Abstract:Intestinal stem cells (ISCs), locating at the base of intestinal crypts and pivotal in orchestrating the homeostasis and damage repair of the intestinal epithelium, are characterized by their self-renewal and multipotential differentiation capabilities. With the continuous discoveries of new ISCs and related markers, the ISC migration and regeneration model has been further improved, greatly promoting the research in related fields. Diet can regulate ISC glycolipid and energy metabolism through influencing the stem cell niche, subsequently modulating overall metabolism. This paper summarizes the biological features of both classical and newly discovered ISCs, and analyzes the effects of common nutrients and different dietary patterns on ISCs, hoping to provide insights for the precise nutrition prevention and treatment of chronic intestinal diseases.

Abstract:Objective To explore the characteristics of tumor immune microenvironment of pancreatic ductal adenocarcinoma (PDAC) based on the differentially expressed genes associated with macrophages in early and late tumor tissues of PDAC patients, so as to provide new targets for early diagnosis and treatment of PDAC. Methods Three early-stage and 4 late-stage tumor samples were collected from PDAC patients. Tissue transcriptome data were analyzed by single-cell sequencing technology. With The Cancer Genome Atlas (TCGA) database, macrophage related genes differentially expressed in early and late PDAC related to prognosis were obtained. The prognostic risk scoring model was constructed using the least absolute shrinkage and selection operator (LASSO)-Cox method. The risk genes associated with PDAC prognosis were screened using the Gene Expression Profiling Interaction Analysis 2 (GEPIA2) online survival analysis tool. Their immune infiltration was analyzed using the cell-type identification by estimating relative subsets of RNA transcripts (CIBERSORT) method, and their expression in different subpopulations of macrophages at different periods was resolved by t-distributed stochastic nearest-neighbour embedding (tSNE) clustering downscaling and the Monocle package. The protein-protein interactions and immunohistochemistry were further analyzed with the help of STRING database and The Human Protein Atlas (HPA) database. Results A total of 48 differentially expressed macrophage-related genes in early and late PDAC were found to be associated with prognosis. Eleven differentially expressed macrophage genes were screened as PDAC prognostic genes, and they were used to construct a prognostic risk scoring model for PDAC. Two prognostic genes with significant risk indicators were screened: 2'-5'-oligoadenylate synthetase 2 (OAS2) was mainly expressed in secreted phosphoprotein 1 (SPP1)-positive macrophages, and assembly factor for spindle microtubules (ASPM) was mainly expressed in proliferation marker protein Ki-67 (MKI67)-positive macrophages. There were significant differences in the expression of OAS2 in PDAC macrophages at different stages. Immune infiltration studies showed that OAS2 and ASPM were highly expressed in regulatory T cells and M2-type macrophages (both P＜0.05). Protein-protein interaction network showed the expression relationship between OAS2 and ASPM and other co-expressed proteins. Immunohistochemistry results showed that the expression of OAS2 was higher in tumor tissues than in normal tissues. Conclusion OAS2 and ASPM are both poor prognostic genes that are specifically expressed and exert negative immune effects in SPP1⁺ macrophages and MKI67⁺ macrophages, respectively, promoting the progression of PDAC and ultimately leading to a poor prognosis, and it is expected to provide new targets for the prevention and treatment of PDAC.

Abstract:Objective To establish and verify a mature and stable glioblastoma (GBM) organoid model, so as to provide an accurate and personalized preclinical model for the research and treatment of GBM. Methods Fresh GBM tissues obtained through surgical procedures were initially processed, and then GBM stem cells (GSCs) were isolated using stem cell culture medium and were identified. Subsequently, GSCs were cultured in organoid culture medium for 3D cultivation, and GBM organoids were successfully obtained. The histological morphology of GBM organoids was observed by hematoxylin-eosin (H-E) staining; the stemness and similarity to the parental tumor were identified by immunofluorescence staining; and the in vivo tumorigenic ability of GBM organoids was identified by orthotopic tumorigenesis experiments in nude mice. Results A total of 7 GBM organoids were constructed from 9 human GBM samples, with a morphology resembling “neurosphere”, and the average duration for organoid formation was 1 week. H-E staining results showed that the histological morphology of GBM organoids under high-power microscope was very similar to that of GBM tumor tissues; immunofluorescence staining results indicated that the GBM organoids possessed stemness characteristics and histological cellular similarity; and GBM organoids had a stronger tumorigenic ability compared to ordinary GBM cells in nude mice. Conclusion This study presents a stable and reliable method for constructing GBM organoids retaining the histological characteristics of the original GBM tissue, which providing new insights for future GBM research and clinical practice.

