Objective:To investigate the survival outcomes and prognostic factors in patients undergoing radical resection for pancreatic body and tail cancer.Methods:A retrospective case series study was conducted on 992 patients who underwent radical resection for pancreatic body and tail cancer at the Pancreatic Center of the First Affiliated Hospital of Nanjing Medical University from January 2016 to June 2024. In this study, 577 (58.2%) were male and 415 (41.8%) were female,with an age of (65±9) years (range: 26 to 86 years). Follow-up continued until June 2024. Survival rates were estimated using the Kaplan-Meier method,and prognostic factors were identified using univariate and multivariate Cox proportional hazards models.Results:Among 992 patients,open surgery was the predominant approach (89.1%, 884/992), and radical antegrade modular pancreatosplenectomy (RAMPS) was performed in 317 patients (32.0%). Combined organ resection,venous resection,and arterial resection were performed in 23.5%, 9.3%,and 11.2% of patients,respectively. The rates of R0, R1-1 mm, and R1-direct resections were 49.8% (494/992),41.5% (412/992), and 8.7% (86/992),respectively. Stage ⅡB was the most common TNM stage (32.2%,319/992). A total of 801 patients (80.8%) received adjuvant chemotherapy. The median follow-up period was 32.0(8.8) months(range:3.2 to 105.3 months),during which 508 patients (51.2%) died. The overall median survival (OS) was 26.4 months,with 1-,3-, and 5-year survival rates of 79.0%,40.0%, and 29.0%, respectively. In the recent five years (from 2020 to 2024), the median OS improved significantly to 34.1 months compared to 20.0 months from 2016 to 2019 ( P<0.01). Histological subtype analysis showed that the median OS time was 26.7 months for pancreatic ductal adenocarcinoma (PDAC, n=855),58.9 months for invasive intraductal papillary mucinous carcinoma (IPMC, n=32),and 15.7 months for adenosquamous carcinoma of pancreas (ASCP, n=73) ( P=0.001). Among PDAC patients, adjuvant chemotherapy significantly improved survival (29.1 months vs. 14.4 months, P<0.01);in IPMC patients, adjuvant chemotherapy also extended survival (65.7 months vs. 58.9 months, P=0.047). Although ASCP patients receiving chemotherapy had a longer median OS time than those without (18.8 months vs. 8.9 months),the difference was not statistically significant ( P=0.151). Multivariate Cox regression analysis in PDAC patients indicated that adjuvant chemotherapy, R0 resection, T stage,N stage,and tumor differentiation were independent prognostic factors ( P<0.01). The median OS time by TNM stage was:not reached for stage ⅠA, 51.6 months for ⅠB, 25.5 months for ⅡA, 23.7 months for ⅡB, 23.0 months for Ⅲ, and 14.4 months for Ⅳ. The median OS time for R0,R1-1 mm,and R1-direct resections was 34.1,24.7,and 15.7 months,respectively ( P<0.01). Conclusion:Adjuvant chemotherapy,R0 resection,tumor stage,and differentiation are independent prognostic factors for pancreatic body and tail cancer.

