Objective To evaluate the safety and efficacy of simultaneous resection for initially resectable rectal cancer with synchronous liver metastases. Methods A retrospective analysis was conducted on 305 patients with initially resectable rectal cancer with synchronous liver metastases. These patients were diagnosed at Zhongshan Hospital, Fudan University from January 2016 to June 2020. Among them, 191 underwent simultaneous rectum and liver resection and 114 underwent staged resection. Propensity score matching (PSM) was performed at a 1∶1 ratio. Clinical data were compared and Kaplan-Meier survival curves were plotted. Results After PSM, 85 patients were included in each group. General data showed no significant differences. Except for liver metastasis resection method, no statistical differences were found in primary tumor surgery approach, intraoperative blood loss, intraoperative complications, time to first flatus and defecation, 30-day mortality, and postoperative hospital stay between the simultaneous resection group and the staged resection group. The overall complication rate was higher in the simultaneous resection group (48.2% vs 29.4%, P＝0.04). Specifically, the grade Ⅱ complications were significantly higher (29.4% vs 14.1%, P＝0.016), but there’s no differences in severe complications (grade Ⅲ-Ⅴ). No statistically differences were observed in median progression-free survival (HR＝0.70, 95%CI 0.50-0.97, P＝0.103) and 5-year overall survival (HR＝0.95, 95%CI 0.63-1.44, P＝0.259). Conclusions Simultaneous resection demonstrates comparable safety and efficacy to staged resection for initially resectable rectal cancer with synchronous liver metastases.

Stem cells therapy is an emerging method for the treatment of erectile dysfunction (ED) in men. Compared with traditional treatment, it has the advantage lies in the ability to treat the pathological damage of the penis in patients with ED, which provides new ideas for solving erectile dysfunction fundamentally. However, due to the special anatomical structure of the penis, the therapeutic effect of stem cells is sometimes unsatisfactory. Therefore, how to improve the effect of stem cells therapy for ED has become a new difficulty. Relevant researches on how to improve stem cell treatment of ED will be reviewed in this article.
Humans ; Erectile Dysfunction/therapy* ; Male ; Stem Cell Transplantation

Objective To minimize variations in treatment outcomes of L5/S1 percutaneous intervertebral radiofrequency thermocoagulation(PIRFT)arising from physician proficiency and achieve precise quantitative risk assessment of the puncture paths.Methods We used a self-developed deep neural network DWT-UNet for automatic segmentation of the magnetic resonance(MR)images of the L5/S1 segments into 7 key structures:L5,S1,Ilium,Disc,N5,Dura mater,and Skin,based on which a needle insertion path planning environment was modeled.Six hard constraints and 6 soft constraints were proposed based on clinical criteria for needle insertion,and the physician's experience was quantified into weights using the analytic hierarchy process and incorporated into the risk function for needle insertion paths to enhance individual case adaptability.By leveraging the proposed skin entry point sampling sub-algorithm and Kambin's triangle projection area sub-algorithm in conjunction with the analytic hierarchy process,and employing various technologies such as ray tracing,CPU multi-threading,and GPU parallel computing,a puncture path was calculated that not only met clinical hard constraints but also optimized the overall soft constraints.Results A surgical team conducted a subjective evaluation of the 21 needle puncture paths planned by the algorithm,and all the paths met the clinical requirements,with 95.24%of them rated excellent or good.Compared with the physician's planning results,the plans generated by the algorithm showed inferior DIlium,DS1,and Depth(P<0.05)but much better DDura,DL5,DN5,and AKambin(P<0.05).In the 21 cases,the planning time of the algorithm averaged 7.97±3.73 s,much shorter than that by the physicians(typically beyond 10 min).Conclusion The multi-constraint optimal puncture path planning algorithm offers an efficient automated solution for PIRFT of the L5/S1 segments with great potentials for clinical application.