Abstract:Objective To explore the mechanism of long non-coding RNA fibroblast activation inhibitory factor 1 (FAIF1) regulates the proliferation, activation, and fibrosis of human cardiac fibroblasts induced by advanced glycation end products (AGEs). Methods Human cardiac fibroblasts were assigned to control group, AGE group, FAIF1 recombinant lentivirus (Lv-FAIF1)＋AGE group or control lentivirus (Lv control)＋AGE group. The expression levels of miRNA-424-5p, FAIF1, and Smad7 in myocardial fibroblasts induced by AGEs were detected by quantitative polymerase chain reaction (qPCR) and Western blotting. Bioinformatics analysis was used to predict the interactions between miRNA-424-5p, FAIF1, and Smad7; and luciferase reporter assays were used for verification. Cell proliferation activity was measured by cell counting kit 8 assay, the expression and secretion of collagen Ⅰ/Ⅲ were observed by immunofluorescence staining, and the effect of Lv-FAIF1 on cell activation markers α-smooth muscle actin (α-SMA) and migration proteins matrix metalloproteinase 9 (MMP9) induced by AGEs was evaluated by qPCR. Results qPCR and Western blotting results showed that AGEs significantly reduced the expression of FAIF1 and Smad7 in myocardial fibroblasts and upregulated the level of miRNA-424-5p (compared with the control group, all P＜0.05). Bioinformatics analysis revealed that the 3'-untranslated region of Smad7 mRNA contained a binding site for the miRNA-424-5p seed sequence “UGCUGCU”, and FAIF1 sequence contained 3 identical binding sites. Luciferase assays showed that miRNA-424-5p inhibited the expression of Smad7, while FAIF1 competed with miRNA-424-5p for binding, thereby relieving the inhibitory effect of miRNA-424-5p on Smad7 mRNA. Functional experiments showed that Lv-FAIF1 significantly inhibited AGEs-induced cell proliferation, collagenⅠ/Ⅲ expression and secretion, as well as α-SMA and MMP9 expression (compared with AGE group, all P＜0.01); and it promoted the expression of Smad7 (compared with AGE group, P＜0.01). Conclusion miRNA-424-5p can inhibit the expression of Smad7, and FAIF1 effectively suppresses AGEs-induced over-activation of cardiac fibroblasts by regulating the miRNA-424-5p/Smad7 axis, which provides a new molecular target for the prevention and treatment of diabetic cardiomyopathy.

Abstract:Objective To observe the effect of hypoxia (HX) on autophagy and pyroptosis-related protein expression of interleukin (IL)-1β-induced chondrocytes, and explore its mechanism of cartilage protection. Methods The expression of Bcl2/adenovirus E1B interacting protein 3-like (BNIP3L/NIX) in normal and osteoarthritis chondrocytes was analyzed by bioinformatics method. The primary chondrocytes from the knee joints of C57BL/6J neonatal mice were extracted and assigned to control group, IL-1β group, HX group, or IL-1β＋HX group. The cells were treated with 10 ng/mL IL-1β for 24 h to simulate osteoarthritis-like chondrocyte injury, and HX treatment was by incubation with 1% O₂ for 24 h. The expression levels of collagen typeⅡ α1 (COL2α1), matrix metalloproteinase 13 (MMP13), a disintegrin and metalloproteinase with thrombospondin 5 (ADAMTS5), nucleotide-binding oligomerization domain-like receptor 3 (NLRP3), gasdermin D N-terminal domain (GSDMD-N), apoptosis-associated speck-like protein containing a CARD (ASC), IL-18, hypoxia induced factor 1α (HIF1α), NIX, Beclin1, microtubule-associated protein-light chain 3 (LC3), and p62 proteins were detected by Western blotting in each group. Results Bioinformatics analysis showed that the expression of NIX was lower in osteoarthritis chondrocytes than in normal chondrocytes. Western blotting showed that compared to the control group, the IL-1β group showed significant decreases in COL2α1 and NIX protein expression (both P＜0.05) and significant increases in MMP13, ADAMTS5, NLRP3, GSDMD-N, ASC, IL-18 and HIF1α protein expression (all P＜0.01). Compared to the IL-1β group, the IL-1β＋HX group showed significant increases in COL2α1, HIF1α, NIX, Beclin1, and LC3Ⅱ/LC3Ⅰ (all P＜0.01) and significant decreases in MMP13, ADAMTS5, NLRP3, GSDMD-N, ASC, IL-18 and p62 (all P＜0.01). Compared to the control group, the HX group exhibited significant increases in HIF1α, NIX, Beclin1, and LC3Ⅱ/LC3Ⅰ (all P＜0.01) and decreases in p62, NLRP3, GSDMD-N and IL-18 (all P＜0.05). Conclusion Hypoxia may eliminate NLRP3 inflammasome and inhibit chondrocyte pyroptosis through HIF1α/NIX-mediated mitochondrial autophagy, thereby reducing IL-1β-induced chondrocyte injury.

