Objective To examine the safety, efficacy and durability of totally endoscopic minimally invasive (TEMI) mitral valve repair in Barlow’s disease (BD). Methods A retrospective study was performed on patients who underwent mitral valve repair for BD from January 2010 to June 2021 in the Guangdong Provincial People’s Hospital. The patients were divided into a MS group and a TEMI group according to the surgery approaches. A comparison of the clinical data between the two groups was conducted. Results A total of 196 patients were enrolled, including 133 males and 63 females aged (43.8±14.9) years. There were 103 patients in the MS group and 93 patients in the TEMI group. No hospital death was observed. There was a higher percentage of artificial chordae implantation in the TEMI group compared to the MS group (P=0.020), but there was no statistical difference between the two groups in the other repair techniques (P>0.05). Although the total operation time between the two groups was not statistically different (P=0.265), the TEMI group had longer cardiopulmonary bypass time (P<0.001) and aortic clamp time (P<0.001), and shorter mechanical ventilation time (P<0.001) and postoperative hospitalization time (P<0.001). No statistical difference between the two groups in the adverse perioperative complications (P>0.05). The follow-up rate was 94.2% (180/191) with a mean time of 0.2-12.4 (4.0±2.4) years. Two patients in the MS group died with non-cardiac reasons during the follow-up period. The 3-year, 5-year and 10-year overall survival rates of all patients were 100.0%, 99.2%, 99.2%, respectively. Compared with the MS group, there was no statistical difference in the survival rate, recurrence rate of mitral regurgitation, reoperation rate of mitral valve or adverse cardiovascular and cerebrovascular events in the TEMI group (P＞0.05). Conclusion TEMI approach is a safe, feasible and effective approach for BD with a satisfying long-term efficacy.

Objective To investigate the epidemiology of elderly respiratory tract infection (RTI) cases in a hospital in Xuzhou region from 2020 to 2022. Methods The cases of RTI patients in a hospital were screened from May 2020 to December 2022, and 548 cases that met the criteria were included in the study. Patient case data were analyzed for symptoms, pathogen distribution, and differences in patient distribution under different screening conditions (age, disease, and season). Results More than 90.00% of the included RTI patients presented with symptoms of cough, sputum, wet rales and pleural effusion was less common. The top three comorbidities were cardiovascular disease (153 patients, 27.92%), cerebrovascular disease (133 patients, 24.27%), and gastrointestinal disease (105 patients, 19.16%).All 548 elderly patients tested positive for respiratory pathogens (100.00%). There were 540 cases of single pathogen infection (98.54%) and 8 cases of mixed infection (1.46%). The top five single pathogen infections were Pseudomonas aeruginosa (92 cases, 16.76%), Escherichia coli (78 cases, 14.21%), drug-resistant Staphylococcus aureus (69 cases, 12.57%), Klebsiella pneumoniae (65 cases, 11.84%), and Mycoplasma pneumoniae (46 cases, 8.38%). The highest detection rate of respiratory pathogens was found in patients >90 years old, whose main pathogens were Pseudomonas aeruginosa, Klebsiella pneumoniae and drug-resistant Staphylococcus aureus. The next highest rates of pathogen detection were found in patients aged 86-91 and 81-85 years, unlike patients >90 years, who had a higher rate of Escherichia coli detection. Unlike other age groups, patients <75 years old had a higher percentage of influenza B virus detection. The highest incidence of pneumonia was found in 45.62% (250 cases). Escherichia coli had the highest detection rate in acute bronchitis/episodes and pneumonia, respiratory syncytial virus had the highest detection rate in wheezing bronchitis, Klebsiella pneumoniae had the highest detection rate in bronchopneumonia, and Pseudomonas aeruginosa had the highest detection rate in fever. The highest detection rate of pathogens was found in fall (36.50%), followed by spring (27.01%). The distribution of pathogen infections in all seasons was matched with the results of pathogenicity testing. Streptococcus oxysporus had the highest number of infections in the fall (χ²=20.33, P<0.001). Conclusion Elderly respiratory tract infections in this region are most common in patients over 90 years old, with the highest incidence of pneumonia and high incidence in fall, and the pathogens are mainly Pseudomonas aeruginosa, Escherichia coli and drug-resistant Staphylococcus aureus. Attention to distinguish the above characteristics can provide some support for early diagnosis and treatment of respiratory infections in the elderly in this region.

