The nicotine demethylase CYP82E4 is essential for the formation of red dapples on flue-cured leaves of cherry-red tobacco.

Common flue-cured tobacco (Nicotiana tabacum L.) primarily accumulates nicotine, and its flue-cured leaves exhibit a lemon appearance. In contrast, a spontaneous cherry-red variant (CR60) primarily accumulates nornicotine, accompanied by distinctive red dapples on the cured leaves. In this study, suppression of conversion of nicotine to nornicotine by genome editing resulted in decreased nornicotine and N-acyl nornicotines (NacNNs), and the subsequent disappearance of red dapples in CR60. Conversely, overexpression of CYP82E4 increased nornicotine and NacNNs accumulation, inducing a red dapple phenotype in common tobacco. Notably, nicotine conversion triggered significant alterations in leaf total sugars, alkaloids, and nitrogens. Metabolome analyses using 1352 identified compounds indicated nicotine conversion dramatically affected the entire metabolic network and induced unique metabolic responses across diverse genetic backgrounds. Further WGCNA analysis revealed that nicotine conversion caused substantial contents variation of alkaloids, flavonoids and amino acids and derivatives in cured leaves. Overall, this research provides valuable insights into the mechanisms underlying red dapple formation in cherry-red tobacco, elucidating profound influence of nicotine conversion on entire metabolic network.

Estimation of irrigated crop artificial irrigation evapotranspiration in China.

Agriculture water use accounts for 70% of the total water withdrawal worldwide. The evapotranspiration during crop growth is one of the important hydrological processes in the agricultural water cycle. This study proposed the concept of artificial irrigation evapotranspiration of irrigated crops to describe that the evapotranspiration caused by irrigation water use. Irrigated crops rely on two kinds of water sources: precipitation and irrigation water. With the construction of irrigation schemes, the artificial irrigation evapotranspiration plays an increasingly important role in the dualistic water cycle system of irrigated cropland. To reveal the amount of artificial irrigation evapotranspiration of 17 categories of irrigated crops in China, this study proposed a new quantitative model system which was established based on traditional evapotranspiration models and soil water balance models. Based on the new model system, we calculated the annual artificial irrigation evapotranspiration of irrigated crops for the period 2013 to 2017 in China. The results showed that the proportion of artificial irrigation evapotranspiration to the total evapotranspiration of irrigated crops was 41.3%, whose value was 228.1 km3 a-1. The artificial irrigation evapotranspiration in different agricultural water management regions were 90.0 km3 a-1 in the northeast region, 86.0 km3 a-1 in the southeast region, and relatively low 52.2 km3a-1 in the west region. The results of this study can provide methods for water management and policy-making in agricultural irrigated areas, and it can also provide a preliminary understanding of the influence of human activities on the dualistic water cycle in cropland.

Research into Prediction Method for Pressure Pulsations in a Centrifugal Pump Based on Variational Mode Decomposition-Particle Swarm Optimization and Hybrid Deep Learning Models.

Centrifugal pump pressure pulsation contains various signals in different frequency domains, which interact and superimpose on each other, resulting in characteristics such as intermittency, non-stationarity, and complexity. Computational Fluid Dynamics (CFD) and traditional time series models are unable to handle nonlinear and non-smooth problems, resulting in low accuracy in the prediction of pressure fluctuations. Therefore, this study proposes a new method for predicting pressure fluctuations. The pressure pulsation signals at the inlet of the centrifugal pump are processed using Variational Mode Decomposition-Particle Swarm Optimization (VMD-PSO), and the signal is predicted by Convolutional Neural Networks-Long Short-Term Memory (CNN-LSTM) model. The results indicate that the proposed prediction model combining VMD-PSO with four neural networks outperforms the single neural network prediction model in terms of prediction accuracy. Relatively high accuracy is achieved by the VMD-PSO-CNN-LSTM model for multiple forward prediction steps, particularly for a forward prediction step of 1 (Pre = 1), with a root mean square error of 0.03145 and an average absolute percentage error of 1.007%. This study provides a scientific basis for the intelligent operation of centrifugal pumps.