Objective·To explore the association between gene-gene interaction of glutamate pathway and anhedonia.Methods·A total of 279 patients with schizophrenia(SZ)and 236 patients with major depression disorder(MDD)recruited in the outpatient department and ward of Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,and 236 healthy controls(HC)recruited in the community from January 2017 to August 2020 were included in the study.General demographic data and clinical characteristics of the three groups were collected and compared.The Chinese version of Temporal Experience of Pleasure Scale(TEPS)was used to evaluate the pleasure experience ability of the three groups.Generalized multifactor dimensionality reduction(GMDR)method was used to establish the interaction model of the single nucleotide polymorphism(SNP)in glutamate pathway genes(NOS1AP,GSK3β,DAOA,DISC1 and GRIN2A).According to the interaction model,SZ and MDD patients were divided into high-risk group and low-risk group,and the differences in pleasure experience ability were compared between the two groups,so as to analyze the effect of gene-gene interaction on anhedonia.Results·There were significant differences in age and years of education among the three groups,and in age of onset and duration of illness between SZ and MDD groups(all P=0.000).There were significant differences among the three groups of participants in terms of overall pleasure experience,anticipatory pleasure experience and consummatory pleasure experience(all P=0.000);the overall pleasure experience,anticipatory pleasure experience and consummatory pleasure experience in the SZ and MDD group were lower than those in the HC group(all Pcorr=0.000),and there was marginal statistical difference in anticipatory pleasure experience between the SZ and MDD groups(Pcorr=0.051).Through GMDR modeling,it was found that the 2-loci interaction model composed of DAOA-rs3916965 and DISC1-rs821577 had a predictive effect on the overall pleasure experience ability of SZ patients(P=0.003),and the 2-loci interaction model composed of NOS1AP-rs1858232 and GRIN2A-rs1014531 had a predictive effect on the anticipatory pleasure experience ability of MDD patients(P=0.037);moreover,the overall pleasure experience ability of patients in the SZ high-risk group and anticipatory pleasure experience ability of patients in MDD high-risk groups were lower than those in their low-risk groups(t=3.443,P=0.000;t=3.471,P=0.001).Conclusion·The interaction of glutamate pathway gene polymorphisms may be involved in the occurrence of anhedonia.

Objective:To investigate the relationship between serum 25-hydroxyvitamin D [25(OH)D] and arterial stiffness in the physical examination population.Methods:It was a cross-sectional study, the data were collected from adults who received physical examination in the Health Management Center of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2016 to April 2022, all the participants completed the tested for brachial and ankle pulse wave conduction velocity (baPWV) and serum 25(OH)D. The general information, anthropometric metrics and relevant laboratory data were recorded. A total of 41 090 participants were included. According to baPWV, the subjects were divided into arterial stiffness group (baPWV≥1 800 cm/s, n=2 440) and normal group (baPWV<1 800 cm/s, n=38 650). The subjects were categorized into three groups based on serum 25(OH)D level: sufficient group [25(OH)D≥30 μg/L, n=2 830], insufficient group [25(OH)D 20-<30 μg/L, n=11 400] and deficiency group [25(OH)D<20 μg/L, n=26 860]. Logistic regression analysis was performed to assess the relationship between 25(OH)D and arterial stiffness. The dose-response relationship between serum 25(OH)D levels and the risk of arterial stiffness was analyzed using restricted cubic spline functions. Results:Of the 41 090 participants included, 25 001 were males and 16 089 were females, 2 440 cases (5.94%) were detected with arterial stiffness. Compared with normal group, the age, body mass index, uric acid, creatinine, 25(OH)D level and proportion of dyslipidemia were all significantly higher in the arterial stiffness group [(60.1±9.8) vs (46.0±10.4) years, (25.3±3.4) vs (24.5±3.4) kg/m 2, (356.2±99.6) vs (345.0±95.8) μmol/L, (77.0±21.5) vs (73.8±15.9) μmol/L, (18.51±7.93) vs (18.11±7.27) μg/L, 48.4% vs 38.5%], while the glomerular filtration rate was significantly lower [(87.2±16.1) vs (99.1±14.0) ml·min -1·1.73 m -2] (all P<0.05). The 25(OH)D deficiency was positively correlated with the risk of arteriosclerosis ( OR=1.26, 95% CI: 1.07-1.51), and the risk of arterial stiffness increased by 16% for every 10 μg/L decrease in serum 25(OH)D levels (all Ptrend<0.001). The mean baPWV level in the 25(OH)D deficiency group was 12.45 cm/s (95% CI: 3.89-21.02) higher than that in 25(OH)D adequacy group; and for every 10 μg/L decrease in 25(OH)D, the baPWV increased by 11.23 cm/s (95% CI: 8.11-14.19) (all Ptrend<0.001). The association between serum 25(OH)D deficiency and the risk of arteriosclerosis was more pronounced in individuals with a body mass index of 24 kg/m2 or above ( Pfor interaction=0.039). Moreover, there was an “L”-shaped dose-response relationship between serum 25(OH)D level and the risk of arteriosclerosis ( Pnon-linear<0.001). Conclusion:The 25(OH)D deficiency is closely correlated with the risk of arteriosclerosis in the physical examination population, and the association is stronger in overweight individuals.

