Objective:This multicenter retrospective study aimed to analyze the clinicopathological features of duodenal adenocarcinoma (DA) and identify prognostic factors for postoperative survival.Methods:Demographic characteristics, clinicopathological features, treatment outcomes and survival of DA patients undergoing surgical treatment at 18 Chinese medical centers from January 2012 to December 2023 were retrospectively analyzed.Results:Among the 2 056 DA patients included, 46.8% (963) had extra-ampullary DA (EA-DA), and 53.2% (1 093) had peri-ampullary DA (PA-DA). The 1-, 3-, and 5-year overall survival (OS) rates for patients who underwent radical surgery were 93.2%, 71.0%, and 57.2%, respectively. The median overall survival was 76 months, and the median progression-free survival (PFS) was 65 months. No differences in survival were observed between the laparotomy group and minimally invasive surgery (MIS) group either before or after propensity score matching (OS: 76 vs. 75 months before PSM, P=0.986; OS: 75 vs. 75 months after PSM, P=0.602). Furthermore, there were no significant differences between-group in operation time and postoperative complications ( P＞0.05). The MIS group experienced less intraoperative blood loss and shorter hospital stays. The multivariate Cox regression analysis revealed that advanced age ( HR=1.43,95% CI:1.18-1.73), elevated carbohydrate antigen 19-9 levels ( HR=1.24,95% CI:1.02-1.51), perineural invasion ( HR=1.44,95% CI:1.14-1.81), vascular invasion ( HR=1.35,95% CI:1.07-1.71), advanced T stage (T3-4 vs. T1-2: HR=1.86,95% CI:1.49-2.31), regional lymph node metastasis ( HR=1.93,95% CI:1.58-2.36), preoperative biliary drainage ( HR=1.26,95% CI:1.04-1.53), intraoperative blood loss ( HR=1.34,95% CI:1.11-1.62), clinically significant postoperative pancreatic fistulas ( HR=1.53,95% CI:1.12-2.09), and postoperative hemorrhage ( HR=1.62,95% CI:1.14-2.29) were independent risk factors for poor prognosis after surgery (all P＜0.05). Conclusions:Radical surgery is associated with favorable overall survival among DA patients, and no difference in survival is observed between EA-DA and PA-DA patients. MIS is a reliable alternative for DA treatment.

Objective Accurate speed perception is crucial for tasks such as man-controlled rendezvous and docking,and teleoperation of space manipulator.Therefore,it is necessary to conduct in-orbit experiments to explore the influence of long-term spaceflight on human speed perception characteristics.Methods The Time-to-Collision(TTC)paradigm was selected to develop experimental software,using a tablet computer for stimulus presentation.Human speed perception characteristics were evaluated based on the subjects'keystroke response data on the keyboard.Through ground-based experiments,the usability and reliability of the paradigm were explored,and the gravity internal model effect was quantitatively analyzed.Through in-orbit experiments on space station tasks,the influence of long-term spaceflight on human speed perception characteristics was further investigated.Results Under the 1G environment on the ground,the TTC paradigm has a high test-retest reliability(r>0.8),and indicators such as average deviation rate and absolute value of average deviation rate show no practice effect.In addition,ground experiments found that compared to vertical upward movement,vertical downward movement is estimated to be faster(i.e.,keystroke time is advanced),showing the existence of the gravity internal model effect.In the microgravity environment of spaceflight,there are no significant differences in average deviation rate and absolute value of average deviation rate among three stages(pre-flight,in-flight,post-flight)and seven tests,indicating that no obvious changes in astronauts'speed perception ability were found at the existing test time points and paradigms.However,the gravity internal model effect(difference between vertical downward and vertical upward)showed a trend of fading in the early stage of astronauts entering orbit.Conclusion Based on the computer screen TTC estimation paradigm,no significant changes in human speed perception ability were found during long-term spaceflight,but microgravity may weaken the human brain's gravity internal model.

Objective:To address the challenges in cultivating young medical researchers, including the lack of initial research funding, insufficient interdisciplinary collaboration, absence of academic exchange platforms, and inadequate talent incentives, this study analyzes the specific practical measures of the new model(Fund-Alliance-Academic activities-Award Model, hereinafter referred to as ″FAAA model″) of A certain medical college in enhancing the innovative capabilities and interdisciplinary research proficiency of young medical talents in initial stage, and evaluates the practical significance of these initiatives.Methods:Through literature review, the inevitability of interdisciplinary integration was examined in the context of China′s developmental needs and medical discipline advancement. Innovative practices under the FAAA model of A certain medical college were retrospectively analyzed, focusing on the construction of a medical youth scientific innovation and development platform.Results:The FAAA model had achieved effective outcomes in improving young researchers′ capabilities, fostering interdisciplinary achievements, expanding academic influence, and advancing talent echelon development, yet required further refinement.Conclusions:The FAAA model effectively addresses critical bottlenecks in the growth of young medical researchers through systematic support mechanisms, significantly enhancing their scientific competitiveness and interdisciplinary innovation capacity. Its practical measures offer referential value for peer institutions. Future efforts should optimize the ″early funding-achievement incubation-national project linkage″ chain, strengthen institutionalized interdisciplinary collaboration, and build a data-driven ecosystem to provide sustainable talent support for medical science and technology innovation.

