Objective:To evaluate the feasibility of transjugular transcatheter tricuspid valve replacement (TTVR) using the LuX-Valve Plus system (Ningbo Jenscare Scientific, China) for the treatment of severe tricuspid regurgitation in real-world clinical settings.Methods:This prospective study enrolled 81 patients with severe ricuspid regurgitation (≥3+) who underwent TTVR with the LuX-Valve Plus system at the Department of Cardiology, West China Hospital of Sichuan University between May 2022 and March 2024. Among them, 44 patients were from a compassionate-use study, and 37 were from two premarket clinical trials. Baseline clinical data, preprocedural imaging, procedural outcomes, and postprocedural follow-up data were collected. The primary endpoint events included device success, procedural success, and 30 d composite adverse events.Results:The age of the cohort was (74.5±7.8) years, with 54 females (67%). Device success and procedural success rates were both 90% (73/81). Post-procedural tricuspid regurgitation improved, with a 6% (5/81) incidence of moderate-to-severe paravalvular leakage. The rate of permanent pacemaker implantation was 12% (10/81), of which 5% (4/81) had pre-existing indications for pacemaker implantation. Major bleeding events occurred in 10% (8/81) of patients, and the 30 d composite endpoint rate was 25% (20/81).Conclusion:TTVR using the LuX-Valve Plus system demonstrates promising feasibility for high-risk surgical patients with severe tricuspid regurgitation, effectively reducing or eliminating regurgitation with acceptable safety. However, challenges remain in reducing risks of major adverse events, including permanent pacemaker implantation and severe bleeding.

OBJECTIVE To investigate the improvement effects and potential mechanism of ulinastatin(UTI)on cisplatin(CP)-induced myocardial injury.METHODS Rabbits were used as study subjects and randomly divided into blank group(normal saline 2 mL/d,for consecutive 7 d),CP group(150 mg/m2,on the 1st and 4th day),UTI low-dose/high-dose group(UTIL/UTIH group,UTL 25 000 or 50 000 IU/kg,once a day,for consecutive 7 d),c-Jun N-terminal kinase(JNK)inhibitor group(JNKi group,SP600125 15 mg/kg,on the 1st and 4th day+CP 150 mg/m2,on the 1st and 4th day+normal saline 2 mL/d,on the other 5 days).Except for the blank group,rabbits in the other groups were injected with relevant medicine and/or normal saline via a marginal ear vein on one side.The serum level of cardiac troponin Ⅰ(cTnⅠ)in rabbits on the 1st and 8th days of the detection experiment,as well as the levels of superoxide dismutase(SOD),glutathione(GSH)and malondialdehyde(MDA)in myocardial tissue on the 8th day of the experiment,were all measured in each group.The pathological changes and myocardial cell apoptosis in myocardial tissue were observed,and the protein expressions of B-cell lymphoma-2(Bcl-2),Bcl-2 associated X protein(Bax),JNK,phosphorylated JNK(P-JNK),mitochondrial fission factor(Mff),and dynamin-related protein 1(Drp1)in myocardial tissue were all determined.RESULTS Compared with the blank group,the CP group showed significant myocardial injury.The cell apoptotic rate,the levels of cTnⅠ in serum and MDA in myocardial tissue,as well as protein expressions of Bax,JNK,p-JNK,Mff,and Drp1,were all significantly increased or up-regulated,SOD level and protein expression of Bcl-2 significantly reduced or down+regulated(P＜0.05).Compared with the CP group,the myocardial injury in rabbits from each drug treatment group showed improvement.The cell apoptosis index,the levels of cTnⅠ in serum and MDA in myocardial tissue,as well as protein expressions of Bax,JNK,p-JNK,Mff(except for UTIL group),and Drp1,were all significantly reduced or down-regulated,while SOD,GSH level and protein expression of Bcl-2 significantly increased or up-regulated(P＜0.05);moreover,the improvement in some indicators was significantly better in the UTIH group and the JNKi group compared to the UTIL group(P＜0.05).CONCLUSIONS UTI may ameliorate CP-induced myocardial injury,the potential mechanism of which may be associated with antagonizing oxidative stress and inhibiting the JNK/Mff signaling pathway.

