Abstract:Helicobacter pylori (H. pylori) infection is the most significant controllable risk factor for gastric cancer, and its eradication is a critical component of gastric cancer prevention in China. A family-based screening and treatment strategy for H. pylori aligns well with China’s public health needs. It demonstrates higher eradication success rate, lower recurrence rate, and superior cost-effectiveness, making it suitable for both high- and low-prevalence regions. Implementation of this family-based strategy can lead to greater precision, higher efficiency, and overall coverage in gastric cancer prevention in China, offering a scalable “China model” for global gastric cancer control.

Abstract:Artificial ligament, as a choice of grafts in anterior cruciate ligament (ACL) reconstruction, has always been a focus of ACL injury research. Since the incidence of ACL injury in the military is significantly higher than that in the general population, artificial ligament can theoretically make up for the limited source of biological grafts and donor site complications, more in line with the needs of rapid rehabilitation and retraining of military patients after surgery, and has been widely used in military ACL reconstruction. However, the special physicochemical characteristics of artificial ligament determine higher requirements for surgical indication selection and bone tunnel positioning technique. At the same time, there are differences and controversies in the published clinical studies regarding its efficacy. Therefore, after nearly 2 decades, it has not yet been able to completely replace biological grafts. Aiming to further standardize and promote the application of artificial ligaments in military ACL reconstruction surgery, led by the Sports Medicine Arthroscopy Branch of the Orthopedics Professional Committee of the Chinese People’s Liberation Army Medical Science and Technology Committee, experts were organized to develop 11 consensus items through clinical evidence sorting and scientific discussions from 3 aspects: surgical indications, surgical techniques, and postoperative management. It is pointed out that artificial ligaments can be used alone or in combination with autologous tendons for the primary and revision surgeries of ACL, which has potential advantages for overweight cases and those requiring accelerated recovery. In addition, more attention should be paid to retaining remnants, isometric tunnel positioning, and cortical bone screw fixation.

Abstract:Chinese Medical Association guideline for clinical diagnosis and treatment of lung cancer (2024 edition) has been released in Sep. 2024. Based on the 2023 edition, the 2024 edition of the guideline has been updated concerning lung cancer screening, pathological evaluation, surgical standards, neoadjuvant therapy, postoperative adjuvant therapy and treatment of advanced lung cancer. This article gives a brief introduction and interpretation on these updated points.

Abstract:Sessile serrated lesion (SSL) is a major precancerous lesion type of colorectal cancer and one of the main causes of colorectal cancer. SSL has unique tissue structures and morphological features, with low detection rate under endoscopy and high variability in histopathological diagnosis, making it one of the most easily missed lesions in colorectal cancer screening. In recent years, the application of artificial intelligence (AI) in the diagnosis of colorectal cancer has been rapidly increasing. Previous studies have found that AI-assisted endoscopic technology can improve the detection rate and diagnostic accuracy of colorectal SSL, and AI-assisted pathological diagnosis can improve diagnostic efficiency and consistency. This article aims to provide a review of current research on AI technology in colorectal SSL.

Abstract:Colorectal cancer (CRC) is one of the most common malignant tumors worldwide, and its incidence has been increasing in recent years, especially among young adults. Non-genetic factors, such as dietary habits, lifestyle and intestinal flora, play an important role in the development of CRC. Dietary factors have a close relationship with CRC development. Insufficient fiber intake and excessive consumption of red and processed meat are generally considered major high-risk factors for CRC, while vegetables and fruits are considered as beneficial factors. The roles of calcium supplements, vitamin D, dairy products, and different dietary patterns in the development of CRC are still controversial. Furthermore, obesity, smoking, alcohol consumption, and lack of physical exercise are also associated with the risk of CRC. The imbalance of intestinal flora is also believed to be associated with the development of CRC. Optimizing dietary habits and maintaining a healthy lifestyle can significantly reduce the risk of CRC. Non-steroidal anti-inflammatory drugs and estrogen supplementation may have beneficial effects in reducing the risk of CRC. For certain individuals at high risk, pharmacological intervention may serve as an effective preventive measure.