Objective:To explore the association between insulin resistance (IR) and new-onset hyperuricemia (HUA) in nurses.Methods:A retrospective cohort study was conducted on 3 792 nurses from Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, who were surveyed from January to July in 2021. A total of 2 995 nurses who were successfully followed up in 2023 and met the inclusion criteria were selected for the study. The nurses were divided into four groups based on their quantiles (Q1 to Q4)for each indicator of insulin resistance (IR), including the triglyceride glucose (TyG), the triglyceride glucose-body mass index (TyG-BMI), the triglyceride/high-density lipoprotein-cholesterol index (TG/HDL-C), and the metabolic score for insulin resistance (METS-IR): groups. The impact of each IR indicator on the risk of HUA was assessed by using Cox regression analysis, while the receiver operating characteristic (ROC) curve was employed to evaluate and compare the predictive power of each indicator.Results:Of the 2 995 nurses, there were 65 males and 2 930 females, with a mean age of (33.19±6.67) years. During the follow-up period of 1.95 (1.87, 2.03) years, 152 new-onset HUA cases were identified, resulting in an incidence density of 26.02 per 1 000 person-years. After adjusting for various confounding factors, the Cox risk regression model analysis indicated that the hazard ratios (95% CI) for the risk of HUA in the highest quartile (Q4) compared to the lowest quartile (Q1) were as follows: 2.20(1.34, 3.63) for TyG, 4.95 (2.76, 8.90) for TyG-BMI, 3.24 (1.92, 5.45) for TG/HDL-C, and 6.15 (3.34, 11.33) for METS-IR. The areas under the ROC curves for TyG, TyG-BMI, TG/HDL-C, and METS-IR levels in predicting the risk of HUA in nurses was 0.71, 0.73, 0.72, and 0.74, respectively. Conclusion:The IR is positively correlated with new-onset HUA in nurses, and each IR index demonstrates a certain predictive efficacy for risk of HUA.

Objective To explore the occurrence and influencing factors of delayed cerebral ischemia(DCI)after clipping surgery in patients with anterior circulation aneurysms.Methods A retrospective analysis was conducted on 248 patients with anterior circulation aneurysms who underwent clipping surgery in our hospital from May 2018 to May 2023.The patients were divided into the DCI group and the non-DCI group based on the occurrence of DCI after surgery.A1∶1 propensity score matching method was used to match 54 patients in the DCI group with 54 patients in the non-DCI group.The random forest algorithm was employed to rank the importance of factors influencing DCI.Multivariable Logistic regression analysis was performed to identify independent risk factors for DCI,and the E-value method was used to assess the sensitivity of model parameters.A DCI risk prediction model was constructed,and the discriminative ability and accuracy of the model were evaluated using ROC curve and Hosmer-Lemeshow test.Results After matching,no statistically significant differences were observed between the two groups in terms of gender,age,body mass index(BMI),smoking history,alcohol consumption,history of cerebral infarction,history of subarachnoid hemorrhage,aneurysm location,and maximum aneurysm diameter(all P＞0.05).Compared to the non-DCI group,the DCI group had a higher proportion of modified Fisher grade 3-4 and Hunt-Hess grade IV patients,higher levels of D-dimer(D-D),total bilirubin(TBIL),TNF-α,high-sensitivity C-reactive protein(hs-CRP),IL-6,and glutamate,and lower levels of immunoglobulin(Ig)G,IgM,and IgA(all P＜0.05).The random forest analysis showed that including Hunt-Hess grade,modified Fisher grade,D-D,glutamate,TB1L,IgA,and IL-6 in the multivariable regression analysis achieved the lowest out-of-bag error rate.Multivariable analysis revealed that Hunt-Hess grade Ⅳ,modified Fisher grade 3-4,D-D,glutamate,TBIL were independent risk factors for DCI,while IgA was a protective factor(all P＜0.05).The risk prediction equation was as follows:P=1/[1+e(3.142+1.307 Hunt-Hess grade+1.086 modified Fisher grade+0.976 D-D+0.748 glutamate+0.552 TBIL-0.524 IgA+0.487 IL-6)].A patient with a risk probability P＞0.65 was considered to have a postoperative occurrence of DCI.The ROC curve results showed that after internal validation,the AUC of the model was 0.869(95％CI:0.836-0.897),with sensitivity and specificity of 81.08％and 97.34％,respectively,indicating good discrimination of the model.The Hosmer-Lemeshow test results showed that after internal validation,the goodness of fit of the model wasx2=4.219,P=0.561,indicating good fit of the model.Conclusions Hunt-Hess grade Ⅳ,modified Fisher grade 3-4,D-D,glutamate,TBIL,and IL-6 are identified as independent risk factors for DCI,while IgA is a protective factor.The predictive model constructed using these factors demonstrates high accuracy and discriminative ability.A risk probability P＞0.65 indicates a postoperative occurrence of DCI in patients.