Objective To explore the medication patterns of the"phlegm-stasis co-treatment"in the treatment of stroke and the regulatory mechanisms of its key components.Methods The relevant literature on the treatment of stroke with intertwined phlegm and blood stasis pattern by traditional Chinese medicine in CNKI,Wanfang Data Knowledge Service Platform and VIP was collected.Excel 2019 and SPSS Modeler 18.0 were applied to statistically analyze the nature,taste,meridian tropism and frequency of the drugs included in the prescriptions.The Apriori algorithm was used to perform association rule analysis and cluster analysis.The potential mechanism of action of the core drug pair was explored by using the network pharmacology method.Results A total of 69 prescriptions involving 161 herbs with 902 cumulative frequency uses were included.The four natures were mainly warm,neutral and cold,the five flavors were mainly bitter,sweet and pungent.and channel tropism were mainly liver meridian and spleen meridian.The analysis of association rules indicates that there was a strong correlation among chuanxiong,Taoren,Dannanxing,Dilong,Honghua,Shichangpu and Fuling.The main active components of the drug combination were quercetin,gallic acid,baicalein and hederagenin.They can regulate signaling pathways such as hypoxia-inducible factor-1,advanced glycation end product/advanced glycation end product receptor,nuclear factor κB,and mixed lineage kinase 3 by acting on genes such as STAT3,SRC,JUN,TP53,and MAPK1.Conclusion The core drugs of"phlegm-stasis co-treatment"method can act on multiple targets and pathways through components such as quercetin,gallic acid,baicalein and hederagenin,thereby exerting a therapeutic effect on stroke.