Abstract:Objective To identify potential biomarkers and establish a prediction model for chemotherapy-related hepatotoxicity susceptibility based on plasma endogenous metabolites of colorectal cancer (CRC) patients before chemotherapy. Methods The plasma samples of 50 CRC patients before capecitabine chemotherapy and the records of their chemotherapy-related hepatotoxicity during the follow-up were collected. An ultra-high-performance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOF-MS) was used to perform untargeted metabolomic analysis. Based on bioinformatics analysis, differential analysis, correlation analysis, and random forest were used to screen for hepatotoxicity-related plasma endogenous metabolites. All samples were randomly assigned (7∶3) to training set or test set. A multivariate logistic regression model was established to predict the hepatotoxicity of capecitabine chemotherapy based on the training set data. The prediction effects of the model in the training, test and entire sets were evaluated by receiver operating characteristic (ROC) curve analysis. Results The endogenous metabolites related to hepatotoxicity in the plasma of CRC patients before chemotherapy were mainly lipid endogenous metabolites. A series of potentially important predictive biomarkers for hepatotoxicity susceptibility were identified, including sphingamine-1-phosphate, ceramide, galactose, arachidonic acid, tyrosine, biliverdin, myristic acid, phosphatidylcholine (35∶1), phosphatidylethanolamine (36∶1), and hexadecanoic acid. The area under curve values of the prediction model based on the above biomarkers in the training, test and entire sets were 0.946 (95% confidence interval ［CI］ 0.842-1.000), 0.920 (95% CI 0.720-1.000), and 0.912 (95% CI 0.810-0.982), respectively. Conclusion The endogenous metabolites in the plasma of CRC patients before chemotherapy can effectively predict the hepatotoxicity of capecitabine chemotherapy. These hepatotoxicity biomarkers indicate that susceptible patients have characteristics related to lipid metabolism disorders

Abstract:Objective To systematically analyze the incidence and mortality characteristics of colorectal cancer (CRC) in China in 2022, so as to provide evidence-based proof for the prevention and control of CRC. Methods The CRC data published by the GLOBOCAN database and the China National Cancer Center in 2022 were collected and the incidence and mortality across different genders, age groups, and geographical regions were analyzed. Results In China, the age-standardized incidence rate (SIR) and age-standardized mortality rate (SMR) of CRC in males were 24.83×10^－5 and 10.87×10^－5, and the SIR and SMR in females were 15.97×10^－5 and 6.56×10^－5, respectively. Around the world, the SIR and SMR of CRC in males were 22.0×10^－5 and 9.90×10^－5, and SIR and SMR in females were 15.20×10^－5 and 6.50×10^－5, respectively. The SIR and SMR of CRC in Chinese males were higher than those in females (χ²＝10.037 and 9.994, P＝0.001 and 0.002), and the SIR and SMR in global males were also higher than those in females (χ²＝7.093 and 7.853, P＝0.013 and 0.011). However, there were no significant differences in SIR or SMR of male or female CRC between China and the world (all P＞0.05). The mortality of CRC in China exhibited an upward trend with the increase of age, particularly after the age of 40 years, with the number of deaths escalated markedly, and the mortality of males was notably higher compared with that of females. The peak mortality for males occurred at the ages of 70-74 years, and it demonstrated a declining trend thereafter. In contrast, the mortality for females continued to rise with age and eventually approached that of males. The regional distributions of CRC incidence and mortality were significantly different in China, with the SIR and SMR of CRC in urban areas being significantly higher than those in rural areas (21.71×10^－5 vs 18.49×10^－5, χ²＝8.037, P＝0.009; 9.02×10^－5 vs 8.17×10^－5, χ²＝5.669, P＝0.031). Conclusion The national prevention and control strategy for CRC should be optimized according to epidemic characteristics (such as age ≥40 years old, males and risk regions), so as to curb the rising trend of CRC incidence and mortality, reduce disease burden and improve social and public benefits.