Double-strand-break repair protein rad21 homolog/Synaptotagmin-7 alleviates Alzheimer's disease in mice by promoting M2 polarization of microglia.

Synaptotagmin-7 (SYT7) has been proposed as an innovative therapeutic strategy for treating cognitive impairment, while its contribution to Alzheimer's disease (AD) alleviation remains unclear. In this study, we investigated the role and potential mechanisms of SYT7 in AD. APP/PS1 mice were induced as an AD mouse model, and RNA-sequencing was conducted to analyze the transcriptomic differences between the brain tissues of AD mice and controls. SYT7, which was the most significantly differentially expressed gene in the RNA-sequencing, was found to be reduced in AD-like mice, and overexpression of SYT7 alleviated cognitive dysfunction and attenuated neuroinflammation and neuronal loss in the hippocampal tissues of mice with AD. Transcription factor double-strand-break repair protein rad21 homolog (RAD21) bound to the promoter of SYT7 to activate SYT7 transcription. SYT7 and RAD21 were expressed in microglia. SYT7 and RAD21 both promoted M2 polarization of microglia, while silencing of SYT7 repressed the M2 polarization of microglia in the presence of RAD21 overexpression. Overall, our results indicate that RAD21 mediated transcriptional activation of SYT7 to promote M2 polarization of microglia, thereby alleviating AD-like symptoms in mice, which might provide prospective cues for developing therapeutic strategies to improve cognitive impairment and AD course.

Establishing a river health evaluation index system for seven rivers in Jiamusi City of China.

The Jiamusi section of the Songhua River is one of the first 17 model river construction sections in China. The implementation of river health assessments can determine the health dynamics of rivers and test the management's effectiveness. Targeting seven rivers, this study conducted river zoning and monitoring point deployment to conduct sufficient field research and monitoring. The authors selected hydrological and water resources, physical structure, water quality, aquatic life, social service functions, and management as guideline layers and 15 indicator layers. Subsequently, the authors established an evaluation index system to evaluate and analyze the ecological status and social service status of each river. The results showed that the Yindamu, Alingda, and Gejie rivers scored well as healthy rivers, with health evaluation scores of 78.98, 76.06, and 75.83, respectively. The Wangsanwu, Lujiagang, and Lingdangmai rivers are generally sub-healthy rivers with scores of 71.55, 67.97, and 60.7, respectively. The Yinggetu River has a score of 54.52 and is therefore assessed as unhealthy. Based on the scientific evaluation index method, this study analyses the current river health state in Jiamusi City to provide the basis for the evaluation of the river chief's work and future river management.

Biomass ash as soil fertilizers: Supercharging biomass accumulation by shifting auxin distribution.

Growing quantities of biomass ashes (phyto-ashs) are currently produced worldwide due to the increasing biomass consumption in energy applications. Utilization of phyto-ash in agriculture is environmentally friendly solution. However, mechanisms involving the coordination of carbon metabolism and distribution in plants and soil amendment are not well known. In the present study, tobacco plants were chemically-fertilized with or without 2‰ phyto-ash addition. The control had sole chemical fertilizer; for two phyto-ash treatments, the one (T1) received comparable levels of nitrogen, phophorus, and potassium from phyto-ash and fertilizers as the control and another (T2) had 2‰ of phyto-ash and the same rates of fertilizers as the control. Compared with the control, phyto-ash addition improved the soil pH from 5.94 to about 6.35; T2 treatment enhanced soil available potassium by 30% but no difference of other elements was recorded among three treatments. Importantly, bacterial (but not fungal) communities were significantly enriched by phyto-ash addition, with the rank of richness as: T2 > T1 > control. Consistent with amelioration of soil properties, phyto-ash promoted plant growth through enlarged leaf area and photosynthesis and induced outgrowth of lateral roots (LRs). Interestingly, increased auxin content was recorded in 2nd and 3rd leaves and roots under phyto-ash application, also with the rank level as T2 > T1 > control, paralleling with higher transcripts of auxin synthetic genes in the topmost leaf and stronger [3H]IAA activity under phyto-ash addition. Furthermore, exogenous application of analog exogenous auxin (NAA) restored leaf area, photosynthesis and LR outgrowth to the similar level as T2 treatment; conversely, application of auxin transport inhibitor (NPA) under T2 treatment retarded leaf and root development. We demonstrated that phyto-ash addition improved soil properties and thus facilitated carbon balance within plants and biomass accumulation in which shifting auxin distribution plays an important role.