Objective:To investigate the clinical efficacy and prognostic factors of neoadju-vant chemotherapy (NACT) and radical resection on adenocarcinoma of esophagogastric junction (AEG) and gastric adenocarcinoma (GC).Methods:The propensity score matching and retrospec-tive cohort study was conducted. The clinicopathological data of 263 patients with AEG and GC who were admitted to Peking University Cancer Hospital from March 2017 to March 2022 were collected. There were 204 males and 59 females, aged (60±10)years. Of the 263 patients, 81 cases with AEG were set as the AEG group, and 182 cases with GC were set as the GC group. Observation indicators: (1) propensity score matching and comparison of clinicopathological characteristics of patients between the two groups after matching; (2) evaluation of the efficacy of NACT and pathological conditions; (3) intraoperative and postoperative conditions; (4) follow-up; (5) analysis of factors affecting prognosis of patients. Comparison of measurement data with normal distribution between groups was conducted using the independent sample t test. Comparison of measurement data with skewed distribution between groups was conducted using the Mann-Whitney rank sum test. Comparison of count data between groups was conducted using the chi-square test. Comparison of ordinal data between groups was conducted using the nonparametric rank sum test. The Cox proportional hazard model was used for univariate and multivariate analyses. The Kaplan-Meier method was used to calculate survival rate and draw survival curve. The Log-rank test was used for survival analysis. Propensity score matching was done by the 1:1 nearest neighbor matching method with a caliper value of 0.02. Results:(1) Propensity score matching and comparison of clinicopathological charac-teristics of patients between the two groups after matching. Of 263 patients, 156 cases were succe-ssfully matched, including 78 cases in the AEG group and 78 cases in the GC group. After propensity score matching, the elimination of age and degree of tumor differentiation confounding bias ensured comparability between the two groups. (2) Evaluation of the efficacy of NACT and pathological condi-tions. After propensity score matching, cases with pathological complete response were 2 in the AEG group, versus 9 in the GC group, showing a significant difference between the two groups ( χ2=4.793, P<0.05). (3) Intraoperative and postoperative conditions. After propensity score matching, the operation time of AEG group was 225(200,283)minutes. The resection range (whole stomach, distal stomach, proximal stomach) were 68, 0, 10, respectively. The digestive tract reconstruction methods (Roux-en-Y, Billroth Ⅰ/Ⅱ/Uncut Roux-en-Y, esophageal residual gastric, double channel) were 68, 0, 5, 5, respectively. Duration of postoperative hospital stay was 12(10,16)days. Total hospi-talization expense was (114 400±4 828)yuan. The above indicators of the GC group were 200(174,234)minutes, 22, 55, 1, 21, 56, 0, 1, 10(9,11)days, (98 790±2 549)yuan, respectively. There were significant differences in the above indicators between the two groups ( Z=-3.813, χ2=85.875, 88.487, Z=-4.060, t=2.524, P<0.05). Cases of complication and cases of serious complication were 32 and 9 in the AEG group, versus 22 and 5 in the GC group, showing no significant difference between the two groups ( χ2=2.832, 1.256, P>0.05). (4) Follow-up. All 156 patients after propensity score matching were followed up after surgery, with a follow-up time of 51(range, 3-84)months. Number of death in the AEG group and GC group were 26 and 25 during the follow-up. The postoperative 3-, 5-year overall survival rate were 70.4%, 58.3% in patients of the AEG group, versus 75.7%, 62.6% in patients of the GC group, showing no significant difference in overall survival between the two groups ( χ2=0.141, P>0.05). (5) Analysis of factors affecting prognosis of patients. Results of multivariate analysis showed that NACT, average tumor diameter after NACT, vascular tumor emboli were independent factors affecting prognosis of patients with AEG and GC after NACT and radical resection before propensity score matching ( hazard ratio=1.864, 1.807, 4.551, 95% confidence interval as 1.137-3.056, 1.124-2.903, 2.709-7.645, P<0.05). Conclusions:Compared with patients of GC, patients of AEG have a lower proportion of pathological complete response after NACT, but there is no signifi-cant difference in the incidence of complication and survival of patients with AEG and GC after NACT and radical resection. NACT, average tumor diameter after NACT, vascular tumor emboli are indepen-dent factors affecting prognosis of patients with AEG and GC after NACT and radical resection.

On the occasion of the 110th Anniversary of the establishment of the Chinese Medical Association, the third conference of the Fourth Editorial Board of Chinese Journal of Digestive Surgery, and the Second Elite Group of Chinese Journal of Digestive Surgery, was successfully held in Kunming on July 4, 2025. This conference systematically summarizes the development experience of the journal over the past 20 years from three aspects: the role of ecological construction of thought in the discipline construction of digestive surgery, the display of the latest academic achievements in the field of digestive surgery, the development difficulties, and breakthrough paths of the discipline, and strategically plans the path of discipline construction in the new era.

Objective To identify the taste critical quality attribute and design and optimize the flavor-correcting formulation of the traditional Chinese medicine oral preparation Qingre Jiedu Oral Liquid,in order to improve its taste and enhance patient medication adherence.Methods The taste assignment method was employed to identify the taste critical quality attribute of Qingre Jiedu Oral Liquid.Based on human sensory evaluation and the standardized Euclidean distance in electronic tongue analysis,suitable types of corrigent were determined.Subsequently,under constraints such as maximum allowable dosage,solubility,and sweetness,the optimal taste formulation for the sugar-free intermediate of Qingre Jiedu Oral Liquid was determined using Box-Behnken experimental design combined with electronic tongue and human sensory evaluation results.The study was reviewed and approved by the Ethics Committee of Beijing University of Chinese Medicine(Ethics Approval Number 2020BZYLL0609).Results The quantitative score for bitter taste of Qingre Jiedu Oral Liquid accounted for 30.36%,confirming bitterness as the taste critical quality attribute requiring attention.The optimal taste formulation for the sugar-free intermediate of Qingre Jiedu Oral Liquid was determined to be 120 mg·mL?1 erythritol,12 mg·mL?1 acesulfame potassium,and 2.4 mg·mL?1 stevioside.This formulation achieved an 11.75-point improvement in sensory evaluation scores compared to the original commercially available oral liquid.Conclusion This study successfully improved the taste of Qingre Jiedu Oral Liquid and established a comprehensive strategy for flavor-correcting formulation optimization,including a method for identifying taste critical quality attribute.This strategy provides a referential paradigm for palatability enhancement of similar traditional Chinese medicine oral preparations,laying a crucial technical foundation for elevating the clinical value of Chinese herbal medicines and promoting the high-quality development of traditional Chinese medicine(TCM).