Abstract:Objective To investigate the role of scar epithelial cells and its potential molecular mechanisms in the efficacy of low-energy CO₂ fractional laser treating post-burn scars. Methods The model of post-major burn scars on the back of rat was established. Three rats with post-major burn scars received 30 mJ low-energy CO₂ fractional laser treatment to detect the activation of scar epidermal cells. Epidermal tissue of scars was isolated for RNA sequencing to screen activated pathways. Subsequently, 18 rats with post-major burn scars were randomly divided into 3 groups (n＝6): the control group without laser treatment, the laser group receiving 30 mJ CO₂ fractional laser treatment, and the laser＋inhibitor group receiving laser treatment and intra-scar injection of IWR-1 (a Wnt/β-catenin pathway inhibitor), to verify the activation status and effects of the selected pathways. Hematoxylin-eosin staining, Masson staining, and Western blotting were used to detect the proliferation of epithelial cells and fibroblasts, the activation of Wnt/β-catenin pathway, as well as the improvement of scar profiles. Results After low-energy laser treatment, there was a significant increase in the number of Ki67-positive, proliferating cell nuclear antigen (PCNA)-positive, cytokeratin 19 (CK19)-positive, and p63-positive cells in the scar epithelial tissue. RNA sequencing coupled with literature analysis identified Wnt/β-catenin pathway as a potential candidate pathway. In the confirmatory experiment, compared to the control group, the Wnt/β-catenin pathway was activated in scar epithelial cells in the laser group 5 d post-laser intervention. After 30 d laser intervention, dermal collagen exhibited a more loosened arrangement, with reduced dermal thickness and significantly less α-smooth muscle actin (α-SMA)-positive fibroblasts compared to the control group. CollagenⅠ, collagen Ⅲ, and the relative ratio of collagen Ⅰ to Ⅲ in the laser group were at a lower level than those in the control group. Administration of the Wnt/β-catenin pathway inhibitor blocked the activation of the Wnt/β-catenin pathway induced by low-energy laser, the proliferation of scar epithelial cells and the improvement of scar profiles. Conclusion Low-energy CO₂ fractional laser treatment can activate the Wnt/β-catenin pathway of scar epithelial cells, thereby activating epithelial cells and yielding significant scar improvements.

Abstract:Objective To investigate the protective effects of Wuling capsule on mice with autoimmune hepatitis (AIH). Methods Mice were randomly divided into control group, AIH model group, Wuling capsule low-dose group (0.5 g·kg^－1·d^－1), Wuling capsule middle-dose group (1.0 g·kg^－1·d^－1), and Wuling capsule high-dose group (2.0 g·kg^－1·d^－1), with 10 mice in each group. The Wuling capsule groups were administered with Wuling capsule suspension of different doses orally at a volume of 10 mL/kg once daily; the control group and AIH model group were given the same volume of saline by gavage. After 14 d of administration, mice in the AIH model group and Wuling capsule groups were injected with concanavalin A (20 mg/kg) via the tail vein, and the serum, liver, and spleen were collected 8 h after injection. Serum alanine transaminase (ALT) and aspartate transaminase (AST) levels were measured using an automatic biochemical analyzer; hematoxylin-eosin staining was used to observe the pathological structure of the liver tissue; the contents of interleukin (IL)-6, IL-4, and tumor necrosis factor (TNF)-α in liver were determined by enzyme-linked immunosorbent assay, and quantitative polymerase chain reaction was used to determine the relative mRNA expression levels of IL-6, IL-4, TNF-α, Toll-like receptor 4 (TLR4), and nuclear factor κB (NF-κB) in the liver. Fluorescence immunoassay was used to analyze the expression and nuclear translocation of NF-κB p65 protein in the liver. Results Compared with the control group, the AIH model group showed abnormal liver morphology and structure, increased serum ALT and AST levels, increased contents of IL-4, IL-6, and TNF-α in the liver, upregulated mRNA expression levels of IL-6, IL-4, TNF-α, TLR4, and NF-κB in the liver, and increased nuclear entry of NF-κB p65. Wuling capsule significantly improved the pathological structure of the liver in AIH mice, reduced serum ALT and AST levels, decreased the contents of IL-4, IL-6, and TNF-α in the liver and the mRNA expression levels of TLR4, NF-κB, IL-4, IL-6, and inhibited the nuclear activation of NF-κB p65. Conclusion Wuling capsule has significant protective effects on AIH mice, which may be related to the TLR4/NF-κB signaling pathway.