Objective To explore the epidemiological characteristics of lung cancer in Quanshan District of Xuzhou cityand analyze the influencing factors, so as to provide theoretical guidance for the prevention and control of lung cancer in Quanshan District of Xuzhou City. Methods A total of 302 patients with lung cancer diagnosed in the Affiliated Hospital of Xuzhou Medical University were selected as case group from January 2019 to December 2023, and 300 healthy persons were selected as control group, a self-designed questionnaire was used to investigate the general and clinical information of the patients, and Logistic regression was used to analyze the risk factors.Results There were a statistically difference in two groups for the smoking index （χ²=40.058，P<0.001)，Chemical occupational environment（χ²=28.153 , P<0.001), weekly exercise mode（χ²=11.021，P=0.004), emphysema score（χ²=142.812，P<0.001). In addition, the CA125 in the case group was (87.11 ± 13.09) U/ml, while the control group was (16.32 ± 5.61) U/ml, with a statistically difference (t=34.581, P<0.001). The logistic regression results showed that smoking index≥20 cigarettes per day (OR=3.448, P=0.021), chemical occupational environment (OR=4.091, P<0.001), emphysema score (OR=1.302, P<0.001) or severe (OR=1.461, P<0.001), and CA125 detection value ≥ 75U/ml (OR>1.6, P<0.001) were independent risk factors for lung cancer, while moderate weekly exercise (OR=0.821, P<0.001) was a protective factor for lung cancer. Conclusion Smoking, high CA125 index, chemical occupational environment, and long-term emphysema are risk factors for the occurrence of lung malignant tumors in Quanshan District of Xuzhou City, screening regularly of CA125 in people who have smoking, emphysema, and being chemical occupational environment should be strengthened, and appropriate health education in proper exerciseshould be provided to prevent and reduce the incidence of lung malignant tumors.

[摘 要] 目的：探讨iSEND免疫评分联合肺癌免疫治疗预后指数（LIPI）在评估非小细胞肺癌（NSCLC）接受免疫治疗预后中的价值。方法：通过回顾性分析2018年2月至2023年2月期间100例接受免疫治疗的晚期NSCLC患者的临床资料，收集并整理患者的iSEND免疫评分和LIPI数据，根据iSEND免疫评分和LIPI分别将患者分为3组（不良组、中等组和良好组），运用Kaplan-Meier方法绘制生存曲线分析所有患者和不同组别患者的无进展生存期（PFS），运用Cox回归分析评估影响患者预后的风险因素。结果：在接受免疫治疗后，NSCLC患者的ORR为42.00%（42/100），DCR为82.00%（82/100）。iSEND免疫评分和LIPI不良组ORR和DCR均最低，良好组均最高，不同组别ORR和DCR比较均有统计学意义（均P < 0.01）。100例NSCLC患者的中位PFS为7.63个月[95% CI（7.23, 8.05）]，iSEND免疫评分不良组、中等组和良好组的中位PFS分别为4.69、6.58和8.99个月，iSEND免疫评分良好组的PFS最长，其次为中等组，不良组最短（χ2=125.391，P < 0.000 1）。LIPI不良组、中等组和良好组的中位PFS分别为4.54、6.39和8.49个月，以LIPI良好组的PFS最长，其次为中等组（χ2 = 115.707，P < 0.000 1）。Cox多因素分析提示，ECOG PS > 1、远处转移、iSEND免疫评分≥ 2分和LIPI ≥ 2分是影响患者独立预后的风险因素。结论：iSEND免疫评分和LIPI可作为评估NSCLC免疫治疗预后的良好指标，具有一定的临床价值。