Abstract:Objective To investigate the cerebral protective role of Duzhi pills on ischemic stroke rats and its mechanisms. Methods The healthy male SD rats were assigned to 5 groups: sham group, model group, Duzhi pill low-dose group (1.0 g/kg a day), Duzhi pill high-dose group (2.0 g/kg a day), or argatroban group (positive control). The low-dose and high-dose groups of Duzhi pills were intragastrically administered once a day for 8 d, while the other groups were intragastrically administered with the same amount of normal saline. Except the sham group, the middle cerebral artery occlusion (MCAO) cerebral ischemia-reperfusion model was established by suture method at 0.5 h after intragastric administration on the 8^th day in other groups, and the ischemia duration was 90 min. Argatroban group was given a single dose (3.0 mg/kg) of argatroban via caudal vein at the same time of reperfusion. After 24 h of cerebral ischemia, the area of cerebral infarction, degree of cerebral infarction and neurological function injury were evaluated by 2,3,5-triphenyltetrazolium chloride (TTC) staining, Nissl staining and neurobehavioral score, respectively. The levels of inflammatory factors (transforming growth factor-β1 ［TGF-β1］ and interleukin-1β ［IL-1β］) in the brain after cerebral ischemia were detected by enzyme-linked immunosorbent assay (ELISA), and the coagulation indexes were detected by an automatic coagulation analyzer. The scavenging ability of Duzhi pills on free radicals was analyzed by 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging experiment. Results High-dose Duzhi pills reduced the cerebral infarction area, decreased the deep Nissl staining score of neural cells, and improved the symptoms of neurobehavioral defects in MCAO rats (compared with the model group, all P＜0.01). The levels of IL-1β and TGF-β1 in the ischemic brain tissue of the model group were significantly increased (compared with the sham group, both P＜0.01), while the levels of IL-1β and TGF-β1 in the brain tissue of the rats treated with low-dose and high-dose Duzhi pills were significantly decreased (compared with the model group, all P＜0.01). The coagulation index fibrinogen level in the model group was significantly higher than that in the sham group (P＜0.01), and both low-dose and high-dose Duzhi pills could inhibit the production of fibrinogen (compared with the model group, both P＜0.01). DPPH scavenging test results showed that Duzhi pills could scavenge free radical, the half inhibitory concentration was (1.33±1.11) mg/mL, and the slope of the curve was 1.378±0.145. Conclusion Duzhi pills play a cerebral protective role in ischemic stroke rats. The mechanism may be related to the inhibition of fibrinogen production, the reduction of inflammatory factors (TGF-β1 and IL-1β), and the antioxidant effects.