Abstract:Objective To explore the effects of chronic stress and stress cessation on hypothalamic appetite regulators in mice, and to explore the stress-dependent mechanism of appetite change. Methods A total of 32 male C57BL/6 mice were randomly divided into control (Ctrl) group (n＝16) and chronic unpredictable mild stress (CUMS) group (n＝16). The mice in the CUMS group were given CUMS to establish the stress model, and those in the Ctrl group were fed normally. The food intake and weight of mice were recorded. The CUMS model was verified through tail suspension experiments and forced swimming experiments. Eight mice in the Ctrl group and 8 mice in the CUMS group were randomly sacrificed at the 12th week. The Ctrl group was re-grouped into the cessation-control (C-Ctrl) group (n＝8), the CUMS group was re-grouped into the cessation-stress (C-CUMS) group (n＝8), and the mice were sacrificed at the 15th week. The mRNA and protein levels of appetite-regulating factors, including orexin 1 receptor (OX1R), leptin receptor (LEPR) and agouti-related protein (AgRP) in the hypothalamus, were detected by quantitative polymerase chain reaction and immunochemistry. Results From week 2 to week 11 of stress, the food intake of the mice in the CUMS group was significantly higher than that in the Ctrl group (all P＜0.05), while there was no significant difference in body weight between the 2 groups within 11 weeks (all P＞0.05). Compared with the Ctrl group, the immobility durations of forced swimming and tail suspension of the CUMS group were markedly longer after 11 weeks (both P＜0.01), indicating successful modeling. AgRP and OX1R mRNA expression in the hypothalamus of the CUMS group was significantly increased (both P＜0.01), while LEPR mRNA expression was significantly decreased (P＜0.01); AgRP protein in the hypothalamic arcuate nucleus of the CUMS group was significantly higher than that of the Ctrl group (P＜0.05), and LEPR protein was markedly lower than that of the Ctrl group (P＜0.01). However, after 3 weeks of stress cessation, the C-CUMS group had less food intake and lower body weight than the C-Ctrl group (both P＜0.05). The LEPR mRNA of the C-CUMS group was significantly increased (P＜0.01), while AgRP and OX1R mRNA were not significantly different (both P＞0.05). There was no significant difference in AgRP protein levels between the C-CUMS group and the C-Ctrl group (P＞0.05), while LEPR protein level of the C-CUMS group was significantly higher than that of the C-Ctrl group (P＜0.01). Conclusion CUMS can lead to increased appetite in mice, which may involve the functional regulation of LEPR and AgRP. After the stress cessation, the appetite decreases, which may involve the functional regulation of LEPR.

Abstract:Objective To investigate the expression and clinical significance of multiple endocrine neoplasia type 1 (MEN1) gene in breast cancer. Methods The Cancer Genome Atlas (TCGA) database was used to analyze the relationship between MEN1 gene and clinicopathological characteristics of breast cancer. Kaplan-Meier method was used to observe the effect of MEN1 on survival of breast cancer patients. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and gene set enrichment analysis (GSEA) were used to predict the function and signaling pathways of MEN1 related and interacting genes. Tumor Immune Estimation Resource (TIMER) and single sample gene set enrichment analysis (ssGSEA) were used to investigate the correlation between the level of immune infiltration and MEN1 expression in breast cancer. Results MEN1 was highly expressed in breast cancer patients, and its expression level was related to PAM50 subtype and menopause status (both P＜0.05). Kaplan-Meier survival analysis showed that high MEN1 expression was associated with poor clinical outcome (P＝0.019). GO and KEGG enrichment analysis showed that MEN1 related and interacting genes were involved in biological processes (histone modification, histone-lysine methylation), cell components (methyltransferase complex and histone methyltransferase complex), molecular functions (histone-methyltransferase activity), and functional pathways (transcriptional disorders in tumors). GSEA identified that the highly expressed MEN1 phenotype was involved in vesicle-mediated transport, complement cascade, B-cell receptor signaling, lymphocyte-non-lymphocyte interaction, interleukin signaling, and cytokine signaling pathways in the immune system. CancerSEA single cell sequencing results indicated that the expression of MEN1 was positively correlated with angiogenesis in MDA-MB-231 cells (P＜0.05). TIMER analysis found that MEN1 in breast cancer was negatively correlated with the infiltration levels of macrophages and CD8⁺ T cells, and positively correlated with the infiltration level of CD4⁺ T cells (all P＜0.05). ssGSEA showed that the infiltration levels of 18 types of immune cells were negatively correlated with MEN1 expression (all P＜0.05). Conclusion High MEN1 level is associated with poor survival and immune infiltration in breast cancer patients.

