NETs treated endoscopically in endoscopy Department of Northern Theater Command General Hospital from December 2021 to December 2023 wereselected, and were divided into 63 cases in the ESD group and 45 cases in the ESMR-L group according to the different treatment modalities.The hospitalization time, hospitalization cost, operation time, tumor length, tumor depth, and postoperative endoscopic complete resection rate, histopathological complete resection rate, intraoperative perforation, and postoperative delayed hemorrhage rate were compared between the two groups.Binary logistic regression analysiswas performed based on postoperative histopathologic complete resection.

The endoscopic complete resection rates were 98.41% and 95.56%, the histopathologic complete resection rates were 93.65% and 82.22%, and the postoperative delayed hemorrhage rates were 4.76% and 0 in the ESD and ESMR-L groups, respectively.The difference was not statistically significant(P>0.05). Intraoperative perforation rates were 1.59% and 11.11%, respectively, but no infection occurred after intraoperative closure by titanium clips, and the difference was statistically significant(P<0.05). There were no cases of postoperative perforation and tumor recurrence in either group.Compared with the ESD group, the ESMR-L group had shorter hospitalization time, hospitalization cost, and operation time (P<0.001). Binary logistic regression analysis showed that tumor length ≥7 mm and tumor depth to the submucosal layer were risk factors affecting the histopathological complete resection rate and patient prognosis.

Endoscopic resection of R-NETs is safe and effective, but a comprehensive preoperative assessment based on tumor length and infiltration depth is needed.For G1-stageR-NETs with a shallow tumor depth and a diameter of < 7 mm, S-ESMR-L is a more economical and effective treatment option T-than ESD.

To investigate the safety and feasibility of linaclotide combined with low-dose Compound Polyethylene Glycol Electrolytes Powder (PEG) for bowel preparation in constipated patients.

A total of 300 patients scheduled for colonoscopy at the Endoscopy Center of Baoding First Central Hospital from March 2022 to October 2023 were enrolled.Participants were randomly divided into two groups using a random number table.Group A as control group, received 4L-PEG for bowel preparation.Group B as Experimental group, received 870μg linaclotide combined with 3L-PEG for bowel preparation.Bowel cleanliness was evaluated using the Boston Bowel Preparation Scale (BBPS) scores (right colon, mid-colon, distal colon, and total score). Adverse event rates were compared between groups.

Group B demonstrated significantly higher BBPS scores in the right colon, mid-colon, distal colon, and total score compared to Group A (P<0.05). Additionally, the adverse event rate in Group B was significantly lower than that in Group A, with the difference being statistically significant (P<0.05).

The bowel preparation protocol combining 870 μg linaclotide with 3L-PEG provides superior bowel cleanliness to the conventional 4L-PEG regimen, with a lower incidence of adverse events.