Objective To evaluate the effectiveness and safety of Su Fei He Ji combined with anlotinib hydrochloride in the treatment of refractory advanced non-small cell lung cancer(NSCLC)patients presenting with phlegm stasis obstructing lung type.Methods Thirty-nine patients with advanced NSCLC were randomly assigned to either a control group(19 patients)or an experimental group(20 patients).The control group received treatment with anlotinib alone,while the experimental group received an additional oral administration of Su Fei He Ji.A comparative analysis was conducted between the two groups based on various parameters including short-term objective therapeutic efficacy,progression-free survival,TCM syndrome scores,KPS scores,weight changes,related tumor markers,incidence of adverse reactions,and variations in plasma concentrations of anlotinib.Results Following treatment,the objective response rate was 5%and the disease control rate was 85%in the experimental group,while the control group showed an objective response rate of 0%and a disease control rate of 78.95%.No statistically significant difference was observed in short-term objective efficacy between the two groups(P>0.05).Notably,the experimental group exhibited a significant improvement compared to the control group in various aspects,including TCM syndrome scores and KPS scores(P<0.05).Conversely,no significant differences were observed in weight changes or the reduction levels of other tumor markers(CEA,SCC,CA125,CA199,CYFRA21-1)(P>0.05).Moreover,the incidence of fatigue was notably lower in the experimental group(P<0.05),while no statistical difference was evident in the occurrence of other adverse reactions,such as hypertension,rash,and bleeding,between the two groups(P>0.05).It is important to highlight that there was no statistically significant variance in plasma concentrations between the groups(P>0.05),and no significant correlation was identified between plasma concentrations and the incidence of adverse reactions(P>0.05).Conclusion The combination of Su Fei He Ji and anlotinib hydrochloride effectively improves clinical symptoms and quality of life,and reduces adverse reactions in advanced NSCLC patients.This is achieved without affecting the plasma concentrations of anlotinib.

Objective:This multicenter retrospective study aimed to analyze the clinicopathological features of duodenal adenocarcinoma (DA) and identify prognostic factors for postoperative survival.Methods:Demographic characteristics, clinicopathological features, treatment outcomes and survival of DA patients undergoing surgical treatment at 18 Chinese medical centers from January 2012 to December 2023 were retrospectively analyzed.Results:Among the 2 056 DA patients included, 46.8% (963) had extra-ampullary DA (EA-DA), and 53.2% (1 093) had peri-ampullary DA (PA-DA). The 1-, 3-, and 5-year overall survival (OS) rates for patients who underwent radical surgery were 93.2%, 71.0%, and 57.2%, respectively. The median overall survival was 76 months, and the median progression-free survival (PFS) was 65 months. No differences in survival were observed between the laparotomy group and minimally invasive surgery (MIS) group either before or after propensity score matching (OS: 76 vs. 75 months before PSM, P=0.986; OS: 75 vs. 75 months after PSM, P=0.602). Furthermore, there were no significant differences between-group in operation time and postoperative complications ( P＞0.05). The MIS group experienced less intraoperative blood loss and shorter hospital stays. The multivariate Cox regression analysis revealed that advanced age ( HR=1.43,95% CI:1.18-1.73), elevated carbohydrate antigen 19-9 levels ( HR=1.24,95% CI:1.02-1.51), perineural invasion ( HR=1.44,95% CI:1.14-1.81), vascular invasion ( HR=1.35,95% CI:1.07-1.71), advanced T stage (T3-4 vs. T1-2: HR=1.86,95% CI:1.49-2.31), regional lymph node metastasis ( HR=1.93,95% CI:1.58-2.36), preoperative biliary drainage ( HR=1.26,95% CI:1.04-1.53), intraoperative blood loss ( HR=1.34,95% CI:1.11-1.62), clinically significant postoperative pancreatic fistulas ( HR=1.53,95% CI:1.12-2.09), and postoperative hemorrhage ( HR=1.62,95% CI:1.14-2.29) were independent risk factors for poor prognosis after surgery (all P＜0.05). Conclusions:Radical surgery is associated with favorable overall survival among DA patients, and no difference in survival is observed between EA-DA and PA-DA patients. MIS is a reliable alternative for DA treatment.