Objective:To investigate the survival outcomes and prognostic factors in patients undergoing radical resection for pancreatic body and tail cancer.Methods:A retrospective case series study was conducted on 992 patients who underwent radical resection for pancreatic body and tail cancer at the Pancreatic Center of the First Affiliated Hospital of Nanjing Medical University from January 2016 to June 2024. In this study, 577 (58.2%) were male and 415 (41.8%) were female,with an age of (65±9) years (range: 26 to 86 years). Follow-up continued until June 2024. Survival rates were estimated using the Kaplan-Meier method,and prognostic factors were identified using univariate and multivariate Cox proportional hazards models.Results:Among 992 patients,open surgery was the predominant approach (89.1%, 884/992), and radical antegrade modular pancreatosplenectomy (RAMPS) was performed in 317 patients (32.0%). Combined organ resection,venous resection,and arterial resection were performed in 23.5%, 9.3%,and 11.2% of patients,respectively. The rates of R0, R1-1 mm, and R1-direct resections were 49.8% (494/992),41.5% (412/992), and 8.7% (86/992),respectively. Stage ⅡB was the most common TNM stage (32.2%,319/992). A total of 801 patients (80.8%) received adjuvant chemotherapy. The median follow-up period was 32.0(8.8) months(range:3.2 to 105.3 months),during which 508 patients (51.2%) died. The overall median survival (OS) was 26.4 months,with 1-,3-, and 5-year survival rates of 79.0%,40.0%, and 29.0%, respectively. In the recent five years (from 2020 to 2024), the median OS improved significantly to 34.1 months compared to 20.0 months from 2016 to 2019 ( P<0.01). Histological subtype analysis showed that the median OS time was 26.7 months for pancreatic ductal adenocarcinoma (PDAC, n=855),58.9 months for invasive intraductal papillary mucinous carcinoma (IPMC, n=32),and 15.7 months for adenosquamous carcinoma of pancreas (ASCP, n=73) ( P=0.001). Among PDAC patients, adjuvant chemotherapy significantly improved survival (29.1 months vs. 14.4 months, P<0.01);in IPMC patients, adjuvant chemotherapy also extended survival (65.7 months vs. 58.9 months, P=0.047). Although ASCP patients receiving chemotherapy had a longer median OS time than those without (18.8 months vs. 8.9 months),the difference was not statistically significant ( P=0.151). Multivariate Cox regression analysis in PDAC patients indicated that adjuvant chemotherapy, R0 resection, T stage,N stage,and tumor differentiation were independent prognostic factors ( P<0.01). The median OS time by TNM stage was:not reached for stage ⅠA, 51.6 months for ⅠB, 25.5 months for ⅡA, 23.7 months for ⅡB, 23.0 months for Ⅲ, and 14.4 months for Ⅳ. The median OS time for R0,R1-1 mm,and R1-direct resections was 34.1,24.7,and 15.7 months,respectively ( P<0.01). Conclusion:Adjuvant chemotherapy,R0 resection,tumor stage,and differentiation are independent prognostic factors for pancreatic body and tail cancer.

Drug-target interaction (DTI) is fundamental to novel drug research and development (R &D), playing a critical role in elucidating drug mechanisms of action and improving the cost-effectiveness of drug discovery. Although China has seen rapid accumulation of drug-target resources in recent years, the industry still faces challenges such as a shortage of original targets and excessively high target concentration. The rapid advancement of artificial intelligence (AI) has provided an efficient technological pathway for DTI prediction, establishing it as a core tool for accelerating drug discovery. This paper systematically reviews the fundamental data support framework for DTI prediction tasks, elaborating in detail on three core data types— drug characterization, target characterization, and drug-target associations-as well as the classification and application boundaries of mainstream benchmark datasets tailored to different tasks within the field. On this basis, it comprehensively surveys the technological evolution of AI-driven DTI prediction, summarizing the core paradigms and technical advances of traditional machine learning and deep learning methods in a single-modality setting, alongside cutting-edge multimodal approaches that integrate two modalities (cross-subject/within-subject fusion) and three or more modalities for multidimensional information integration. Finally, this paper analyzes the current major challenges in data quality, model generalizability and interpretability, and real-world deployment, while also discussing future trends in standardized dataset construction, generative AI, and large-scale biomedical foundation models, aiming to provide a reference for both research and industrial applications in the AI-driven DTI prediction field.

Aim To investigate the effect of adenovirus(ADV)-mediated Profurin(PF)expression on the plaque stability of ApoE-/-mice.Methods ApoE-/-mice were fed with high-fat diet for 8 weeks,and then treated with ADV-mediated PF intervention,followed by high-fat diet for 4 weeks.Aortic roots were isolated for atherosclerotic plaque area analysis and immunohistochemical analysis.Plasma phospholipid transfer protein(PLTP)activity was detec-ted by fluorescence donor essay,plasma total cholesterol(TC)and triglyceride(TG)were measured by enzyme assay kits,and fast protein liquid chromatography was used for lipoprotein profile analysis.Results Compared with the con-trol group,the plasma TC and TG levels,PLTP activity and circulating tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels in ADV-PF group were significantly decreased(P＜0.01).In the ADV-PF group,there was no significant change in atherosclerotic lesions on the inner surface of the full-length aorta,but the plaque area and lipid area in the aortic root were reduced(P＜0.01),the content of macrophages was significantly decreased(P＜0.01),and the smooth muscle cells and collagen area were not significantly different.The content of matrix metalloproteinase-9 in plaque was signifi-cantly decreased(P＜0.05).Conclusion Overexpression of PF can alleviate atherosclerosis and reduce the levels of circulating inflammatory factors to a certain extent,and effectively improve the plaque stability of ApoE-/-mice.