The International Severe Asthma Registry (ISAR) was established in 2017 to advance the understanding of severe asthma and its management, thereby improving patient care worldwide. As the first global registry for adults with severe asthma, ISAR enabled individual registries to standardize and pool their data, creating a comprehensive, harmonized dataset with sufficient statistical power to address key research questions and knowledge gaps. Today, ISAR is the largest repository of real-world data on severe asthma, curating data on nearly 35,000 patients from 28 countries worldwide, and has become a leading contributor to severe asthma research. Research using ISAR data has provided valuable insights on the characteristics of severe asthma, its burdens and risk factors, real-world treatment effectiveness, and barriers to specialist care, which are collectively informing improved asthma management. Besides changing clinical thinking via research, ISAR aims to advance real-world practice through initiatives that improve registry data quality and severe asthma care. In 2024, ISAR refined essential research variables to enhance data quality and launched a web-based data acquisition and reporting system (QISAR), which integrates data collection with clinical consultations and enables longitudinal data tracking at patient, center, and population levels. Quality improvement priorities include collecting standardized data during consultations and tracking and optimizing patient journeys via QISAR and integrating primary/secondary care pathways to expedite specialist severe asthma management and facilitate clinical trial recruitment. ISAR envisions a future in which timely specialist referral and initiation of biologic therapy can obviate long-term systemic corticosteroid use and enable more patients to achieve remission.

Objective To analyze the application effects of artificial intelligence (AI) software and Mimics software in preoperative three-dimensional (3D) reconstruction for thoracoscopic anatomical pulmonary segmentectomy. Methods A retrospective analysis was conducted on patients who underwent thoracoscopic pulmonary segmentectomy at the Second People's Hospital of Huai'an from October 2019 to March 2024. Patients who underwent AI 3D reconstruction were included in the AI group, those who underwent Mimics 3D reconstruction were included in the Mimics group, and those who did not undergo 3D reconstruction were included in the control group. Perioperative related indicators of each group were compared. Results A total of 168 patients were included, including 73 males and 95 females, aged 25-81 (61.61±10.55) years. There were 79 patients in the AI group, 53 patients in the Mimics group, and 36 patients in the control group. There were no statistical differences in gender, age, smoking history, nodule size, number of lymph node dissection groups, postoperative pathological results, or postoperative complications among the three groups (P>0.05). There were statistical differences in operation time (P<0.001), extubation time (P<0.001), drainage volume (P<0.001), bleeding volume (P<0.001), and postoperative hospital stay (P=0.001) among the three groups. There were no statistical differences in operation time, extubation time, bleeding volume, or postoperative hospital stay between the AI group and the Mimics group (P>0.05). There was no statistical difference in drainage volume between the AI group and the control group (P=0.494), while there were statistical differences in operation time, drainage tube retention time, bleeding volume, and postoperative hospital stay (P<0.05). Conclusion For patients requiring thoracoscopic anatomical pulmonary segmentectomy, preoperative 3D reconstruction and preoperative planning based on 3D images can shorten the operation time, postoperative extubation time and hospital stay, and reduce intraoperative bleeding and postoperative drainage volume compared with reading CT images only. The use of AI software for 3D reconstruction is not inferior to Mimics manual 3D reconstruction in terms of surgical guidance and postoperative recovery, which can reduce the workload of clinicians and is worth promoting.