Abstract:Objective To investigate the value of contrast-enhanced ultrasound (CEUS) liver imaging reporting and data system version 2017 (LI-RADS v2017) in the differential diagnosis between hepatocellular carcinoma (HCC) and other hepatic malignancies (OM) less than or equal to 3 cm. Methods The clinical and imaging data of 163 liver lesions less than or equal to 3 cm in 126 patients with pathologically-confirmed liver malignancy were retrospectively analyzed. The patient underwent CEUS from Jan. 2018 to Jun. 2022 in our hospital, including 133 with HCC and 30 with OM. Nodules were classified based on the CEUS features according to the CEUS LI-RADS v2017. The evaluation of CEUS characteristics and CEUS LI-RADS v2017 in differential diagnosis of HCC and OM were calculated based on pathological findings. Results There were significant differences in the characteristics of arterial phase enhancement, timing of washout onset and washout degree between the HCC group and the OM group (all P＜0.001). The HCC group was mainly LR-3 (20 lesions, 15.04%), LR-4 (25 lesions, 18.80%) and LR-5 (82 lesions, 61.65%), and the OM group was mainly LR-M (28 lesions, 93.33%). The specificity and positive predictive value of late washout for HCC were 93.33% (28/30) and 98.06% (101/103), respectively; and the sensitivity of early washout for OM was 93.33% (28/30). With LR-5 as the criterion to diagnose HCC, the sensitivity was 61.65% (82/133), the specificity was 93.33% (28/30), and the positive predictive value was 97.62% (82/84); with LR-4/5 as the criterion to diagnose HCC, the sensitivity was 80.45% (107/133), the specificity was 93.33% (28/30), and the positive predictive value was 98.17% (107/109), with the sensitivity of LR-4/5 being significantly higher than those of LR-5 (P＝0.001). With LR-M as the criterion to diagnose OM, the sensitivity was 93.33% (28/30) and the specificity was 95.49% (127/133). Conclusion The CEUS LI-RADS v2017 can effectively distinguish HCC from OM less than or equal to 3 cm. LR-5 has a low sensitivity for HCC, while LR-4/5 can improve the sensitivity for HCC.

Abstract:Gastric cancer (GC) is one of the main causes of death in China. Recently, the patients diagnosed with early GC has increased year by year. However, drug resistance has seriously limited the effects of surgery and chemotherapy. Therefore, it is urgent to explore new therapeutic targets for GC. Ferroptosis is an iron-dependent programmed cell death, and it is characterized by intracellular lipid peroxidation. GC cells are very sensitive to the level of intracellular iron metabolism. Ferroptosis plays an important role in the development, progression, treatment and drug resistance of GC. Ferroptosis-related genes and non-coding RNAs in GC cells are closely related to metastasis, drug resistance and prognosis of GC. In recent years, research on the regulatory effect of ferroptosis on the proliferation of GC cells has made some progress, and targeted ferroptosis may be an effective treatment for GC. This article describes the role of ferroptosis in the proliferation, invasion, metastasis and drug resistance of GC cells, summarizes the target genes related to ferroptosis, and prospects the application of targeted regulation of ferroptosis in the treatment of GC.

Abstract:Neurotrophic receptor tyrosine kinase (NTRK) gene fusions are oncogenic drivers in multiple solid tumors, and they are also important clinical biomarkers. NTRK fusion-positive thyroid cancer (TC) exhibits distinctive clinicopathological features. Patients with advanced, metastatic, or iodine-refractory TC should receive evaluation of NTRK fusion status. However, there have been no authoritative recommendations or standardized procedures for the diagnosis and treatment of NTRK fusions in TC. This review discusses the research advances regarding NTRK fusion-positive TC, summarizes the clinicopathological features of the disease, and outlines the current statuses of NTRK fusion detection and targeted therapeutic agents.

Abstract:Traumatic brain injury (TBI) is mostly caused by motor vehicle traffic accidents or competitive sports, with high mortality and disability. TBI mainly includes primary injury and secondary injury. Primary injuries were caused directly by external forces. Secondary injuries include brain edema, excitotoxic effect of neuron cells, oxidative stress and neuroinflammation, etc. Effective intervention of secondary injury not only helps to improve the prognosis of patients with TBI, but also reduces the risk of Parkinson’s disease and other neurodegenerative diseases related to TBI. Autophagy is one of approaches to regulate homeostasis in cells, and autophagy dysfunction has been found in several neurodegenerative diseases and TBI. It is speculated that autophagy dysfunction may play an important role in TBI and explain why patients with TBI have higher risk of neurodegenerative disease. Discovering the role of autophagy in the pathological mechanism of TBI may provide new targets for TBI clinical treatment and cognitive impairment prevention in patients with TBI.

