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Background Cardiovascular disease is a leading cause of death and disability worldwide. There is still a lack of research reports on the risk assessment of cardiovascular disease in rural populations in Naxi, an area in low-to-high altitudes (1 000-3 500 meters) . Objective To investigate the exposure and aggregation of cardiovascular disease risk factors, and to assess the 10-year risk of ischemic cardiovascular disease (ICVD) in rural population aged 35-75 years in Naxi area of Yunnan's Lijiang City from August to September 2020. Methods By use of random sampling, 35-75-year-old Naxi people were selected from 8 villages in Yunnan, and received a questionnaire survey, physical examination and laboratory examination. The 10-year ICVD risk was used to assess the modified 10-year ICVD risk Scale in Chinese Adults, and statistically analyzed. Results A total of 381 cases were included. Individuals from high altitudes had higher systolic blood pressure and triacylglycerol (TG) , and lower total cholesterol (TC) , low-density lipoprotein cholesterol (LDL-C) , and fasting blood glucose than those from moderate altitudes (P

Virtual power plant （VPP） technology can realize the effective aggregation and coordinated control of distributed resources to reduce the carbon emissions of power system operation and improve renewable energy consumption. The technology has become an effective way to promote the realization of “dual-carbon” goals. Firstly， the general situation and research status of VPP technology are introduced in terms of intelligent metering， information communication， and coordinated control. Next， given the promotion effect of VPP on the “dual-carbon” goals， the VPP dispatch modes for carbon emission reduction and renewable energy consumption are introduced respectively. Then， the construction status of three different types of VPPs in Shanghai， Jiangsu and a city in Zhejiang are introduced. And the impact of various factors on the key technologies and low-carbon dispatch mode selection of VPPs is analyzed. The results show that VPPs should be further developed in terms of intelligent metering， information communication and coordinated control； key technologies for VPPs and low-carbon dispatch mode should be selected rationally in accordance with load characteristics， resource distribution， and other factors.

New energy stations and energy storage power stations are working in closer cooperation in the context of a high proportion of new energy access with high uncertainty. Given the characteristics of distributed autonomous decision-making between new energy stations and energy storage power stations， a decomposition collaborative mechanism based on the alternating direction method of multipliers （ADMM） is used to establish a distributed collaborative optimization model of two operators considering the uncertainty of new energy. The optimal energy storage charging and discharging strategy under the distributed framework is obtained through few information iterations. The effectiveness and applicability of the proposed algorithm are verified by comparing the computational results of the proposed algorithm with those of the centralized algorithm using data from a small integrated energy system in North China.

Purpose: This research aims to compare the efficacy of neoadjuvant hepatic arterial infusion chemotherapy (HAIC) combined with Lenvatinib (Len) to direct liver resection (LR) in patients with resectable or borderline resectable hepatocellular carcinoma (HCC). Methods: This retrospective study included 154 patients with hepatocellular carcinoma (HCC) treated at the a large-scale hepatocellular carcinoma Research Center between March 2019 and June 2023. Patients were assigned to one of two groups: 63 received neoadjuvant hepatic arterial infusion chemotherapy (HAIC) combined with Lenvatinib followed by liver resection (HAIC+Len→LR), while 91 received direct liver resection (LR). The primary outcomes assessed were median overall survival (mOS), median progression-free survival (mPFS), median duration of response (mDOR), and adverse events (AEs). Results: Patients in the HAIC+Len→LR group demonstrated significantly longer median overall survival (mOS) (40.1 months vs 35.9 months, P=0.001) and median progression-free survival (mPFS) (32.8 months vs 23.8 months, P=0.0023) compared to the LR group. Preoperative complete response (CR) to HAIC was associated with better median duration of response (mDOR) and mOS compared to partial response (PR) (not reached vs 28.9 months, P=0.006; 40.0 vs 29.1 months, P=0.037). Subgroup analysis revealed no significant difference in OS or PFS between the HAIC+Len→LR and LR groups in early Barcelona Clinic Liver Cancer (BCLC) stages. However, in late BCLC stages, the HAIC+Len→LR group exhibited significantly improved OS and PFS (HR 0.471, P=0.016; HR 0.551, P=0.022). Treatment-related grade ≥ 3 adverse events were comparable between the two groups. Conclusion: For patients with resectable or marginally resectable HCC in the intermediate to advanced stages of BCLC, surgery after neoadjuvant HAIC+Len may offer improved long-term prognosis. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of This study is exploring the intraoperative and perioperative differences between patients undergoing conversion surgery and those undergoing direct surgery, so as to improve preoperative preparation. Methods: The retrospective study was approved by an ethics review committee. A total of 232 patients with hepatocellular carcinoma who underwent surgical resection at the First Affiliated Hospital of Chongqing Medical University from September 2022 to December 2023 were included, comprising 210 operating patients and 53 conversion patients. Propensity score matching was employed for comparison in order to minimize bias. Results: The conversion group had more intraoperative bleeding (each P=0.001), longer operation time (P=0.033; PSM p=0.025), and higher intraoperative blood transfusion rate (p=0.001; PSM p=0.044). The incidence of perioperative complications, including perioperative ascites formation (p=0.011; PSM p=0.005), moderate to severe anemia (p=0.001; PSM p=0.002), postoperative blood transfusion (p=0.004; PSM p=0.036), and postoperative ICU transfer (p=0.041; PSM p=0.025), was higher in the conversion group compared to the operation group. The postoperative hospital stay (p=0.001; PSM p=0.003) was prolonged in the conversion group. Conclusion: Post-conversion operations carry a higher risk of bleeding and are more likely to result in moderate to severe anemia and ascites formation in the perioperative period. However, the risk is reversible with adequate preoperative blood preparation and prompt postoperative symptomatic treatment. Conversion patients should be encouraged to undergo operating therapy when they can withstand surgical resection. [ABSTRACT FROM AUTHOR]

Background: The treatment of choledocholithiasis with nondilated common bile duct (CBD) is a challenge for surgeons who often choose endoscopic retrograde cholangiopancreatography with laparoscopic cholecystectomy (LC) staging surgery instead of simultaneous laparoscopic CBD exploration with LC because of the small CBD diameter. This study aims to introduce and assess the clinical applicability of a technique we developed to identify and extract CBD stones using laparoscopic ultrasound (LUS). Methods: We retrospectively reviewed surgical procedures and clinical data of 13 patients who underwent LC and CBD exploration using LUS between May 2022 and August 2023. The cystic duct was used for CBD stone removal. Results: Ten patients were successfully treated; 2 patients with residual stones were treated with ursodeoxycholic acid, whereas 1 patient required a microincision near the CBD and choledochoscopy because of stone incarceration in the duodenal papilla. The CBD diameter was 6 mm (5–9 mm). There were less than three CBD stones, with diameters of 2–6 mm; the median operative time was 105 minutes (range, 52–155 minutes). One patient developed postoperative cholangitis. The median postoperative hospital stay was 6 days (3–8 days). The stone clearance rate was 76.9%, and the CBD stone detection rate was 100%. No intraoperative complications, postoperative bile leakage, and mortality occurred. Conclusions: CBD exploration and transcystic stone extraction under LUS guidance are safe and effective approaches for patients with choledocholithiasis; strict control over surgical indications is necessary. This study could provide new strategies for effectively treating choledocholithiasis. [ABSTRACT FROM AUTHOR]