Objective: To investigate the effects of Erianin on cell proliferation and apoptosis in human oral squamous cell carcinoma (OSCC) cells, providing a research foundation for the clinical treatment of OSCC. Methods: Erianin was applied to OSCC cells (CAL27 and SCC9) at concentrations of 0, 2.5, 5, and 10 μmol/L. The inhibitory effect of Erianin on OSCC cell proliferation was evaluated using CCK-8 and soft agar colony formation assays. Western blotting (WB) was employed to analyze the expression levels of anti-apoptotic proteins B-cell lymphoma-extra large (Bcl-xL), B-cell lymphoma-2 (Bcl-2), myeloid cell leukemia-1 (Mcl-1), and apoptotic protein cleaved-Caspase 3 (c-Caspase 3) in OSCC cells. Caspase 3 activity was further assessed using a caspase 3 activity detection kit to examine the pro-apoptotic effect of Erianin in OSCC cells. Mcl-1 overexpression was induced in CAL27 cells via plasmid transfection, and the influence of Mcl-1 on the effects of Erianin in CAL27 cells was analyzed by WB and caspase 3 activity measurement. All animal experiments were approved by the Ethics Committee of Hunan Cancer Hospital. A CAL27 xenograft mouse model was established and randomly divided into two groups (n = 5): the treatment group received intraperitoneal injection of Erianin (25 mg/kg), while the control group was injected with phosphate-buffered saline (PBS) as the vehicle. Immunohistochemistry (IHC) was used to detect the expression levels of Ki67 and Mcl-1 in the tumor tissues. Results: Erianin inhibited the proliferation of CAL27 and SCC9 cells in a dose-dependent manner and downregulated the protein expression of Mcl-1, with minimal effects on Bcl-2 and Bcl-xL. Furthermore, Erianin induced apoptosis in OSCC cells, as evidenced by increased expression of c-Caspase 3 and enhanced caspase 3 activity (P<0.001). Overexpression of Mcl-1 inhibited the Erianin-induced increase in c-Caspase 3 protein levels and caspase 3 activity. In vivo results were consistent with the in vitro findings. After Erianin treatment, CAL27 cell growth in nude mice was suppressed (P<0.001), and the expression levels of the proliferation marker Ki67 and the anti-apoptotic protein Mcl-1 in the tumor tissues were downregulated (P<0.001). Conclusion Erianin exhibits potent anti-tumor effects, effectively inhibiting the proliferation of OSCC cells and inducing apoptosis. The underlying mechanism may involve the downregulation of the pro-survival protein Mcl-1.

Osteoporosis （OP） is a systemic metabolic disease with a strong correlation with age. The prevalence of osteoporosis is rising annually as a consequence of the growing issue of population ageing. The current treatments for OP have numerous shortcomings. In contrast， traditional Chinese medicine has a long history and a rich species diversity. Furthermore， recent years have seen an increase in the number of studies examining the anti-OP properties of traditional Chinese medicine. This may provide a safe and effective alternative strategy for the treatment of OP. The zebrafish， due to its favourable optical transparency and high homology with human genes， has been extensively employed as an animal research model in the investigation of human skeletal-related disease mechanisms and drug screening. This paper presents a review of anti-osteoporosis studies of traditional Chinese medicine using zebrafish as a model for osteoporosis. It also provides a summary of the experimental evaluation methods involved in such studies， an analysis of the current status of traditional Chinese medicine in the treatment of osteoporosis using zebrafish as a model， and a summary of the mechanism of action and the signalling pathways involved in traditional Chinese medicine in the anti-osteoporosis treatment of zebrafish. The current research status of Chinese medicine in the treatment of OP was analysed， as well as the mechanism of action of Chinese medicine against OP and the signalling pathways involved. Furthermore， the advantages and disadvantages of various zebrafish modelling methods of OP were compared with those of traditional animal models. The objective of this study is to provide a reference for the evaluation method of the zebrafish model in the study of bone-related diseases， as well as for the study of the mechanism of action of traditional Chinese medicine against OP and for the reference of the research and development of new drugs.