Objective:To investigate the pathogenetic characteristics and risk factors of nosocomial infection with multidrug-resistant organisms (MDRO) in trauma patients.Methods:A retrospective case-control study was conducted to analyze the clinical data of 103 trauma patients with nosocomial infection admitted to the 926th Hospital of the Joint Logistics Support Force of the PLA from January 2021 to December 2023, including 84 males and 19 females aged 12-80 years [50(39, 59)years]. The patients were divided into MDRO infection group ( n=36) and non-MDRO infection group ( n=67) according to whether nosocomial MDRO infection occurred. The pathogenetic characteristics of MDRO infection were observed. Univariate analysis was used to compare the two groups in terms of their demographic characteristics (gender, age), comorbidities (hypertension, diabetes mellitus), injuries [multiple injuries, open injuries, injury severity score (ISS)], laboratory indicators (hemoglobin, leukocytes) on admission, and other treatment data (emergency admission to the healthcare facility, transferal, length of hospital stay before diagnosis of infection, number of surgeries before diagnosis of infection, blood transfusion before diagnosis of infection, tracheotomy/tracheal intubation before diagnosis of infection). Logistic regression analysis was used to screen the independent risk factors for nosocomial MDRO infection in trauma patients. Results:A total of 52 MDRO strains were detected, including 17 Gram-positive (33%) and 35 Gram-negative (67%) ones, with the top 5 strains being Escherichia coli, Staphylococcus aureus, Acinetobacter baumannii, Klebsiella pneumoniae, and Staphylococcus epidermidis, respectively. The specimen source with the most detected MDRO strains was wound/incision secretion, followed by sputum. The results of the univariate analysis showed statistically significant differences in ISS and hemoglobin on admission between two groups ( P<0.05); however, no statistically significant differences were observed in gender, age, hypertension, diabetes mellitus, multiple injuries, open injuries, leukocytes on admission, emergency admission to the healthcare facility, transferal, length of hospital stay before diagnosis of infection, number of surgeries before diagnosis of infection, blood transfusion before diagnosis of infection, or tracheotomy/tracheal intubation before diagnosis of infection ( P>0.05). The results of the multivariate Logistic regression analysis showed that male gender ( OR=5.01, 95% CI 1.09, 23.08, P<0.05), age ( OR=1.03, 95% CI 1.00, 1.07, P<0.05), multiple injuries ( OR=5.28, 95% CI 1.04, 26.87, P<0.05), hemoglobin on admission ( OR=0.97, 95% CI 0.95, 0.99, P<0.05), and length of hospital stay before diagnosis of infection ( OR=1.06, 95% CI 1.01, 1.11, P<0.05) were significantly associated with the occurrence of nosocomial MDRO infection in trauma patients. Conclusions:In trauma patients, nosocomial MDRO infection pathogens were predominantly Gram-negative and the top five strains are Escherichia coli, Staphylococcus aureus, Acinetobacter baumannii, Klebsiella pneumoniae and Staphylococcus epidermidis, respectively. Male gender, age, multiple injuries, hemoglobin on admission and length of hospital stay before diagnosis of infection are independent risk factors for the occurrence of nosocomial MDRO infection in trauma patients.

Tumor microenvironment is the result of dynamic interactions between different cellular and non-cellular components,including cancer cells themselves,extracellular matrix,immune cells and various non immune cells.Microenvironment is closely related to the growth,metastasis and prognosis of breast cancer,and is closely related to the current popular targeted therapy and immunotherapy.Radiomics is a new field of translational medicine based on extracting high-dimensional data from images to obtain reliable models that can be applied to clinical practice.In this review,the latest advances in the application of radiomics to the tumor microenvironment of breast cancer are discussed.

[Objective]To investigate the mechanism of Wumen Gumibao Decoction in treating senile osteoporosis(SOP)of senescence accelerated mouse prone 6(SAMP6)mice.[Methods]SAM-resistant 1(SAMR1)mice was set as control group,SAMP6 mice were randomly divided into model group(SAMP6),Chinese medicine low dose group(SAMP6+Wumen Gumibao Decoction 7.5 g·kg-1)and Chinese medicine high dose group(SAMP6+Wumen Gumibao Decoction 15.0 g·kg-1),with 10 mice in each group.Mice in control group and model group were gavaged with equal volume of 0.9%sodium chloride solution,and the two groups of Chinese medicine were given Wumen Gumibao Decoction,once a day for 12 weeks.The changes of body mass were observed during the experiment.At the end of the experiment,hematoxylin-eosin(HE)staining was used to observe the pathological changes of the femur in mice.Micro computed tomography(Micro-CT)was used to observe the microstructure and parameters of the femur.The serum levels of calcium(Ca),phosphorus(P)was detected with biochemical method,and the serum levels of calcitonin(CT),procollagen type Ⅰ N-terminal propeptide(PⅠNP),bone γ-carboxyglutamic acid-containing protein(BGP),alkaline phosphatase(ALP),tartrate resistant acid phosphatase(TRACP),procollagen type Ⅰ C-terminal propeptide(PⅠCP),insulin-like growth factor-1(IGF-1),parathyroid hormone(PTH)were detected by enzyme-linked immunosorbent assay(ELISA).Immunohistochemical(IHC)staining was used to detect Wnt3α,phosphorylated-b-catenin(p-b-catenin),osteoprotegerin(OPG),receptor activator of nuclear factor-κB(RANK)and ligand of receptor activator of NF-κB(RANKL),secretory protein Dickkopf-1(DKK1)and glycogen synthase kinase 3b(GSK3b).[Results]Compared with control group,the cortical bone texture,direction and arrangement of bone cells in bone tissue of model group were disordered,and the trabecular structure was loose,showing a state of osteoporosis,bone microstructure parameters bone mineral density,bone volume/tissue volume ratio,trabecular number,trabecular thickness decreased significantly(P<0.05)and trabecular separation increased significantly(P<0.05).The serum levels of Ca,BGP,PⅠNP,CT and ALP were significantly decreased(P<0.05),and P,TRACP,PⅠCP and IGF-1 were significantly increased(P<0.05).In addition,the expression of Wnt3a as significantly down-regulated(P<0.05),and the expression of p-β-catenin,OPG,RANK,RANKL,DKK1 and GSK3β was significantly up-regulated(P<0.05).Compared with model group,Chinese medicine low and high dose groups can improve the pathological morphology of the femur to varying degrees,increase the number of bone trabeculae and reduced the fracture of bone trabeculae,and improved the related parameters of bone microstructure(P<0.05).The levels of serum Ca,CT,BGP,PⅠNP and ALP were increased(P<0.05),and the levels of P,TRACP,PⅠCP and IGF-1 were decreased(P<0.05),and PTH was increased(P<0.05).At the same time,it could up-regulate the expression of Wnt3α protein in the femur(P<0.05)and down-regulate the expression of p-β-catenin,OPG,RANK,RANKL,DKK1 and GSK3b protein(P<0.05).[Conclusion]Wumen Gumibao Decoction has the effect of significantly improving osteoporosis in SAMP6 mice,and its mechanism may be related to its regulation of Wnt/β-catenin and OPG/RANK/RANKL signaling pathways.

Aim To investigate the effect of adenovirus(ADV)-mediated Profurin(PF)expression on the plaque stability of ApoE-/-mice.Methods ApoE-/-mice were fed with high-fat diet for 8 weeks,and then treated with ADV-mediated PF intervention,followed by high-fat diet for 4 weeks.Aortic roots were isolated for atherosclerotic plaque area analysis and immunohistochemical analysis.Plasma phospholipid transfer protein(PLTP)activity was detec-ted by fluorescence donor essay,plasma total cholesterol(TC)and triglyceride(TG)were measured by enzyme assay kits,and fast protein liquid chromatography was used for lipoprotein profile analysis.Results Compared with the con-trol group,the plasma TC and TG levels,PLTP activity and circulating tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels in ADV-PF group were significantly decreased(P＜0.01).In the ADV-PF group,there was no significant change in atherosclerotic lesions on the inner surface of the full-length aorta,but the plaque area and lipid area in the aortic root were reduced(P＜0.01),the content of macrophages was significantly decreased(P＜0.01),and the smooth muscle cells and collagen area were not significantly different.The content of matrix metalloproteinase-9 in plaque was signifi-cantly decreased(P＜0.05).Conclusion Overexpression of PF can alleviate atherosclerosis and reduce the levels of circulating inflammatory factors to a certain extent,and effectively improve the plaque stability of ApoE-/-mice.

Objective To observe the mid-and long-term effects of Kegel training combined with Pilates training on urinary conti-nence recovery in different body mass index(BMI)male patients with urinary incontinence after prostatectomy.Methods From May,2023 to June,2024,48 patients in Beijing Bo'ai Hospital were recruited and divided into group A(<25 kg/m2,n=15),group B(25 to 30 kg/m2,n=18)and group C(>30 kg/m2,n=15)according to their BMI.All the groups performed Kegel training combined with Pilates training for two months,and followed up at six months from baseline.They were evaluated with one hour pad test,the number of daily urinary incontinence,In-ternational Consultation on Incontinence Questionnaire-Short Form(ICIQ-SF)and modified Oxford Rating Scale before treatment,and four weeks,eight weeks and six months after treatment.Results The intra-group effect,the inter-group effect and interaction effect were significant in the results of one hour pad test and the daily number of urinary incontinence(F>2.955,P<0.05).Post Hoc test showed that they were worse in group C than in groups A and B(P<0.05),and the number of daily urinary incontinence was more in group B than in group A(P<0.05).There was significant difference in the scores of ICIQ-SF and modified Ox-ford Rating Scale among groups in different time points after treatment(Z>10.476,P<0.05)except the score of ICIQ-SF four weeks after treatment(P>0.05),and they were the worst in group C.BMI(group A=1,group B=2,group C=3)was correlated with the results of one hour pad test(r=0.79,P<0.001),the number of daily uri-nary incontinence(r=0.68,P<0.001),and the scores of ICIQ-SF(r=0.68,P<0.001)and modified Oxford Rating Scale(r=-0.47,P=0.001)six months after treatment.Conclusion Kegel training combined with Pilates training could improve the urinary control in patients with urinary in-continence after prostatectomy.The decrease of BMI can promote the recovery of urinary control,and improve the symptoms of later urinary incontinence in mid-and long-term.

Objective To explore the application value of CT fusion navigation technology in Stanford B-type aortic dissection endovas-cular isolation surgery.Methods Nineteen patients who underwent Stanford B-type aortic dissection endovascular isolation surgery were selected.Prior to surgery,all patients underwent chest and abdominal CT plain scan and enhanced scan,and three-dimensional vascular reconstruction was performed at the post-processing workstation;During the operation,a chest(region of interest)digital subtraction angiography(DS A)3D-CT scan was first performed as the intraoperative matching localization image.Then,a thin-layer(1.0 mm)CT enhanced tomographic image of the chest and abdomen was extracted from the picture archiving and communication system(PACS).At the same time,the DSA 3D-CT image and the thin-layer CT enhanced image were opened for overlapping regis-tration of bony landmarks.After registration,the three-dimensional vascular volume rendering(VR)image of the aorta from the thin-layer CT was fused with the DSA 3D-CT,and the positioning and release of the covered stent were guided by the newly fused multimodal real-time image.Results All 19 patients underwent guided surgery with precise positioning of the covered lesions and successful release of the covered stents,with a success rate of 100％ for the guided technique.The intraoperative placement time of the covered stent was(5.4±2.4)s,the exposure time was(12.8±3.2)min,the surgical duration was(53.9±25.3)min,the intraopera-tive contrast agent dosage was(125.8±25.3)mL,the X-ray fluoroscopy dose was(221.3±155.7)mGy,and the total X-ray exposure dose was(1 056.4±330.3)mGy.There were no serious complications during the operation,and all patients received 1-3 months of follow-up which found they all recovered well.Conclusion The use of CT and DSA fusion navigation technology in guiding the treat-ment of Stanford B-type aortic dissection with covered stents provides real-time three-dimensional fusion images for the operator,which can quickly and accurately locate and release the stent,and has certain clinical value.