Abstract:Objective To analyze the mutation status of Kirsten rat sarcoma viral oncogene homolog (KRAS), phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA), v-raf murine sarcoma viral oncogene homolog B1 (BRAF) genes, and the expression of mismatch repair (MMR) and human epidermal growth factor receptor 2 (HER-2) proteins in tumor tissues of patients with colorectal cancer (CRC) harboring neuroblastoma rat sarcoma viral oncogene homolog (NRAS) gene mutations, and explore their relationships with the clinicopathological characteristics of CRC patients. Methods The clinicopathological data of 546 patients with NRAS mutation CRC were retrospectively analyzed. The mutation status of NRAS, KRAS, PIK3CA, and BRAF genes was detected by AmoyDx amplification refractory mutation system (ARMS)-polymerase chain reaction (PCR) kit (fluorescent PCR method), the expression levels of MMR and HER-2 proteins were detected by immunohistochemical staining EnVision method, and the relationship between them and the clinicopathological characteristics of patients were analyzed. Results The mutation rate of single-point mutations in the NRAS gene was 98.35% (537/546), double-point mutations in the NRAS gene were 1.65% (9/546), and double mutations in the NRAS and KRAS genes were 1.47% (8/546). No patients were found to harbor mutations in the PIK3CA or BRAF genes. The types of NRAS mutations included Q61R (or Q61K, Q61L, Q61H) mutations (266/546, 48.72%), G12D (or G12S) mutations (154/546, 28.21%), G13R (or G12C, G12V, G12A, G13V) mutations (134/546, 24.54%), and A146T mutation (1/546, 0.18%). G13R (or G12C, G12V, G12A, G13V) mutations in the NRAS gene were more likely to occur in the rectum cancer patients (P＝0.035); although the tumors had a larger diameter (P＝0.029), the patients had a longer progression-free survival after surgery (P＝0.028). Among patients with NRAS gene mutations, HER-2 positive expression was associated with perineural invasion (P＝0.003), and the patients with deficient MMR were younger on average (P＝0.041) and were associated with double-point mutations in the NRAS gene (P＝0.018). Conclusion CRC harboring NRAS mutations may have unique clinicopathological characteristics and molecular phenotypes, providing possibilities for individualized treatment and prognosis evaluation of CRC.

Abstract:Objective To analyze the expression differences in immune cells and cytokines in advanced ovarian cancer with different homologous recombination deficiency (HRD) statuses, and provide insights for novel therapeutic strategies. Methods A total of 68 patients with International Federation of Gynecology and Obstetrics (FIGO) stage Ⅲ-Ⅳ epithelial ovarian cancer, who were treated at Department of Obstetrics and Gynecology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from Jan. 2018 to Jan. 2023, were enrolled. Based on genetic testing results, patients were stratified into HRD-positive (n＝30) and HRD-negative (n＝38) groups. Baseline characteristics and clinical outcomes were compared. The expression levels of CD4, CD8 and CD25 in ovarian cancer tissues of the 2 groups were analyzed by immunohistochemical staining. The proportions of CD4⁺ T cells, CD8⁺ T cells, and CD4⁺CD25⁺ regulatory T cells (Treg cells) and CD4⁺/CD8⁺ ratio in blood were analyzed by flow cytometry. The serum levels of interferon-γ (IFN-γ), interleukin (IL)-2, IL-6 and IL-10 were detected by enzyme-linked immunosorbent assay. Results There were no significant differences in age, course of disease, family history, initial treatment, tumor FIGO stage, or tumor differentiation degree between the HRD-positive group and HRD-negative group (all P＞0.05). In terms of clinical efficacy, the objective remission rate and disease control rate of patients in the HRD-positive group were significantly higher than those in the HRD-negative group (both P＜0.05). Compared with the HRD-negative group, the expression levels of CD4, CD8, and CD25 in tumor tissues of patients were all increased in the HRD-positive group (all P＜0.05), the proportions of CD4⁺ T cells, CD8⁺ T cells, and CD4⁺CD25⁺ Treg cells in blood were all increased (all P＜0.05), the CD4⁺/CD8⁺ ratio in blood was increased (P＜0.05), the serum levels of IL-2, IL-6, and IL-10 were all increased (all P＜0.05), while the serum level of IFN-γ had no significant difference between the 2 groups (P＞0.05). Conclusion HRD-positive ovarian cancer displays enhanced tumor-infiltrating lymphocytes and immunomodulatory cytokine secretion compared to HRD-negative cases, suggesting greater sensitivity to immunotherapy and better prognosis.