Objective To evaluate the effectiveness and safety of Su Fei He Ji combined with anlotinib hydrochloride in the treatment of refractory advanced non-small cell lung cancer(NSCLC)patients presenting with phlegm stasis obstructing lung type.Methods Thirty-nine patients with advanced NSCLC were randomly assigned to either a control group(19 patients)or an experimental group(20 patients).The control group received treatment with anlotinib alone,while the experimental group received an additional oral administration of Su Fei He Ji.A comparative analysis was conducted between the two groups based on various parameters including short-term objective therapeutic efficacy,progression-free survival,TCM syndrome scores,KPS scores,weight changes,related tumor markers,incidence of adverse reactions,and variations in plasma concentrations of anlotinib.Results Following treatment,the objective response rate was 5%and the disease control rate was 85%in the experimental group,while the control group showed an objective response rate of 0%and a disease control rate of 78.95%.No statistically significant difference was observed in short-term objective efficacy between the two groups(P>0.05).Notably,the experimental group exhibited a significant improvement compared to the control group in various aspects,including TCM syndrome scores and KPS scores(P<0.05).Conversely,no significant differences were observed in weight changes or the reduction levels of other tumor markers(CEA,SCC,CA125,CA199,CYFRA21-1)(P>0.05).Moreover,the incidence of fatigue was notably lower in the experimental group(P<0.05),while no statistical difference was evident in the occurrence of other adverse reactions,such as hypertension,rash,and bleeding,between the two groups(P>0.05).It is important to highlight that there was no statistically significant variance in plasma concentrations between the groups(P>0.05),and no significant correlation was identified between plasma concentrations and the incidence of adverse reactions(P>0.05).Conclusion The combination of Su Fei He Ji and anlotinib hydrochloride effectively improves clinical symptoms and quality of life,and reduces adverse reactions in advanced NSCLC patients.This is achieved without affecting the plasma concentrations of anlotinib.

Objective:To address the challenges in cultivating young medical researchers, including the lack of initial research funding, insufficient interdisciplinary collaboration, absence of academic exchange platforms, and inadequate talent incentives, this study analyzes the specific practical measures of the new model(Fund-Alliance-Academic activities-Award Model, hereinafter referred to as ″FAAA model″) of A certain medical college in enhancing the innovative capabilities and interdisciplinary research proficiency of young medical talents in initial stage, and evaluates the practical significance of these initiatives.Methods:Through literature review, the inevitability of interdisciplinary integration was examined in the context of China′s developmental needs and medical discipline advancement. Innovative practices under the FAAA model of A certain medical college were retrospectively analyzed, focusing on the construction of a medical youth scientific innovation and development platform.Results:The FAAA model had achieved effective outcomes in improving young researchers′ capabilities, fostering interdisciplinary achievements, expanding academic influence, and advancing talent echelon development, yet required further refinement.Conclusions:The FAAA model effectively addresses critical bottlenecks in the growth of young medical researchers through systematic support mechanisms, significantly enhancing their scientific competitiveness and interdisciplinary innovation capacity. Its practical measures offer referential value for peer institutions. Future efforts should optimize the ″early funding-achievement incubation-national project linkage″ chain, strengthen institutionalized interdisciplinary collaboration, and build a data-driven ecosystem to provide sustainable talent support for medical science and technology innovation.

Hormone receptor-positive/HER-2-negative(HR+/HER2-)breast cancer exhibits low sensitivity to neoadjuvant chemotherapy(NCT);with minimal benefits observed from NCT.Neoadjuvant endocrine therapy(NET)achieves a clinical response comparable to that of NCT,but with lower toxicity.In addition,CDK4/6 inhibitors have changed the treatment landscape of HR+/HER2-breast cancer,raising new clinical challenges in the selection of the most effective endocrine therapies.In clinical practice,adaptive research designs should be adop-ted based on tumor biology,therapeutic efficacy,and tumor burden.In addition,optimizing treatment strategies and performing precise treatment is important.In this review,we discuss the application value of NET,efficacy evaluating and predicting methods,and potential NET-based combination therapies to provide reference information regarding the treatment of HR+/HER2-breast cancer for clinicians.