CD276-dependent efferocytosis by tumor-associated macrophages promotes immune evasion in bladder cancer.

Interplay between innate and adaptive immune cells is important for the antitumor immune response. However, the tumor microenvironment may turn immune suppressive, and tumor associated macrophages are playing a role in this transition. Here, we show that CD276, expressed on tumor-associated macrophages (TAM), play a role in diminishing the immune response against tumors. Using a model of tumors induced by N-butyl-N-(4-hydroxybutyl) nitrosamine in BLCA male mice we show that genetic ablation of CD276 in TAMs blocks efferocytosis and enhances the expression of the major histocompatibility complex class II (MHCII) of TAMs. This in turn increases CD4 + and cytotoxic CD8 + T cell infiltration of the tumor. Combined single cell RNA sequencing and functional experiments reveal that CD276 activates the lysosomal signaling pathway and the transcription factor JUN to regulate the expression of AXL and MerTK, resulting in enhanced efferocytosis in TAMs. Proving the principle, we show that simultaneous blockade of CD276 and PD-1 restrain tumor growth better than any of the components as a single intervention. Taken together, our study supports a role for CD276 in efferocytosis by TAMs, which is potentially targetable for combination immune therapy.

Examining the Antecedents of Novice STEM Teachers' Job Satisfaction: The Roles of Personality Traits, Perceived Social Support, and Work Engagement.

It is reported that teachers' satisfaction levels are lower and stress levels are higher than other professional groups in many countries. This is especially true for science, technology, engineering, and mathematics (STEM) teachers. Considering job satisfaction has a direct impact on turnover intention, low satisfaction levels have led to high turnover rates and thus exacerbated the shortages of STEM teachers. Hence, there is an urgent need to explore the antecedents of novice STEM teachers' job satisfaction. This study proposes a new model to show how novice STEM teachers' personality traits and perceived social support influence their job satisfaction. A total of 2592 novice STEM teachers in eighteen randomly selected high schools in China were recruited. Data were analyzed using the structural equation modeling approach. The results illustrated that most novice STEM teachers had low levels of job satisfaction. Novice STEM teachers' personality traits could directly and indirectly impact their job satisfaction. Meanwhile, novice STEM teachers' job satisfaction was also directly influenced by work engagement and indirectly influenced by their perceived social support. Our findings theoretically contribute to the understanding of the determinants of STEM teachers' job satisfaction and have important practical implications.

Multi-User Redirected Walking in Separate Physical Spaces for Online VR Scenarios.

With the recent rise of Metaverse, online multiplayer VR applications are becoming increasingly prevalent worldwide. However, as multiple users are located in different physical environments, different reset frequencies and timings can lead to serious fairness issues for online collaborative/competitive VR applications. For the fairness of online VR apps/games, an ideal online RDW strategy must make the locomotion opportunities of different users equal, regardless of different physical environment layouts. The existing RDW methods lack the scheme to coordinate multiple users in different PEs, and thus have the issue of triggering too many resets for all the users under the locomotion fairness constraint. We propose a novel multi-user RDW method that is able to significantly reduce the overall reset number and give users a better immersive experience by providing a fair exploration. Our key idea is to first find out the "bottleneck" user that may cause all users to be reset and estimate the time to reset given the users' next targets, and then redirect all the users to favorable poses during that maximized bottleneck time to ensure the subsequent resets can be postponed as much as possible. More particularly, we develop methods to estimate the time of possibly encountering obstacles and the reachable area for a specific pose to enable the prediction of the next reset caused by any user. Our experiments and user study found that our method outperforms existing RDW methods in online VR applications.