Objective:This study aims to analyze the economic impact of postoperative complications after colorectal cancer surgery.Methods:A retrospective cohort study was conducted. Patients with a preoperative pathological diagnosis of colorectal cancer who met surgical indications and underwent surgical treatment were included, while those with incomplete hospitalization cost data were excluded. From March 2017 to March 2022, three hundred and ninety-two colorectal cancer patients treated at Peking University Cancer Hospital and Institute Gastrointestinal Cancer Center I, were enrolled. Descriptive statistics were performed on the incidence of complications, hospitalization costs, and postoperative length of stay. A cohort was established based on the presence of postoperative complications (POC) and absence of postoperative complications (non-POC) to study economic differences. Propensity score matching analysis was employed to reduce potential confounding factors.Results:Among 392 colorectal cancer patients, 90 (23.0%) developed POC (POC group), while 302 were in the non-POC group. Significant statistical differences were found between the two groups in terms of operation duration, extent of resection, and stoma creation (all P < 0.05); other baseline indicators showed no significant differences (all P>0.05). The median hospitalization cost for patients with postoperative anastomotic leakage was 115 973 yuan, an increase of 38 941 yuan (50.5%) over the non-POC group's 77 059 yuan; the median hospitalization cost for patients with mechanical obstruction was 111 477 yuan, an increase of 34 418 yuan (44.7%) over the non-POC group; and the median hospitalization cost for patients with wound infection was 95 860 yuan, an increase of 18 801 yuan (24.4%) over the non-POC group. The median postoperative length of stay for patients with anastomotic leakage, mechanical obstruction, and wound infection was 22.0 days, 22.0 days, and 18.5 days, respectively, compared to 9.0 days in the non-POC group, extending by 13.0 days, 13.0 days, and 9.5 days. After propensity score matching, each group had 68 patients, and there were no statistically significant differences in preoperative and intraoperative observations between the two groups (all P>0.05); compared to the non-POC group, the hospitali- zation costs in the POC group significantly increased (89 165 yuan vs. 75 437 yuan, P<0.001), and the postoperative length of stay also significantly extended (14.0 days vs. 8.0 days, P<0.001). Conclusions:The occurrence of POC after colorectal cancer surgery significantly increases hospitalization costs and length of stay. This study provides specific and accurate reference data for subsequent health economic decision-making. This is the first detailed economic impact analysis of postoperative complications of colorectal cancer with a large sample size, which includes an economic impact analysis for each POC and subgroup.