Traumatic supraorbital fissure syndrome (TSOFS) is a symptom complex caused by nerve entrapment in the supraorbital fissure after skull base trauma. If the compressed cranial nerve in the supraorbital fissure is not decompressed surgically, ptosis, diplopia and eye movement disorder may exist for a long time and seriously affect the patients′ quality of life. Since its overall incidence is not high, it is not familiarized with the majority of neurosurgeons and some TSOFS may be complicated with skull base vascular injury. If the supraorbital fissure surgery is performed without treatment of vascular injury, it may cause massive hemorrhage, and disability and even life-threatening in severe cases. At present, there is no consensus or guideline on the diagnosis and treatment of TSOFS that can be referred to both domestically and internationally. To improve the understanding of TSOFS among clinical physicians and establish standardized diagnosis and treatment plans, the Skull Base Trauma Group of the Neurorepair Professional Committee of the Chinese Medical Doctor Association, Neurotrauma Group of the Neurosurgery Branch of the Chinese Medical Association, Neurotrauma Group of the Traumatology Branch of the Chinese Medical Association, and Editorial Committee of Chinese Journal of Trauma organized relevant experts to formulate Chinese expert consensus on the diagnosis and treatment of traumatic supraorbital fissure syndrome ( version 2024) based on evidence of evidence-based medicine and clinical experience of diagnosis and treatment. This consensus puts forward 12 recommendations on the diagnosis, classification, treatment, efficacy evaluation and follow-up of TSOFS, aiming to provide references for neurosurgeons from hospitals of all levels to standardize the diagnosis and treatment of TSOFS.

Objective:To investigate the value of the American College of Radiology Thyroid Imaging, Reporting and Data System (ACR TI-RADS), real-time ultrasound elastography (RTE), and contrast-enhanced ultrasound (CEUS), individually and in combination, in the diagnosis of TBSRTC Ⅲ-Ⅴ thyroid nodules.Methods:A retrospective analysis was performed on 106 patients with TBSRTC Ⅲ-Ⅴ thyroid nodules who were pathologically diagnosed by fine needle aspiration cytology at Bao Ji People's Hospital between February 2022 and December 2023. All patients were assessed using ACR TI-RADS grading, RTE, and CEUS, with postoperative pathological diagnosis serving as the gold standard. The diagnostic effectiveness of ACR TI-RADS, RTE, and CEUS, individually and in combination, for TBSRTC Ⅲ-Ⅴ thyroid nodules was analyzed using the receiver operating characteristic (ROC) curve.Results:There were statistically significant differences in nodule size, blood supply, and proportion of TBSRTC Ⅲ-Ⅴ nodule between the two groups ( χ2 = 4.67, 42.56, 26.09, all P < 0.05), while there was no statistical significance in other general data (all P > 0.05). Of the 106 patients with TBSRTC Ⅲ-Ⅴ nodules, 69 patients were diagnosed with malignant nodules and 37 with benign nodules. The area under the curve (95% CI) of ACR-TIRADS, RTE, and CEUS in identifying malignant nodules were 0.860 [95% CI (0.779-0.920)], 0.712 [95% CI (0.616-0.796)], and 0.788 [95% CI (0.698-0.862)], respectively, with sensitivities of 85.51%, 66.67%, and 73.91%, respectively and specificities of 86.49%, 75.68%, and 83.78%, respectively. The Youden indices were 0.719, 0.423, and 0.577, respectively. Among the three diagnostic methods, ACR TI-RADS had the highest diagnostic efficiency, while RTE had the lowest. Pairwise comparisons in ROC analysis revealed statistically significant differences between ACR TI-RADS and RTE, ACR TI-RADS and CEUS, as well as RTE and CEUS ( Z = 4.22, 3.02, 2.78, all P < 0.05). The ACR TI-RADS + RTE + CEUS combination had the highest sensitivity, specificity, Youden index, and AUC (95% CI) values: 94.20%, 89.19%, 0.834, and 0.917 (95% CI: 0.847-0.962). The RTE + CEUS combination had the lowest values: 76.81%, 78.38%, 0.552, and 0.776 (95% CI: 0.685-0.851). The pairwise comparison results in the ROC curve revealed that significant differences were observed between ACR TI-RADS + RTE and RTE + CEUS, ACR TI-RADS + RTE and ACR TI-RADS + RTE + CEUS, ACR TI-RADS + CEUS and ACR TI-RADS + RTE + CEUS, RTE + CEUS and ACR TI-RADS + RTE + CEUS, and ACR TI-RADS + CEUS and RTE + CEUS ( Z = 3.13, 2.40, 2.16, 4.07, 3.32, all P < 0.05). However, there was no significant difference between ACR TI-RADS + RTE and ACR TI-RADS + CEUS in ROC analysis ( Z = 0.06, P > 0.05). Conclusion:The combined utilization of ACR TI-RADS, RTE, and CEUS offers enhanced information on thyroid nodules, encompassing malignant risk stratification, nodular elasticity, and contrast agent perfusion, thereby aiding in improving the diagnostic precision of TBSRTC Ⅲ-Ⅴ malignant nodules.