Smoking, Symptoms Improvement, and Total Antioxidant Capacity in Patients with Drug-naive First-episode Schizophrenia: A Prospective Cohort Study.

BACKGROUND: It has been hypothesized that smoking is associated with the severity of negative symptoms. Until now, no studies have investigated whether the impact of smoking on negative symptoms is dependent on antioxidants. This study was designed to evaluate the effect of smoking on therapeutic response and total antioxidants capacity (TAOC) in antipsychotic-naïve first-episode (ANFE) patients. METHODS: The severity of the patient's symptoms was assessed using the Positive and Negative Syndrome Scale (PANSS). A total of 237 ANFE patients were recruited and treated with risperidone (oral tablets, 4-6 mg/day twice a day) for 12 weeks. PANSS was assessed at baseline and a 12-week follow-up. Plasma TAOC levels were also assayed at baseline and week 12. RESULTS: Relative to nonsmokers with ANFE SZ, smokers had higher PANSS negative subscores. There was no significant difference in TAOC changes after 12 weeks of treatment with risperidone between smokers and non-smokers. However, we found greater improvement in negative symptoms in smokers compared to non-smokers. Further analysis in smokers with SZ demonstrated that improvements in negative symptoms were not associated with changes in TAOC. CONCLUSION: Our study suggested that smoking affected the severity of baseline negative symptoms and further contributed to their reduction after risperidone treatment. However, improvement in negative symptoms was not dependent on the changes in TAOC.

Sewage network operational risks based on InfoWorks ICM with nodal flow diurnal patterns under NPIs for COVID-19.

Non-Pharmaceutical Interventions (NPIs) have been widely employed globally over the past three years to control the rapid spread of coronavirus disease 2019 (COVID-19). These measures have imposed restrictions on urban residents' activities and significantly influenced sewage discharge characteristics within sewage network, particularly in densely populated cities in China. This study focused on the nodal flow diurnal patterns and sewage network operational risks before and after epidemic lockdown in Beijing from March to May in 2022. Nodal flow diurnal patterns on weekdays and weekends before and after NPIs were analyzed using measured data through statistical and mathematical methods. A sewage network model was established to simulate and analyze the operational risks based on InfoWorks ICM before and after epidemic lockdown. The main conclusions were as follows: (1) In predominantly residential areas, the total wastewater volume increased by approximately 28.76 % to 33.52 % after the implementation of strict NPIs. The morning and midday "M" peaks on normalized weekdays transformed into "N" peaks, and the morning peak time was delayed by 0.5 to 1 hour after the lockdown; (2) Following NPIs, More than 90 % of manholes' average water levels rose to varying degrees, approximately 50 % of pipe lengths exhibited a full flow state; (3) When the lockdown was in place during a hot summer day, sewage overflow phenomena were observed in 4.6 % and 9.6 % of manholes, respectively, with per capita daily drainage equivalent reaching 40-50 %. These findings hold significant implications for the proactive planning and operational management of water industry infrastructure during major emergencies.

Dynamic monitoring of maize grain quality based on remote sensing data.