Abstract:Objective To systematically evaluate the performance and methodological quality of the risk prediction models for urinary incontinence after radical prostatectomy, so as to provide a reference for selecting the appropriate risk prediction tool. Methods A systematic search was conducted in PubMed, Web of Science, Cochrane Library, CINAHL, EMBASE, CNKI, Wanfang, VIP, and Chinese biomedical literature database from inception to Jan. 23, 2024. Two researchers independently conducted literature screening and data extraction, and the prediction model risk of bias assessment tool (PROBAST) was applied to assess the risk of bias and applicability of the included studies. MedCalc software was used to perform a meta-analysis of the area under curve (AUC) of the validation groups using the random effect model, and the publication bias and sensitivity analysis were also performed. Results A total of 8 studies were included, with a combined sample size of 7 216 cases. Six models reported the AUC values, and 7 models reported calibration. The applicability of 2 studies was acceptable, while 6 were poor. The most commonly used type of prediction model was logistic regression. After excluding models with extreme AUC values, the random-effects meta-analysis result was 0.840 (95% confidence interval 0.786 to 0.895), with no heterogeneity (I²＝0%, P＝0.737). The bias risk was high in all 8 studies, mainly due to retrospective cohort data, transformation of continuous variables into binary variables, unaddressed missing data, selection of predictors based on univariate analysis, incomplete report of the model discrimination and calibration, and lack of external validation. Egger test result indicated no significant publication bias. Conclusion The development and validation process of the existing risk prediction models for urinary incontinence after radical prostatectomy is still imperfect. Future research should construct prediction models based on multicenter and large-sample data, strengthen the clinical applicability assessment of the models, and strictly follow the reporting standards and procedures, so as to establish high-quality risk prediction models for clinical practice.

Abstract:Objective To explore the mediating role of intolerance of uncertainty (IU) and moderating role of the negative emotion differentiation in the influence of perceived stress on anxiety among college students from a cognitive perspective. Methods A total of 271 participants were surveyed using the perceived stress scale, intolerance of uncertainty scale, depression anxiety and stress scale (Chinese version), and the test on negative emotional differentiation. SPSS 22.0 was used to perform descriptive statistics and correlation analyses and to test the moderated mediation model. Results Perceived stress affected anxiety and IU played a mediating role－perceived stress could affect anxiety through influencing IU. At the same time, the influence of IU on anxiety could be adjusted through the negative emotion differentiation. The higher the degree of negative emotion differentiation, the lower the degree of anxiety increase (β＝0.17, t＝5.70, P＜0.01). Conclusion It may be effective to develop training programs to reduce anxiety by regulating perceived stress, increasing acceptance of uncertainty, and improving the negative emotion differentiation, which can help individuals reduce anxiety by perceiving and adjusting anxiety-related emotional or cognitive factors in a timely manner.

Abstract:Diabetes mellitus is a serious chronic disease globally. However, the main methods for controlling blood glucose are still injections and oral hypoglycemic drugs. Stem cell therapy as a novel treatment is gaining attention, especially mesenchymal stem cells (MSCs), which are widely studied due to their low immunogenicity, immunomodulatory properties, and multi-lineage differentiation potential. Clinical research on MSC therapy for diabetes mellitus and its complications is extensive, with multiple studies demonstrating the effectiveness and safety of the treatment. The potential mechanisms of MSC therapy for diabetes mellitus include homing effects and improvement of β-cell function, differentiation of MSCs, regeneration and survival of islets, immune modulation, and improvement of insulin resistance. Possible methods to enhance the therapeutic effects of MSCs in the future could include genetic modification, combination therapies, application of exosomes, and encapsulation techniques. There are still many risks and challenges associated with stem cell therapy for diabetes mellitus that require further in-depth research.

Abstract:Alzheimer’s disease is a neurodegenerative disorder characterized by complex and not fully understood pathogenesis. Recent research has revealed that abnormalities in lipid metabolism and inflammatory responses play a crucial role in the development and progression of Alzheimer’s disease. This review aims to explore the modulatory effects of lipid metabolism on inflammatory responses and their subsequent influence on the pathological processes of Alzheimer’s disease from the aspects of the relationship between dysregulated lipid metabolism, increased inflammatory responses, and Alzheimer’s disease, the regulatory effects of lipid mediators, and the role of microglia in these processes.

Abstract:Sepsis is an organ dysfunction caused by a dysregulated host response to infection, often characterized by immune dysfunction. This condition typically manifests as an excessive inflammatory response at early stages, followed by immunosuppression at later stages. Due to this immunosuppressive state, patients with sepsis are susceptible to new infections, termed secondary infections, even after the primary infection has been controlled or resolved. In recent years, secondary infections in sepsis have garnered increasing clinical attention due to their risks to exacerbate the disease course, prolong hospital stay, and increase mortality risk. The sepsis-induced immunosuppression is central to the development of secondary infections, especially at the later stage of sepsis. Specifically, T cell function becomes impaired, natural killer cell activity decreases, and macrophage phagocytic ability weakens, all contributing to diminished immune surveillance. Additionally, the immune evasion mechanisms employed by pathogens responsible for secondary infections further complicate treatment. This review aims to elucidate the mechanisms of immunosuppression and its clinical significance in sepsis-related secondary infections, providing a guidance for optimizing treatment strategies.