Abstract:Recently, the theoretical system and practical path for the deep integration of digitalization and traditional industrialization have gradually matured. Medical innovation and digital technology are progressing, and the deep integration of intensive care medicine and intelligence is surpassing the traditional informatization and ushering in new development opportunities. Technologies such as 5G, big data, artificial intelligence, and digital twins can help to understand more complex critical care issues, improve the diagnoses and prediction of diseases and symptoms, develop more accurate treatment strategies, and even transform the service model of critical care medicine. This paper summarizes the application and challenge of digital technology in the practical scenarios of critical care medicine, so as to further consolidate infrastructure, enrich application scenarios, accelerate implementation, improve effectiveness, and strengthen the safety and compliance with the regulations.

Abstract:The prevention and research of military training injuries (MTI) are crucial for reducing non-battle casualties, ensuring combat readiness, and enhancing the effectiveness of military training. In-depth analyses of the prevention and treatment strategies of MTI and related research can provide concrete guidance for scientific training practices. As a critical component of national defense, the Chinese Navy has experienced rapid development in recent years, and the prevention and research of MTI in naval forces have become a key focus. In recent years, rehabilitation medicine has been increasingly recognized for its importance in areas such as physical capability enhancement and injury prevention. The comprehensive adoption of rehabilitation concepts and the early implementation of rehabilitation measures have been widely accepted. It has important guiding significance for further strengthening the application of rehabilitation in preventing and treating injuries in naval training. This article discusses how to further strengthen the rehabilitation strategies for the prevention and research of MTI in the Navy, so as to provide insights and prospects for this field.

Abstract:Objective To investigate the effect of deoxyelephantopin (Deo) on regulation of cell apoptosis pathway by reactive oxygen species (ROS) in human non-small cell lung cancer A549 cells. Methods A549 cells were treated with different concentrations of Deo. Cell counting kit 8 (CCK-8) assay was used to detect the cell viability, 2’,7’-dichlorodihydrofluorescein diacetate (DCFH-DA) staining was used to measure cellular ROS content, and Hoechst 33342 staining was used to detect apoptotic bodies. Cell apoptosis and mitochondrial membrane potential were examined by flow cytometry. Quantitative polymerase chain reaction and Western blotting were used to detect the expression of apoptosis-related proteins. A549 xenograft tumor model in nude mice was used to evaluate the anti-tumor effect of Deo in vivo. Hematoxylin-eosin staining and TUNEL assay were used to observe the necrosis and cell apoptosis in tumor tissues. Results With the increase of Deo concentration (1, 2, 4, 8, 16, 32 μmol/L), the viability of A549 cells showed a decreasing trend. Deo at 10 μmol/L could increase the ROS content in A549 cells, reduce mitochondrial membrane potential and promote cell apoptosis. Deo at 10 and 20 μmol/L promoted the mRNA and protein expression of Bax and caspase-3 and inhibited the mRNA and protein expression of Bcl-2, accompanied by significantly increased protein expression of cytochrome C in the cytoplasm. The volume and weight of transplanted tumor in nude mice were significantly inhibited after 17 d of administration of Deo of 10 and 20 mg·kg^－1·d^－1, and the necrotic area and the number of apoptotic cells in the tumor tissue were increased. Conclusion Deo can induce intracellular ROS production, and then activate the mitochondrial apoptosis pathway and consequently promote the apoptosis of A549 cells.

Abstract:Objective To explore the feasibility and safety of fastest recovery after surgery (FRAS) in laparoscopic surgery of gastrointestinal tumors. Methods The clinical data of patients undergoing laparoscopic surgery for gastrointestinal tumors under FRAS and enhanced recovery after surgery (ERAS) from Jan. 2023 to May 2024 were collected, and perioperative safety and medical cost were analyzed. Results A total of 87 patients were enrolled, including 43 in the FRAS group and 44 in the ERAS group. Compared with the ERAS group, the FRAS group had significantly shorter surgical time (3.0 ［2.5, 3.5］ h vs 3.0 ［2.5, 4.0］ h), first postoperative movement time (［2.85±4.29］ h vs ［20.18±6.13］ h), first postoperative oral feeding time (2.0 ［2.0, 3.0］ h vs 24.0 ［15.0, 48.0］ h), postoperative hospital stay (24.0 ［20.0, 40.0］ h vs 192.0 ［150.0, 216.0］ h), lower hospitalization costs (50 515.61 ［46 650.44, 56 827.12］ yuan vs 65 555.09 ［58 683.21, 86 239.02］ yuan), and lower medication costs (2 671.09 ［2 063.31, 3 127.09］ yuan vs 7 326.90 ［5 104.66, 10 674.26］ yuan) (all P＜0.05). Conclusion It is safe and feasible to use FRAS during the perioperative period of laparoscopic radical gastrectomy for gastrointestinal tumors, and FRAS can also reduce the costs of hospitalization and medications.