Objective To explore the medication patterns of the"phlegm-stasis co-treatment"in the treatment of stroke and the regulatory mechanisms of its key components.Methods The relevant literature on the treatment of stroke with intertwined phlegm and blood stasis pattern by traditional Chinese medicine in CNKI,Wanfang Data Knowledge Service Platform and VIP was collected.Excel 2019 and SPSS Modeler 18.0 were applied to statistically analyze the nature,taste,meridian tropism and frequency of the drugs included in the prescriptions.The Apriori algorithm was used to perform association rule analysis and cluster analysis.The potential mechanism of action of the core drug pair was explored by using the network pharmacology method.Results A total of 69 prescriptions involving 161 herbs with 902 cumulative frequency uses were included.The four natures were mainly warm,neutral and cold,the five flavors were mainly bitter,sweet and pungent.and channel tropism were mainly liver meridian and spleen meridian.The analysis of association rules indicates that there was a strong correlation among chuanxiong,Taoren,Dannanxing,Dilong,Honghua,Shichangpu and Fuling.The main active components of the drug combination were quercetin,gallic acid,baicalein and hederagenin.They can regulate signaling pathways such as hypoxia-inducible factor-1,advanced glycation end product/advanced glycation end product receptor,nuclear factor κB,and mixed lineage kinase 3 by acting on genes such as STAT3,SRC,JUN,TP53,and MAPK1.Conclusion The core drugs of"phlegm-stasis co-treatment"method can act on multiple targets and pathways through components such as quercetin,gallic acid,baicalein and hederagenin,thereby exerting a therapeutic effect on stroke.

Gastric cancer is a high-incidence malignancy that poses a serious threat to public health in China, ranking among the top three cancers in both incidence and mortality. The majority of patients are diagnosed at an advanced stage, resulting in limited treatment options and poor prognosis. To address key challenges in gastric cancer diagnosis and treatment, a research team led by Professor Jiafu Ji at Peking University Cancer Hospital has focused on the project "Development and Dissemination of Precision Medicine Approaches in Gastric Cancer Management". Through a series of high-quality multicenter clinical studies, the team established a set of new international standards in perioperative treatment, individua-lized drug selection, intelligent noninvasive diagnostics, and novel immunotherapy strategies. These advances have significantly improved treatment efficacy and reduced surgical trauma, achieving key technological breakthroughs in diagnosis, therapy, and mechanistic understanding, and systematically enhancing outcomes for gastric cancer patients. The project ' s findings had a broad international impact, including hosting China ' s first International Gastric Cancer Congress. Through nationwide dissemination, they have promoted the development of precision diagnosis and treatment of gastric cancer as a discipline, and led the formulation of the National Health Commission's guidelines for gastric cancer diagnosis and treatment. In recognition of its achievements, the project was awarded the First Prize of the 2024 Chinese Medical Science and Technology Award.
Stomach Neoplasms/genetics* ; Humans ; Precision Medicine/methods* ; China ; Immunotherapy/methods*

BACKGROUND: Neoadjuvant therapy enhances the possibility of achieving radical resection and improves the prognosis for locally advanced gastric cancer (GC). However, there is a lack of evidence regarding the optimal extent of resection for locally advanced proximal GC after neoadjuvant therapy. METHODS: In this study, 330 patients underwent resection in Peking University Cancer Hospital, with curative intent after neoadjuvant therapy for histologically confirmed proximal GC from January 2009 to December 2022. RESULTS: In this study, 45 patients underwent proximal gastrectomy (PG), while 285 underwent total gastrectomy (TG). After propensity-score matching, 110 patients (71 TG and 39 PG) were included in the analysis. No significant differences between PG and TG regarding short-term outcomes and long-term prognosis were found. Specifically, PG demonstrated comparable overall survival to TG ( P = 0.47). Subgroup analysis revealed that although not statistically significant, PG showed a potential advantage over TG in overall survival for patients with tumor-long diameters less than 4 cm ( P  = 0.31). However, for those with a long diameter larger than 4 cm, TG had a better survival probability ( P  = 0.81). No substantial differences were observed in baseline characteristics, surgical safety, postoperative recovery, and postoperative complications. CONCLUSION For locally advanced proximal GC with objective response to neoadjuvant therapy (long diameter <4 cm), PG is an alternative surgical procedure.
Humans ; Stomach Neoplasms/drug therapy* ; Gastrectomy/methods* ; Neoadjuvant Therapy/methods* ; Male ; Female ; Middle Aged ; Propensity Score ; Aged ; Adult ; Retrospective Studies