Abstract:Objective To describe and analyze the influencing factors of psychological crisis among college students with borderline personality disorder (BPD) traits. Methods Self-compiled general information questionnaire, personality assessment inventory-borderline features scale (PAI-BOR), brief version of the difficulties in emotion regulation scale (DERS-16), short version of the UPPS-P impulsive behavior scale (S-UPPS-P), patient health questionnaire-9 (PHQ-9), and psychological crisis screening questionnaire were used to survey 340 college students in Shanghai selected by convenience sampling. Participants were assigned to BPD trait or non-BPD trait groups based on PAI-BOR scores. The risk of psychological crisis and influencing factors of the 2 groups were analyzed. Results A total of 323 valid questionnaires were collected. The average age of the participants was (21.39±2.98) years old, and 164 participants were male and 159 were female. The detection rate of borderline personality disorder traits was 19.20% (62/323). There were significant differences in family relationship, experiences of major changes, difficulties in emotion regulation, impulsivity and depression between the 2 groups (all P＜0.05). The detection rates of mild psychological crisis and severe psychological crisis were significantly higher in the BPD trait group than in the non-BPD trait group (both P＜0.001). Stepwise multinomial logistic regression analysis showed that sensation seeking and difficulties in emotion regulation were risk factors for mild psychological crisis in the BPD trait group (both P＜0.05), and sensation seeking and history of mental disorders in close relatives were risk factors for severe psychological crisis in the BPD trait group (both P＜0.05). Conclusion BPD traits in college students are associated with the risk of psychological crisis. Sensation seeking, difficulties in emotion regulation, and history of mental disorders in close relatives are risk factors of psychological crisis among students with BPD traits. Colleges and universities should put more emphasis on the mental health of students with BPD traits, and formulate targeted preventive measures.

Abstract:Objective To analyze the factors influencing the deterioration of nutritional status after radiotherapy/radiochemotherapy for esophageal cancer, so as to provide reference for nutritional management during antitumor therapy. Methods A total of 106 patients with esophageal cancer who received radiotherapy or radiochemotherapy at Anqing First People’s Hospital of Anhui Medical University from Dec. 2017 to Dec. 2023 were enrolled. Patients’ gender, age, surgical history, timing of radiotherapy intervention, synchronous chemoradiotherapy, radiotherapy dose, clinical stage, initial nutritional status, and performance status score were collected. The patient generated subjective global assessment scale (PG-SGA) scores were monitored before and after antitumor treatment. According to the nutritional status at the beginning of enrollment and at the end of radiotherapy, the patients were assigned to deterioration group or non-deterioration (stable or improved) group. The clinical characteristics of the 2 groups were compared. The factors influencing the deterioration of nutritional status were screened by logistic regression analysis. The correlation between nutritional status deterioration and adverse reactions (radiation esophagitis, pulmonary infection, neutropenia, thrombocytopenia, and elevated aminotransferase) was analyzed by Spearman correlation analysis. Results There were no significant differences in gender, radiotherapy dose, initial nutritional status, or performance status score between the 2 groups for the deterioration of nutritional status after radiotherapy (all P＞0.05). The proportions of patients with previous surgical history of esophageal cancer, synchronous chemoradiotherapy, initiation of radiotherapy at less than 90% of target calorie requirement, and clinical stage Ⅳ were significantly higher in the deterioration group than those in the non-deterioration group (all P＜0.05). Logistic regression analysis showed that clinical stage Ⅳ (odds ratio ［OR］＝4.684, 95% confidence interval ［CI］ 1.252-17.519, P＝0.022) and previous surgical history of esophageal cancer (OR＝7.338, 95% CI 1.878-28.666, P＝0.004) were the independent adverse risk factors for the deterioration of nutritional status after radiotherapy/radiochemotherapy. The timing of radiotherapy intervention was also an independent risk factor for the deterioration of nutritional status, and taking the tolerance of 70%-90% target energy as the reference level, starting radiotherapy when the tolerance of 90%-100% target energy had the optimal protection of nutritional status (OR＝0.166, 95% CI 0.050-0.551, P＝0.003). Spearman correlation analysis showed that the deterioration of nutritional status was positively correlated with elevated transaminases after radiotherapy (r_s＝0.283, P＝0.003), while it was not correlated with the other adverse reactions (all P＞0.05). Conclusion Under the standard nutritional intervention model, patients with previous surgery and recurrent metastatic esophageal cancer who receive radiotherapy/chemoradiotherapy are still at risk of nutritional status deterioration. Tolerance to 90%-100% target energy requirement may be a more appropriate timing for radiotherapy intervention. When the nutritional status deteriorates during treatment, it is necessary to be alert to the elevated transaminases.