[摘 要] 目的：探讨环状RNA hsa_circ_0046701在胶质瘤组织中的表达及其对胶质瘤U251细胞增殖、迁移与侵袭的影响。方法：收集2022年6月至2023年3月期间在同济大学附属普陀人民医院接受手术治疗的52例胶质瘤患者的瘤组织标本及临床资料，另收集30例正常脑组织标本作为对照。通过qPCR法检测胶质瘤组织中hsa_circ_0046701表达水平，分析其与患者临床特征间的关系，通过Kaplan-Meier法分析hsa_circ_0046701水平与生存预后的关系。利用RNA干扰技术，分别将circ_0046701过表达及空载体（vector）、siRNA-circ_0046701及阴性对照（si-NC）质粒转染到胶质瘤U251细胞中，实验分为si-circ_0046701组、si-NC组、circ_0046701 OE组、Vector组。应用CCK-8法、Transwell小室实验检测各组细胞的增殖、迁移及侵袭能力，WB法检测各组细胞中vimentin、Snail、E-cadherin和cyclin D1蛋白的表达。结果：胶质瘤组织中hsa_circ_0046701表达显著高于正常脑组织（P < 0.01）。hsa_circ_0046701高表达组患者WHO脑胶质瘤分级（Ⅲ~Ⅳ级）占比显著高于低表达组（P < 0.01），其高表达组患者术后生存期显著短于低表达组。与si-NC组相比，si-circ_0046701组U251细胞的增殖能力显著降低（P < 0.05或P < 0.01）、迁移及侵袭细胞数均显著减少（均P < 0.01），细胞中vimentin、Snail、cyclin D1蛋白表达均明显降低（均P < 0.01）、E-cadherin蛋白表达明显增高（P < 0.01）；与Vector组相比，circ_0046701 OE组U251细胞的增殖能力显著升高（P < 0.01）、迁移及侵袭细胞数均显著增多（均P < 0.01），细胞中vimentin、Snail、cyclin D1蛋白表达均显著增高（均P < 0.01）、E-cadherin蛋白表达明显降低（P < 0.01）。结论：环状RNA hsa_circ_0046701在胶质瘤组织中呈高表达，并与患者的不良预后密切相关；敲低hsa_circ_0046701表达能够抑制脑胶质瘤U251细胞的增殖、迁移及侵袭能力。

[摘 要] 目的：探索预后营养指数（PNI）在接受诱导化疗联合免疫（化免）序贯放疗的局部晚期食管鳞状细胞癌（ESCC）中的疗效预测价值及预后影响。方法: 回顾性分析浙江省肿瘤医院2019年5月至2023年8月期间收治的126例行诱导化免序贯放疗的局部晚期ESCC患者的临床资料。绘制受试者工作特征曲线（ROC曲线），确定患者诱导化免前1周内、放疗前1周内、放疗开始后4 ± 1周的PNI最佳临界值并对患者进行分组。采用Kaplan-Meier法绘制生存曲线，并用Log-Rank法比较组间患者的总生存期（OS）及无进展生存期（PFS），采用Cox回归分析探讨诱导化免序贯放疗的局部晚期ESCC患者的预后影响因素。结果: 共纳入126例局部晚期ESCC患者，男性118例，女性8例，中位年龄65岁（44~78岁）。运用ROC曲线确认的患者诱导化免前、放疗前和放疗中PNI最佳临界值为46.2、48.3和37.9。放疗前PNI ≥ 48.3组中位OS、PFS分别为47.3、28.2个月，放疗前PNI < 48.3组中位OS、PFS分别为18.7、15.2个月（P < 0.01，P < 0.05）。放疗中PNI ≥ 37.9组中位OS未达到，中位PFS为25.7个月，放疗中PNI < 37.9组中位OS、PFS分别为17.0、12.5个月（P < 0.01，P < 0.05）。诱导化免后PNI升高组中位OS未达到，中位PFS为28.4个月；PNI降低组中位OS、PFS分别为20.4、16.0个月（P < 0.01，P < 0.05）。多因素分析显示，放疗中PNI[HR = 2.292，95% CI（1.264,4.159），P < 0.05]、诱导化免后PNI变化[HR = 2.120, 95% CI（1.007, 4.463），P < 0.05]为影响OS因素。结论: 放疗中PNI、诱导化免后PNI变化与患者治疗疗效及预后有一定相关性，可作为预测ESCC化免序贯放疗获益的重要指标。