Remote sensing data have been widely used to monitor crop development, grain yield, and quality, while precise monitoring of quality traits, especially grain starch and oil contents considering meteorological elements, still needs to be improved. In this study, the field experiment with different sowing time, i.e., 8 June, 18 June, 28 June, and 8 July, was conducted in 2018-2020. The scalable annual and inter-annual quality prediction model for summer maize in different growth periods was established using hierarchical linear modeling (HLM), which combined hyperspectral and meteorological data. Compared with the multiple linear regression (MLR) using vegetation indices (VIs), the prediction accuracy of HLM was obviously improved with the highest R 2, root mean square error (RMSE), and mean absolute error (MAE) values of 0.90, 0.10, and 0.08, respectively (grain starch content (GSC)); 0.87, 0.10, and 0.08, respectively (grain protein content (GPC)); and 0.74, 0.13, and 0.10, respectively (grain oil content (GOC)). In addition, the combination of the tasseling, grain-filling, and maturity stages further improved the predictive power for GSC (R 2 = 0.96). The combination of the grain-filling and maturity stages further improved the predictive power for GPC (R 2 = 0.90). The prediction accuracy developed in the combination of the jointing and tasseling stages for GOC (R 2 = 0.85). The results also showed that meteorological factors, especially precipitation, had a great influence on grain quality monitoring. Our study provided a new idea for crop quality monitoring by remote sensing.

Green infrastructure optimization considering spatial functional zoning in urban stormwater management.

Green infrastructure (GI) is used as an alternative and complement to traditional urban drainage system for mitigating urban stormwater issues mainly caused by climate change and urbanization. The combination of hydrological model and optimization algorithm can automatically find the optimal solution under multiple objectives. Given the multi-functional characteristics of GI, choosing the optimization objectives of GI are critical for multiple stakeholders. This study proposes a GI optimization method considering spatial functional zoning. Based on the basic conditions, the study area is divided into the flood risk control zone (FRCZ) and the total runoff control zone (TRCZ). The integrated model coupling hydrological model and optimization algorithm is applied to obtain the Pareto fronts and corresponding non-dominated solutions. The Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method is used to support the decision-making process. The optimal solution obtained for the FRCZ achieves a flood risk reduction rate of 60.49% with an average life cycle cost per year of 0.20 × 108 Chinese Yuan (CNY); The optimal solution obtained for the TRCZ achieves a total runoff reduction rate of 22.83% with an average life cycle cost per year of 0.17 × 108 CNY. This study provides a reference for stakeholders in GI planning and design.

Suicidal ideation in Chinese adults with schizophrenia: associations with neurocognitive function and empathy.

BACKGROUND: Suicidal ideation is common among people diagnosed with schizophrenia spectrum disorders and may be related to neurocognitive, social cognitive, and clinical variables. This study aimed to investigate the relationships between suicidal ideation and both neurocognitive function and empathy. METHODS: The sample for this cross-sectional study comprised 301 schizophrenic patients aged 18-44 years. All participants were administered the Beck Scale for Suicide Ideation-Chinese Version (BSI-CV), the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Interpersonal Reactivity Index (IRI), and the Positive and Negative Syndrome Scale (PANSS). The demographic and clinical data of the patients were also collected. RESULTS: In total, 82 patients reported suicidal ideation. Compared to patients without suicidal ideation, patients with suicidal ideation showed significant differences in the IRI-Personal Distress subscale, PANSS-General Psychopathology symptom scores, and suicide attempts. Moreover, there were moderating effects of neurocognitive function and empathy on the relationship between suicide attempts and suicidal ideation. CONCLUSIONS: These results indicate that the personal distress component of empathy, general psychopathology symptoms and suicide attempts are independent risk factors for suicidal ideation in Chinese adults with schizophrenia. Moreover, neurocognitive function may also be related to suicidal ideation through a moderating relationship. In order to reduce suicidal ideation among patients with schizophrenia, early screening of empathy and neurocognitive function is essential.

Serum total cholesterol levels associated with immediate memory performance in patients with chronic schizophrenia.