Abstract:Objective To study the current research and future focus of transcutaneous electrical nerve stimulation (TENS) for pain treatment. Methods We retrieved the literatures on TENS for pain treatment from Jan. 1, 2013 to Dec. 31, 2022 from CNKI and Web of Science, and Bibliometrix package in R language and the VOSviewer software in Java language were used to analyze the literatures, identifying the current research and future focus on TENS for pain treatment. Results A total of 143 articles in Chinese and 769 articles in English were included in this study, and both showed an increasing trend from 2013 to 2022; the highest citation for Chinese article was 130 and the highest for English article was 235. Total frequency analysis of keywords of English literatures showed that effectiveness and mechanism research were the research focus. The frequency analysis of keywords over years showed that brain-stem, prevention, and shoulder pain were the most frequent keywords in 2021. The strategic coordinate map results showed 2 major future development directions: (1) postoperative pain, analgesia, and opioid receptors, and (2) neuropathic pain, spinal cord, and activation. Total frequency analysis of keywords of Chinese literatures showed that transcutaneous nerve electrical stimulation, pain, analgesia, labor analgesia, and transcutaneous acupoint electrical stimulation were the research focuses. Conclusion TENS therapy for pain is gradually gaining popularity, with a focus on the clinical effectiveness and mechanisms of various types of pain. Future research may focus on further need to anisms study of opioid receptors and spinal cord.

Abstract:Objective To study the oral health status of officers and soldiers in a certain unit, so as to provide a basis for the formulation and implementation of oral health support plans. Methods A total of 437 officers and soldiers in a certain unit were enrolled to assess their oral health status through questionnaire survey and clinical examination. Results The prevalences of dental caries and periodontal diseases were 87.6% (383/437) and 90.4% (395/437), respectively; the detection rates of impacted third molars, recurrent aphthous stomatitis, other mucosal diseases, and temporomandibular joint disorders were 12.6% (55/437), 54.2% (237/437), 29.5% (129/437), and 19.2% (84/437), respectively. In terms of oral medical needs, 23.3% (102/437) patients did not need treatment, 66.1% (289/437) required elective treatment, 9.2% (40/437) required early treatment, and 1.4% (6/437) required urgent treatment. Conclusion Officers and soldiers in this study have a variety of oral diseases, with periodontal diseases having the highest prevalence. Supportting plans should be formulated based on the characteristics of the prevalence of oral diseases among them, and regular oral diagnosis and treatment should be carried out to prevent the development and progression of oral diseases.

Abstract:Objective To estimate the sample size of radiological diagnostic tests in multireader multicase (MRMC) design, and to explore the numbers of readers and cases under 3 different inference situations: random-reader random-case, fixed-reader random-case, and random-reader fixed-case. Methods The images of 114 participants (45 cases diagnosed as aortic coarctation by the gold standard) in the Van Dyke dataset were used, and 5 radiologists read these images under 2 different magnetic resonance imaging (MRI) sequences (Spin-echo and Cine MRI) to obtain the pre-experiment data. Then Obuchowski-Rockette method was used to estimate sample size. Results The mean area under curve (AUC) of aortic coarctation determined by radiologists was 0.941 (95% confidence interval ［CI］ 0.899-0.983) with the Spin-echo MRI sequence, and 0.897 (95% CI 0.837-0.957) with the Cine MRI sequence. When the effect size was 0.044 and the number of readers was 5, we needed 337 participants for random-reader random-case, 162 participants for fixed-reader random-case, and 282 participants for random-reader fixed-case. Conclusion In MRMC design, we need both the number of readers and cases; the larger the number of readers, the smaller the cases required. We need more samples under the situation of random-reader random-case, when the number of readers is ≥5.

Abstract: