Abstract With the rapid development of emerging industries and industrialization in China, soil nickel contamination has become a serious concern, with food being the primary source of nickel exposure to the human body. The level of nickel contamination in food is gennerally higher in developed regions of China. Among different food categories, grains, legumes and aquatic products exhibit relatively higher nickel content and detection rates. Currently in China, the methods for studying nickel dietary exposure risk are relatively conservative, primarily employing point assessment, simple distribution and probability assessment to calculate daily exposure levels among residents and quantifying cumulative exposure risks using the hazard index method. It is found that there is still a certain risk of dietary nickel among residents with younger age groups and under extreme conditions of high consumption or high pollution. Additionally, the cancer risk among the rural population is higher than that among the urban population. This article reviews the research progress on the current status of nickel contamination in Chinese food and the assessment of dietary exposure risk for residents, based on literature from databases such as CNKI and PubMed up to 2023, aiming at providing a reference for future research into nickel exposure and risk assessment in food.

Objective To study the local recurrence,distant recurrence and survival rate of anastomotic leak after surgery in patients with colorectal cancer.Methods Chinese and English related studies published from January 1970 to June 2011 were searched in PubMed/Medline,Excerpta medica database (EMBASE),Springger,Google scholar,China national knowledge infrastructure (CNKI),China biomedical literature database (CBM),Wanfang data.All controlled trials related to anastomotic leak after surgery in patients with colorectal cancer were retrieved.Outcomes were evaluated including local recurrence,distant recurrence and survival rate,then Mate-analysis was performed using RevMan 5.0 software provided by the Cochrane network.Results Fifteen studies were included,including a total of 18 225 patients.There were 1 425 patients with anastomotic leak and 16 800 patients without anastomotic leak.The patients with anastomotic leak were compared with patients without anastomotic leak.The OR value of local recurrence was 2.47 (95％ CI 1.72-3.55,P ＜ 0.01),the OR value of distant recurrence was 1.18 (95％ CI 0.98-1.43,P =0.08),and the OR value of 5-year survival rate was 1.68 (95％ CI 1.36-2.07,P ＜ 0.01).Conclusions Anastomotic leak after surgery is a bad prognosis factor in patients with colorectal cancer.It can increase the local recurrence rate,and decrease survival rate.

BACKGROUND: With the development of three-dimensional (3D) printing technology, it has been widely used in spinal surgery. However, whether 3D printing-assisted surgery for lumbar spondylolisthesis has an advantage over traditional surgery is still controversial. OBJECTIVE: To compare the clinical efficacy and safety of 3D printing-assisted versus conventional surgery for the treatment of lumbar spondylolisthesis using system evaluation. METHODS: Randomized controlled trials about 3D printing technology for lumbar spondylolisthesis in CNKI, Wanfang database, CBM, VIP, PubMed, Cochrane Library, Embase, and Web of Science were searched via computer from inception to November 16, 2019. The retrieved literatures were screened according to predefined inclusion and exclusion criteria, and quality evaluation was performed. Then, the available data were extracted and analyzed with the Stata 11. 0 software. RESULTS AND CONCLUSION: (1) Six randomized controlled trials including 394 cases were included. Among them, 201 cases were assigned to the 3D printing-assisted group and 193 cases to the conventional group. (2) Meta-analysis results showed that the 3D printing-assisted group proved significantly superior to the conventional group regrading the operation time [WMD=-38. 17, 95%CI(-43. 93, -32. 41), P=0. 00], intraoperative blood loss [WMD=-61. 61, 95%CI(-69. 19, -54. 03), P=0. 00], the frequency of fluoroscopy [WMD=-4. 89, 95%CI(-6. 38, -3. 41), P=0. 00] and the screw placement accuracy [OR=3. 89, 95%CI(2. 43, 6. 25), P=0. 00]. (3) However, in terms of the postoperative visual analogue scale scores [WMD=-0. 47, 95%CI(-1. 21, 0. 27), P=0. 215], Oswestry disability index [WMD=-1. 41, 95%CI(-2. 87, 0. 05), P=0. 058], Japanese Orthopaedic Association scores [WMD=1. 02, 95%CI(-0. 68, 2. 72), P=0. 240] and the rate of complications [OR=0. 37, 95%CI(0. 12, 1. 11), P=0. 075], no statistically significant differences were found between the two groups. (4) In conclusion, the application of 3D printing technology in the surgical treatment of lumbar spondylolisthesis has the advantage of shortening the operation time, reducing intraoperative blood loss and frequency of fluoroscopy and improving the accuracy of the screw placement.

Objective To explore the associations between polymorphisms in CYP24A1 gene and the risk and prognosis of colorectal cancer ( CRC) .Methods A case-control study consisting of 528 CRC patients and 605 cancer free controls and a follow up study with 317 cases were conducted to explore the associations be-tween two polymorphisms in CYP24A1 and the risk and prognosis of CRC,as well as the combinations and inter-actions of polymorphisms with dietary factors on CRC risk.Results Although there was no association between polymorphisms in CYP24A1 and the risk of CRC,significant combinative effects between polymorphisms and diet-ary factors on CRC risk were observed.For Rs4809957 polymorphism,the prognosis of AA genotype carriers was worse than GG/GA carriers in CRC,colon cancer and rectal cancer(Log-rank test P=0.01,P=0.01,P=0.02,respectively).Compared with GG genotype,AA genotype carriers of Rs4809957 polymorphism had worse prognosis in CRC(HR =2.35,95%CI =1.28~4.30),colon caner(HR =2.37,95% CI =1.09~5.14) and rectal cancer(HR =2.11,95% CI =1.11~4.01).Conclusion The combinations of the polymorphisms in CYP24A1 gene with dietary factors are associated with the susceptibility of CRC,and Rs4809957 polymorphism may lead to a worse prognosis of CRC.

Objective To investigate the prognostic value of CD 4+CD25+/high CD127 low/-and CD14+HLA-DRlow/-for evaluating the severity of acute pancreatitis .Methods The percentages of CD4+CD25+/highCD127low/-and CD14+HLA-DRlow/-and the CD64 index were measured by flow cytometry in pa-tients with acute pancreatitis ( including 43 cases of mild acute pancreatitis and 24 cases of severe acute pan-creatitis).Moreover, the levels of C-reactive protein (CRP), acute physiology and chronic health evaluationⅡ( APACHEⅡ) score and CT severity index ( CTSI ) were detected for a correlation analysis .Results The percentages of CD4+CD25+/highCD127low/-and CD14+HLA-DRlow/-and the CD64 index in patients with severe and mild acute pancreatitis were significantly higher than those in healthy subjects .Patients with se-vere acute pancreatitis showed higher percentages of CD 14+HLA-DRlow/-than patients with mild acute pan-creatitis.With the disease progression, the CD64 index and the levels of CD4+CD25+/highCD127low/-, CD14+HLA-DRlow/-and CRP were significantly dropped after an initial increase in patients with mild acute pancrea -titis, while these indexes were continuously elevated in patients with severe acute pancreatitis .The percent-age of CD14+HLA-DRlow/-was positively correlated with CD64 index, CRP level, APACHEⅡ score and CTSI.Conclusion CD14+HLA-DRlow/-level was closely related to the severity of acute pancreatitis , which could be used as immune parameter for the estimation of the clinical severity of acute pancreatitis .

Objective:To analyze clinical application of intra?aortic balloon pump in the treatment of septic shock.Methods:A total of 62 patients with septic shock in our hospital were assigned into the control group and the observation group according to digital table method, with 31 cases in each group. Patients in the control group were treated with conventional antishock method and patients in the observation group were given intra?aortic balloon pump therapy based on the treatment.Blood pressure, heart rate, urine volume and adverse event in the two groups were compared after treatment.Results:After treatment,blood pressure, heart rate and urine volume of the observation group were improved significantly compared with that in the control group (P<0.05).The overall incidence of adverse events in the observation group (16.13%) was significantly lower than that in the control group (45.16%) after treatment (P<0.05). Conclusion:Intra-aortic balloon pump therapy exerts obvious effect in the treatment of septic shock, significantly improves the patient??s blood pressure and heart rate, increases urine volume, causes less adverse events,and is safe and effective.

Objective To investigate the effect of asiatic acid(AA)on the apoptosis of HT-22 cells induced by sevoflurane(SEVO)by regulating phosphatidylinositol 3-kinase/protein kinase B(PI3K/AKT)signaling pathway.Methods Different concentrations of AA(0,5,10,15,20,30 μmol/L)were used to treat HT-22 cells induced by sevoflurane for 24 hours,and CCK-8 was used to detect HT-22 cell viability;HT-22 cells were divided into control group,sevoflurane(SEVO)group,AA low concentration(AA-L,10 μmol/L)group,AA medium concentration(AA-M,15 μmol/L)group,AA high concentration(AA-H,20 μmol/L)group,and AA high concentration+PI13K pathway inhibitor LY294002(AA-H+LY294002,20 μmol/L AA+5 μmol/L LY294002)group.Inverted microscopy was applied to observe changes of cell morphology,ELISA was applied to detect the levels of inflammatory factors TNF-α and IL-6,oxidative stress indicators SOD,GSH-Px,and MDA,ROS detection kit was applied to detect ROS levels,TUNEL kit was applied to detect HT-22 apoptosis,JC-1 method was applied to detect mitochondrial membrane potential,ATP content detection kit was applied to detect ATP content,and Western blot was applied to detect the expressions of Bcl-2,Bax,Caspase-3,p-PI3K,PI3K,p-AKT,and AKT proteins.Results Compared with 0 μmol/L,the activity of HT-22 cells treated with 5-30 μmol/L AA increased in a concentration-dependent manner(P<0.05),concentrations of 10 μmol/L,15 μmol/L,and 20 μmol/L of AA were selected for subsequent experiments.Compared with the SEVO group,the levels of TNF-α,IL-6,MDA,ROS,cell apoptosis rate,and expressions of Bax and Caspase-3 proteins in the AA-L,AA-M,and AA-H groups were reduced,the levels of SOD and GSH-Px,red/green JC-1 fluorescence ratio,content of ATP,the expression of Bcl-2 protein,the phosphorylation levels of PI3K and AKT were increased(P<0.05),and were concentration dependent.LY294002 was able to reverse the protective effect of AA on HT-22 cell damage induced by sevoflurane(P<0.05).Conclusion AA protects HT-22 cells from damage induced by sevoflurane by activating the PI3K/AKT signaling pathway,which provides a theoretical reference for the development of novel drugs to reduce sevofluran-induced neurotoxicity.

Objective To explore the value of prophylactic anticoagulation in the 28-day prognosis of patients with severe COVID-19.Methods The clinical data of COVID-19 patients admitted to Guangdong Provincial People's Hospital from December 2022 to January 2023 were collected,including age,gender,past medical history,routine blood test,liver and renal function,procalcitonin,coagulation function,Padua prediction score,antiviral therapy,hormonotherapy,immunotherapy and anticoagulation therapy.The patients were divided into an anticoagula-tion group and a non-anticoagulation group.The differences in various indicators were compared between the two groups.Cox regression was performed to assess the independent risk factors for 28-day mortality and the anticoagula-tion efficacy between the subgroups.Results Among 158 patients,128 received anticoagulation;There were significant differences between the two groups in case number of hypertension and critical condition,lymphocyte count,prothrombin time,D-dimer,and case number of immunotherapy.COX logistic regression showed that antico-agulation(HR = 2.25,95%CI:1.01～5.01,P = 0.048)was an independent risk factor for all-cause mortality of COVID-19 patients within 28 days.Subgroup analysis showed that anticoagulation therapy led to an increase in the 28-day mortality as level of procalcitonin of≥0.5 pg/mL(HR = 2.72,95%CI:1.05～7.04)or D-dimer of<2 000 ng/mL(HR = 9.16,95%CI:1.63～51.48).Conclusions Prophylactic anticoagulation did not reduce all-cause mortality of COVID-19 within 28 days.

Objective : To explore the regulatory mechanism of ginsenoside Rb1 on focal cerebral ischemia-reperfusion injury ( CIRI) ． Methods : A total of 60 C57 / BL mice were randomly divided into 6 groups (n = 10) : shamoperated group ，CIRI model group ，ginsenoside Rb1 low －，medium －，and high-dose group and nimodipine (positive control) group．The surgical method was used to construct the focal CIRI mouse model．The neurological function scores and behavioral tests were performed，and Nissl staining was utilized to detect the number of nissl bodies in the hippocampus．The effect of ginsenoside Rb1 on the molecule expression of the Wnt signaling pathway in the hippocampus was detected by qPCR , Western blot and immunohistochemistry assays．The regulatory mechanism of ginsenoside Rb1 was investigated through molecular docking and co-precipitation assays. Results : Compared with the CIRI model group，the addition of ginsenoside Rb1 reduced the neurological function scores of mice (P＜0. 05) ，shortened the time passing the balance beam (P＜0. 05) ，but increased the time entering the correct arm (P＜0. 05) and the swinging time and climbing time of mice (P ＜0. 05 ) ，indicating that ginsenoside Rb1 could effectively resume the function of the nervous system in mice and improve the behavioral ability of model mice．After ginsenoside Rb1 treatment，axis inhibition protein 2 (Axin2) and glycogen synthase kinase-3 β ( GSK- 3 β) in the hippocampus decreased，whereas the expression of Wnt3a，Wnt1 and β-catenin increased． Conclusion The ginsenoside Rb1 can improve neurological function of the CIRI mouse model and increase the number of Nissl bodies in the hippocampus，which is correlated with the activation of the Wnt signaling pathway，and it may be neuroprotective against focal CIRI during stroke treatment.

Objective:We aimed to develop a novel visualized model based on nomogram to predict postoperative overall survival.Methods:This was a multicenter, retrospective, observational cohort study, including participants with histologically confirmed gastric and colorectal cancer who underwent radical surgery from 11 medical centers in China from August 1, 2015 to June 30, 2018. Baseline characteristics, histopathological data and nutritional status, as assessed using Nutrition Risk Screening 2002 (NRS 2002) score and the scored Patient-Generated Subjective Global Assessment, were collected. The least absolute shrinkage and selection operator regression and Cox regression were used to identify variables to be included in the predictive model. Internal and external validations were performed.Results:There were 681 and 127 patients in the training and validation cohorts, respectively. A total of 188 deaths were observed over a median follow-up period of 59 (range: 58 to 60) months. Two independent predictors of NRS 2002 and Tumor-Node-Metastasis (TNM) stage were identified and incorporated into the prediction nomogram model together with the factor of age. The model's concordance index for 1-, 3- and 5-year overall survival was 0.696, 0.724, and 0.738 in the training cohort and 0.801, 0.812, and 0.793 in the validation cohort, respectively.Conclusions:In this study, a new nomogram prediction model based on NRS 2002 score was developed and validated for predicting the overall postoperative survival of patients with gastric colorectal cancer. This model has good differentiation, calibration and clinical practicability in predicting the long-term survival rate of patients with gastrointestinal cancer after radical surgery.