Cognitive impairments are common in patients with schizophrenia. Changes in total cholesterol (TC) may be involved in the development of schizophrenia and associated with cognitive function. This study aimed to investigate differences in serum TC level and cognitive function between schizophrenia patients and healthy controls and explore the relationship between serum TC level and cognitive function in patients with schizophrenia. A total of 105 schizophrenia patients and 105 healthy controls were recruited. Results showed that patients with schizophrenia had significantly lower scores on the overall RBANS scale and subscales (i.e., immediate memory, language, attention, and delayed memory) than those of healthy controls. Pearson's correlation analyses showed that in patients with schizophrenia, serum TC levels were positively associated with RBANS subscale scores of immediate memory and language. Furthermore, multivariate regression analyses showed that serum TC level was positively associated with the immediate memory index in patients with schizophrenia. However, no significant association was found between serum TC level and RBANS score in the healthy control group. Our results suggest that elevated serum TC level may be related to improved cognitive function in patients with schizophrenia, especially that of immediate memory.

[Multi-dimensional Analysis of the Synergistic Effect of Pollution Reduction and Carbon Reduction in Tianjin Based on the STIRPAT Model].

Based on the STIRPAT model, this study quantitatively analyzed the synergistic effect of pollution reduction and carbon reduction in Tianjin from three dimensions:total emission, emission reduction, and synergy coefficient. The results showed that the main emission sources of air pollutants and greenhouse gases in Tianjin were industrial sources, and the Pearson correlation coefficient of air pollutants and greenhouse gases was 0.984. The total population, urbanization rate, gross regional product, energy intensity, and carbon dioxide emission intensity were important factors affecting the synergistic effect of pollution reduction and carbon reduction in Tianjin. In 2011 and 2012, Tianjin's air pollutants and greenhouse gas emissions increased synergistically, and the synergistic effect coefficients were 0.18 and 0.17, respectively. From 2013 to 2014 and from 2018 to 2023, the air pollutant emission reduction and greenhouse gas emission increased, the synergistic effect coefficient was less than 0, and the pollution reduction and carbon reduction had no synergistic effect. In 2015-2017 and 2024-2060, air pollutants and greenhouse gas emissions were predicted to be reduced at the same time, with a synergistic effect coefficient ranging from 2.74 to 8.76. Tianjin had the conditions to enter the synergistic stage of pollution reduction and carbon reduction in 2024. The most important things for Tianjin to do to promote the synergy of pollution reduction and carbon reduction were to strictly control the total amount of greenhouse gas emissions, continue to promote the reduction in energy intensity and carbon dioxide emission intensity, and reasonably control the total population, urbanization rate, and regional GDP.

Obesity, antioxidants and negative symptom improvement in first-episode schizophrenia patients treated with risperidone.

Negative symptoms remain a main therapeutic challenge in patients with schizophrenia (SZ). Obesity is associated with more severe negative symptoms after the first episode of psychosis. Oxidative stress caused by an impaired antioxidant defense system is involved in the pathophysiology of SZ. Yet, it is unclear regarding the role of obesity and antioxidants in negative symptom improvements in SZ. Therefore, this longitudinal study was designed to assess the impact of obesity on antioxidant defenses and negative symptom improvements in first-episode SZ patients. A total of 241 medication-naive and first-episode patients with SZ were treated with risperidone for 3 months. Outcome measures including symptoms, body weight, and total antioxidant status (TAS) levels were measured at baseline and the end of the third month. We found that after 12 weeks of treatment with risperidone, the body weight increased and clinical symptoms significantly improved. Baseline body mass index (BMI) was negatively correlated with negative symptom improvement after treatment and an increase in TAS was negatively associated with an increase in BMI only in the high BMI group. More importantly, the TAS × BMI interaction at baseline was an independent predictor of negative symptom improvement. Our longitudinal study indicates that the improvement in negative symptoms by risperidone was associated with baseline BMI and TAS levels in patients with SZ. Baseline BMI and TAS may be a predictor for negative improvement in SZ patients after risperidone treatment.

Making Resets away from Targets: POI aware Redirected Walking.

Rapidly developing Redirected Walking (ROW) technologies have enabled VR applications to immerse users in large virtual environments (VE) while actually walking in relatively small physical environments (PE). When an unavoidable collision emerges in a PE, the ROW controller suspends the user's immersive experience and resets the user to a new direction in PE. Existing ROW methods mainly aim to reduce the number of resets. However, from the perspective of the user experience, when users are about to reach a point of interest (POI) in a VE, reset interruptions are more likely to have an impact on user experience. In this paper, we propose a new ROW method, aiming to keep resets occurring at a longer distance from the virtual target, as well as to reduce the number of resets. Simulation experiments and real user studies demonstrate that our method outperforms state-of-the-art ROW methods in the number of resets and dramatically increases the distance between the reset locations and the virtual targets.

The Considerable Water Evaporation Induced by Human Perspiration and Respiration in Megacities: Quantifying Method and Case Study in Beijing.

The water cycle in urban areas is called the natural-social dualistic water cycle, and it is driven not only by natural forces, but also by human activities. As the drivers of the social water cycle, human perspire continuously, and this is often overlooked as a contributing factor to the water cycle. This paper proposes a method for quantifying the water evaporation induced by human perspiration and respiration in megacities. A calculation based on the sweating prediction model was applied to the city of Beijing to evaluate the evaporation from the human body. The results show that the greatest volume of evaporation produced by human occurs in summer, and the least in spring. The total evaporation produced by human was converted to the evaporation on unit area of the city and reached 5075.2 m3/km2 in the six core districts of Beijing. According to the calculation, the total volume was considerable and reached 14.0 million m3 in 2020, which was equivalent to the annual evapotranspiration from an area of 104.9 km2 of Acer truncatum forest (15 cm diameter at breast height, afforestation density 800 plants/hm2), and even twice the annual total water use in Tartu, Estonia. The results of the study provide a reference for dualistic water cycle research and water cycle flux calculation in urban areas.

Analysis of Laparoscopic Ultrathin Choledochoscope Curative Effect on Common Bile Duct Exploration and Choledocholithotomy in 47 Cases.

Objective: The aim of the present study is to summarize the experience of using a 2. 7 mm choledochoscope for laparoscopic cholecystectomy combined with an ultrathin choledochoscope for common bile duct exploration and choledocholithotomy in the treatment of cholecystolithiasis associated with choledocholithiasis after the implementation of strict inclusion and exclusion criteria. Methods: A retrospective analysis of 47 patients with cholecystolithiasis complicated with choledocholithiasis who were treated in the hepatopancreatobiliary surgery department of the Chinese People's Liberated Army General Hospital between January 2015 and December 2019 was performed in the present study. Clinical data of laparoscopic cholecystectomy combined with ultrathin choledochoscope transcystic duct exploration for common bile duct and choledocholithotomy. Results: All 47 patients completed the operation successfully. The gallbladder duct was closed using a surgical clamp. Only 2 patients were administered with an abdominal drainage tube. The operation time was 50-160 min, the intraoperative blood loss was 5-50 ml, and the postoperative hospital stay was 2-8 days. No patients had serious complications, such as bile leakage, postoperative bleeding, cholangitis, biliary pancreatitis, and wound infection. Minor complications, such as abdominal pain (Abdominal pain was defined as a patient felt tolerable or unbearable abdominal pain but improved or disappeared with medication) and diarrhea, were present in a few patients; these improved after conservative treatment. There was no recurrence of calculi during the 1-5 years of follow-up, and the patient quality of life was good. Conclusion: Laparoscopic cholecystectomy combined with ultrathin choledochoscope common bile duct exploration and choledocholithotomy is a safe and effective method after adopting strict inclusion and exclusion criteria. This technology was started in the First Medical Center, Chinese People's Liberation Army General Hospital in September 2009, and it has become extremely mature in the past 5 years.