italic>Salmonella has emerged as a promising tumor-targeting strategy in recent years due to its good tumor targeting ability and certain safety. In order to further optimize its therapeutic effect, scientists have tried to modify Salmonella, including its attenuation and drug loading. This paper summarizes the mechanism and research progress of Salmonella-mediated targeted tumor therapy, and introduces the strategies and related progress of its modification and optimization. At the same time, the advantages, current challenges and future development directions of Salmonella-mediated tumor therapy are summarized.

AIM:To study whether glycyrrhizic acid(GL)can resist the ototoxicity of cisplatin(CDDP)in mice and its molecular mechanism.METHODS:Male C57BL/6J mice were divided into 5 groups:control group,DMSO(5%)group,CDDP(4 mg/kg)group,CDDP+low-dose(50 mg/kg)GL group,and CDDP+high-dose(100 mg/kg)GL group(n=14).Auditory brainstem response(ABR)was used to detect hearing changes of mice.HE staining was used to observe the morphological change of cochlear stria vascular in mice.Evans blue(EB)staining was used to observe the per-meability change of the blood-labyrinth barrier(BLB).Immunohistochemical technique was used to detect the expression and distribution of adhesion protein VE-cadherin and tight junction protein ZO-1 on the cochlear stria.ELISA assay and immunofluorescence technology were employed to detect the expression of tumor necrosis factor-α(TNF-α)and interleu-kin-1β(1L-1β).RESULTS:In CDDP group,ABR waveforms of all frequencies were disturbed,the hearing threshold was significantly increased,and I wave latency was prolonged(P＜0.05).In CDDP+GL group,ABR waveforms of various frequencies were well differentiated,the hearing threshold was significantly decreased,and the latency of I-wave was shortened(P＜0.01).The disordered morphology and more vacuoles in the stria vascularis were observed by HE staining in CDDP group.The GL alleviated CDDP-induced damage in the stria vascularis.In EB staining,CDDP caused an increase in per-meability of BLB(P＜0.01),which was improved by GL treatment(P＜0.01).Immunohistochemical results showed that the expression of VE-cadherin and ZO-1 in CDDP group were decreased(P＜0.01),which was restored in CDDP+GL group(P＜0.01).The ELISA and immunofluorescence results showed that the expression of IL-1β and TNF-α was in-creased after CDDP treatment(P＜0.01),which was restored in CDDP+GL group(P＜0.01).CONCLUSION:The GL alleviates CDDP-induced hearing loss in mice by inhibiting CDDP-induced inflammation and reducing the permeability of BLB.

This study constructed a LHCGR-CRE-luc-HEK293 transgenic cell line according to the activation of the cAMP signaling pathway after recombinant human chorionic gonadotropin binding to the receptor. The biological activity of recombinant human chorionic gonadotropin was assayed using a luciferase assay system. The relative potency of the samples was calculated using four-parameter model. And the method conditions were optimized to validate the specificity, relative accuracy, precision and linearity of the method. The results showed that there was a quantitative potency relationship of human chorinonic gonadotropin (hCG) in the method and it was in accordance with the four-parameter curve. After optimization, the conditions were determined as hCG dilution concentration of 2.5 μg·mL^-1, dilution ratio of 1∶4, cell number of 10 000-15 000 cells/well, and induction time of 6 h. The method had good specificity, relative accuracy with relative bias ranging from -8.9% to 3.4%, linear regression equation correlation coefficient of 0.996, intermediate precision geometric coefficient of variation ranging from 3.3% to 15.0%, and linearity range of 50% to 200%. This study successfully established and validated a reporter gene method to detect hCG biological activity, which can be used for hCG biological activity assay and quality control.