Abstract:Objective To investigate the feasibility of breast-conserving surgery (BCS) after neoadjuvant chemotherapy (NC) for triple-negative breast cancer (TNBC). Methods One hundred and thirty-two TNBC patients who were admitted to The Second Affiliated Hospital of Nanchang University from Jun. 2014 to Jun. 2017 were divided into NC group (62 patients who received NC followed by BCS) and control group (70 patients who received only conventional standard BCS). The response rate was calculated for patients in the NC group. The general clinicopathological data of the 2 groups were compared. The disease-free survival (DFS) of the 2 groups was analyzed using the Kaplan-Meier method, and the effect of NC followed by BCS on the DFS was analyzed using Cox proportional hazards regression method. Results The response rate of patients in the NC group was 96.8% (60/62). There were no differences in age, histological grade, axillary lymph node status or Ki67 index between the 2 groups (all P＞0.05), and the maximum tumor diameter after NC in the NC group was similar to that of the control group (P＞0.05). The ratio of intraventricular cancerous thrombus invasion cases was higher in the NC group than in the control group (P＜0.01). The 1-, 3-, and 5-year DFS rates in the NC group were 100% (62 cases), 93.5% (58 cases), and 69.4% (43 cases), respectively, with a mean of 55.5 months; the 1-, 3-, and 5-year DFS rates in the control group were 100% (70 cases), 95.7% (67 cases), and 72.9% (51 cases), respectively, with a mean of 55.6 months; and there was no difference in DFS between the 2 groups (P＞0.05). Cox proportional hazards regression analysis showed that BCS after NC was not a risk factor for DFS in patients with TNBC (hazard ratio＝1.133, 95% confidence interval 0.600-2.139, P＝0.701). Conclusion The response rate to NC is high in TNBC patients, and the treatment strategy of BCS after NC is feasible.

Abstract:Objective To observe the clinical effect of Xiaotan Zhitong gel on heel pain caused by plantar fasciitis. Methods A total of 72 patients diagnosed with plantar fasciitis heel pain were randomly divided into observation group (36 cases) and control group (36 cases). Patients in the control group were treated with local application of diclofenac diethylamine emulgel twice a day and those in the treatment group were treated with Xiaotan Zhitong gel twice a day, with both treatments lasting for 28 d. The visual analogue scale (VAS) score of heel pain, the quantitative scale score of heel pain symptom grading, and the American Foot and Ankle Society (AOFAS) ankle-hindfoot score were evaluated before and after treatment. The changes of plantar fascia thickness were examined ultrasonographically before and after treatment in the 2 groups. The effective rates of treatment and the 3-month relapse rates were observed in the 2 groups. Results Before treatment, there were no significant differences in heel pain VAS score, heel pain symptom grading quantitative scale score, AOFAS ankle-hindfoot score, or plantar fascia thickness between the 2 groups (all P＞0.05). After treatment, the above indexes were improved in both groups compared with those before treatment (all P＜0.05); and the pain VAS score, heel pain symptom grading quantitative scale total score, heel pain symptom grading quantitative scale pain score, heel pain symptom grading quantitative scale pressure score, heel pain symptom grading quantitative scale dysfunction score, and AOFAS ankle-hindfoot score in the observation group were significantly improved compared with those in the control group (all P＜0.05). The thickness of plantar fascia was significantly thinner than that of the control group (P＜0.05), and the insomnia scores on the heel pain symptom grading quantitative scale were not significantly different between the 2 groups (P＞0.05). The effective rate of the observation group (80.6%, 29/36) was significantly higher than that of the control group (55.6%, 20/36) (P＜0.05), and the 3-month recurrence rate in the observation group (16.7%, 6/36) was significantly lower than that of the control group (41.7%, 15/36) (P＜0.05). Conclusion Xiaotan Zhitong gel can reduce heel pain, improve foot function, and reduce plantar fascia thickness in patients with plantar fasciitis, also with low recurrence rate after treatment.

Abstract: