1.Proteomic analysis of serum proteins in mice with carbapenem-resistant hypervirulent Klebsiella pneumoniae bloodstream infection
Jinfeng BAO ; Yating MA ; Yin XU ; Yanjuan HE ; Yuyue WANG ; Luoluo SHI ; Chengbin WANG
Chinese Journal of Nosocomiology 2025;35(6):823-828
OBJECTIVE To observe the changes of serum proteins in the mice with carbapenem-resistant hyperviru-lent Klebsiella pneumoniae(CR-hvKP)bloodstream infection by using liquid chromatogram-mass spectrometer(LC-MS),find out the differentially expressed proteins and carry out corresponding biological function analysis.METHODS The models of ICR mice with CR-hvKP and classical Klebsiella pneumoniae(cKP)bloodstream infec-tions were established,the serum specimens were collected from the mice at 12 hours of establishment of the in-fection models and were detected by using LC-MS.The result of LC-MS was identified by using Maxquant soft-ware.The corresponding bioinformatics analysis was performed for the differentially expressed proteins.RESULTS As compared with the normal control group,there were 24 upregulated proteins and 20 downregulated proteins in CR-hvKP group.As compared with cKP group,there were 107 upregulated proteins in the CR-hvKP group.The 134 differentially expressed proteins were retrieved one by one from Uniprot database,it was found that the pro-teins were involved in biological regulation,immune process,biological interaction,movement,metabolic process,response to stimulation,signal transduction,inflammatory response,oxidative stress and angiogenesis.The signal pathway analysis involved multiple metabolism-related pathways,including complement and coagula-tion cascades,cholesterol metabolism,bacterial infection,heme clearance,and assembly,remodeling and clear-ance of plasma lipoprotein.In terms of the proteins being attached great importance,the expression levels of kal-likrein B1(KLKB1)and serpin family A(Serpina)1b were downregulated as compared with the normal control group and were upregulated as compared with the cKP group;the expression levels of serum amyloid A protein(SAA)1,SAA2,Vanin-3(VNN3)and hemoglobinβpolypeptide chain b2(HBB-b2)were upregulated as com-pared with both the cKP group and the normal control group.CONCLUSIONS The CR-hvKP bloodstream infection involves the activation and action of multiple proteins.The rise of SAA1,SAA2,VNN3 and HBB-b2 or the de-cline of KLKB1 and Serpina1b may indicate the CR-hvKP bloodstream infection.
2.Expression of GALNT1 mRNA and LAMTOR5 mRNA in Gastric Cancer and Their Correlation with Epithelial Mesenchymal Transition and Clinical Prognostic Value
Jun XU ; Jinfeng JI ; Yongfeng CAO ; Jieyun MA
Journal of Modern Laboratory Medicine 2025;40(3):52-58
Objective To investigate the correlation and clinical prognostic value between the expression of polypeptide N-acety lgalactosaminyltransferases 1(GALNT1),lysosomal adaptor MTOR activator 5(LAMTOR5),and epithelial mesenchymal transition(EMT)in gastric cancer.Methods 102 gastric cancer patients admitted to Nantong Tumor Hospital from January 2018 to January 2020 were selected.Immunohistochemistry(IHC)and real-time fluorescence quantitative PCR(RT-PCR)were used to detect the expression of GALNT1,LAMTOR5 mRNA and protein,as well as the expression of EMT indicators Snail mRNA,N-cad mRNA and Vimentin mRNA in cancer and adjacent tissues.Pearson correlation analysis was performed to investigate the correlation between markers.Kaplan Meier curve analysis was used to investigate the relationship between GALNT1 mRNA,LAMTOR5 mRNA and the prognosis of gastric cancer patients.COX regression analysis was used to identify factors that affect the prognosis of gastric cancer patients.Results GALNT1 mRNA(3.38±0.29)and LAMTOR5 mRNA(3.17±0.26)in gastric cancer tissue were higher than those in adjacent tissues(0.72±0.16,0.65±0.13),and the differences were statistically significant(t=81.111,87.553,all P<0.001).The positive rates of GALNT1(92.16%),LAMTOR5(90.20%)proteins in gastric cancer tissues were higher than those in adjacent tissues(7.84%,11.76%),and the differences were statistically significant(χ2=145.020,125.538,P<0.001).The expression of GALNT1 mRNA and LAMTOR5 mRNA in gastric cancer was positively correlated(r=0.757,P<0.001).The expression of GALNT1 mRNA and LAMTOR5 mRNA in gastric cancer was significantly positively correlated with Snail mRNA,N-cad mRNA and Vimentin mRNA expression(r=0.654,0.712,0.689;0.706,0.645,0.723,all P<0.001).The expression of GALNT1 mRNA and LAMTOR5 mRNA was correlated with TNM stage and lymph node metastasis in gastric cancer patients.The expression of GALNT1 mRNA and LAMTOR5 mRNA in cancer tissues with TNM stage III and lymph node metastasis was higher than that in TNM stage I~II and no lymph node metastasis,and the differences were statistically significant(χ2=29.417~290.104,all P<0.001).The 3-year overall survival rate of the high expression group of GALNT1 mRNA was 40.00%(20/50),which was lower than 76.92%(40/52)of the low expression group,the 3-year overall survival rate of the high expression group of LAMTOR5 mRNA was 38.78%(19/49),which was lower than the 77.36%(41/53)of the low expression group,and the differences were statistically significant(Log-Rank χ2=7.327,5.197,P=0.009,0.023).TNM stage III,lymph node metastasis,GALNT1 mRNA was highly expressed,and high LAMTOR5 mRNA was highly expressed were risk factors affecting the prognosis of gastric cancer(Wald χ2=6.409~16.805,all P<0.001).Conclusion The expression of GALNT1 and LAMTOR5 are elevated in gastric cancer tissues.Both of them are related to EMT indicators and adverse clinicopathological features.They are biomarkers for evaluating the prognosis of gastric cancer patients.
3.Predicting the invasion degree of subsolid nodule lung adenocarcinoma by artificial intelligence quantitative parameters combined with imaging signs
Kejia NING ; Rui WU ; Jinfeng GU ; Junbo SONG ; Lei MA ; Huiping CAO
Journal of Practical Radiology 2025;41(8):1299-1303
Objective To predict the invasion degree of subsolid nodule(SSN)lung adenocarcinoma using a combined model incorporating artificial intelligence(AI)quantitative parameters and imaging signs,and to validate the predictive efficacy of this model.Methods A total of 281 SSN lung adenocarcinoma CT images in 243 patients were retrospectively collected and randomly divided into training set(224 cases)and validation set(57 cases)in an 8∶2 ratio,with atypical adenomatous hyperplasia(A AH)+adenocarcinoma in situ(AIS)+minimally invasive adenocarcinoma(MIA)(191 cases)as the non-invasive adenocarcinoma(I AC)group and I AC(90 cases)as the IAC group.Multivariate logistic regression analysis was performed based on the AI quantitative parameters and CT signs in the training set to obtain independent predictors of IAC.A combined model and nomogram were then constructed and validated.The diagnostic efficacy and clinical applicability of the model were evaluated by the receiver operating characteristic(ROC)curve,calibration curve,and clinical decision curve analysis(DCA).Results Multivariate logistic regression analysis of the training set showed nodule type,spicule sign,vascular abnormality,long diameter>11.5 mm,median CT value>—426.25 HU,and mass>391.5 mg were independent predictors of IAC(P<0.05).The area under the curve(AUC)of the training set model,based on these independent predictive factors,was 0.915[95%confidence interval(CI)0.875-0.954],and the AUC of the validation set model was 0.903(95%CI 0.824-0.982),indicating both the training set and validation set models had high efficacy in distinguishing IAC.The nomogram model,which quantified these independent factors,demonstrated enhanced predictive power for IAC.The calibration curve indicated good fit of the prediction model,and the clinical DCA showed the model had good clinical applicability.Conclusion The model combining AI quantitative parameters and imaging signs has a higher ability to predict the risk of IAC,compared to a single indicator.It helps clinicians in determining the appropriate surgical timing,formulating surgical methods,and reducing overtreatment.
4.A real-world study of 15,644 patients undergoing D2 radical gastrectomy over 11 years at Shanxi provincial cancer hospital
Baoping JIAO ; Kai TAO ; Gang ZHAI ; Zefeng GAO ; Feng LI ; Kaiqing GUO ; Yutao ZHANG ; Nan QIAO ; Yi JIA ; Zongliang GUO ; Erli WANG ; Zhe BAI ; Xiangnan ZHAO ; Haoruo ZHANG ; Yuye GAO ; Jinfeng MA
Chinese Journal of Gastrointestinal Surgery 2025;28(11):1302-1313
Objective:To summarize the clinicopathological features, evolving trends in treatment and surgical approaches, and survival outcomes of patients who underwent D2 radical gastrectomy for gastric cancer in Shanxi Provincial Cancer Hospital over the past 11 years with the goal of providing a reference for the clinical practice of gastric cancer in this region.Methods:A retrospective observational study was conducted to analyze the clinicopathological data of patients who underwent D2 radical gastrectomy for pathologically confirmed gastric malignancy at the Department of Gastrointestinal Surgery, Shanxi Provincial Cancer Hospital from January, 2013 to December, 2023. Exclusion criteria consisted of: (1) residual gastric cancer or recurrent gastric cancer after surgery; (2) emergency gastric cancer resection due to bleeding, perforation, obstruction, or other causes; (3) comorbidity with other primary malignant tumors; (4) severe preoperative cardiopulmonary insufficiency or hepatic and renal insufficiency who cannot tolerate radical surgery; and (5) inconsistent main diagnosis information across the medical record system, pathological system, and gastric cancer-specific database. Patients were divided into three groups based on treatment methods: the surgery-only group, the perioperative chemotherapy group, and the adjuvant chemotherapy group. Endpoints included: (1) baseline patient characteristics; (2) trends in tumor location and pathological features; (3) evolution of treatment modalities; and (4) survival outcomes.Results:A total of 15,644 patients were included in the analysis, with 12,591 males and 3,053 females, the male-to-female gender ration was approximately 4∶1; the mean age was (61.2±9.5) years. The tumor sites were mainly concentrated in the esophagogastric junction (EGJ) (57.4%), followed by the antrum (25.9%). The incidence of EGJ cancer initially rose and then declined. However, gastric antrum tumors remained stable, and gastric body tumors showed a slow upward trend after 2020, accounting for 16.7%. In terms of pathological types, poorly differentiated carcinoma was the most prevalent, accounting for 55.9%, followed by moderately differentiated carcinoma (24.2%), mucinous adenocarcinoma (or signet ring cell carcinoma,14.1%), neuroendocrine carcinoma (4.8%), and well-differentiated carcinoma (0.9%). The proportion of poorly differentiated adenocarcinoma showed a significant upward trend overall as well, peaking at 65.6% in 2022 and decreasing to 57.5% in 2023. Mucinous adenocarcinoma (or signet ring cell carcinoma) exhibited fluctuations with a first increase followed by a decrease: it peaked at 17.3% in 2018, dropped sharply to 8.4% in 2022, and rose back to 13.8% in 2023. The proportions of well-differentiated adenocarcinoma, moderately differentiated adenocarcinoma, and neuroendocrine tumors remained stable year by year. In terms of pathological staging, the overall proportions of gastric cancer at Stage 0, Stage I, Stage II, Stage III, and Stage IVa were 0.5%, 17.3%, 25.1%, 54.9%, and 2.3%, respectively. For Stage III, its proportion was 74.6% in 2013, which decreased to 46.4% by 2023. Stages I and II gastric cancer showed an upward trend, with their proportions rising from 10.2% and 12.1% in 2013 to nearly 21.0% and 29.6% in 2023, respectively. Between 2013 and 2023, the proportion of patients who received surgery alone continued to decrease, with this proportion dropping to 34.7% in 2023. In contrast, the number of patients who received adjuvant chemotherapy increased year by year, reaching 54.2% in 2023. Since 2017, the application of perioperative chemotherapy has gradually increased, rising to 11.1% in 2023. Immunotherapy showed an almost synchronous growth trend with perioperative chemotherapy. However, targeted therapy exhibited a downward trend after a period of growth. There were 10,704 cases of open surgery (68.4%), 4,744 cases of laparoscopic surgery (30.3%), and 193 cases of transthoracic surgery (1.2%). Pathological margin positivity was observed in 443 cases (2.8%), and the volume of gastric cancer surgeries gradually increased, peaked in 2021 before subsequently decreasing gradually. However, the volume of laparoscopic surgeries did not decrease; instead, it showed an upward trend. The main resection method for EGJ tumors was total gastrectomy, accounting for 78.5% of the total, followed by proximal gastrectomy, which accounted for 21.5%. After total gastrectomy, esophagojejunal Roux-en-Y anastomosis was the primary anastomotic method, and for proximal gastrectomy, the main anastomotic method was esophagogastric anastomosis, which accounted for 68.0% of the total. For distal gastrectomy, Billroth II anastomosis was the most common anastomotic technique, accounting for 92.7% of these procedures. The overall incidence of postoperative complications was 14.5% (2,264/15,644), among which the incidence of severe complications (grades III-IV) was 4.5% (706/15,644). The entire cohort was followed up with for (47.1±36.8) months, and the 1-year, 3-year, and 5-year overall survival rates were 86.4%, 65.9%, and 58.1%, respectively. For patients with stage 0, I, II, III, and IV gastric adenocarcinoma, the 1-year overall survival rates were 95.7%, 98.0%, 89.4%, 81.0%, and 49.1%, respectively; the 3-year overall survival rates were 92.1%, 94.6%, 81.9%, 51.4%, and 14.7%, respectively; and the 5-year overall survival rates were 89.4%, 91.7%, 75.1%, 41.5%, and 10.0%, respectively. For patients with stage I, II, III, and IV gastric neuroendocrine carcinoma, the 1-year overall survival rates were 96.7%, 91.1%, 73.8%, and 52.6%, respectively; the 3-year overall survival rates were 87.2%, 69.6%, 46.1%, and 32.1%, respectively; and the 5-year overall survival rates were 87.2%, 62.2%, 36.7%, and 32.1%, respectively.Conclusions:Gastric cancer in Shanxi Province is characterized by a male predominance, a high prevalence of tumors at the esophagogastric junction, a large proportion of poorly differentiated adenocarcinoma, and presentation at advanced stages (predominantly Stage III). The detection rate of early gastric cancer has been increasing year by year, the volume of laparoscopic surgeries has been on the rise annually, and the treatment model has shifted from single surgery to comprehensive treatment.
5.Expression of GALNT1 mRNA and LAMTOR5 mRNA in Gastric Cancer and Their Correlation with Epithelial Mesenchymal Transition and Clinical Prognostic Value
Jun XU ; Jinfeng JI ; Yongfeng CAO ; Jieyun MA
Journal of Modern Laboratory Medicine 2025;40(3):52-58
Objective To investigate the correlation and clinical prognostic value between the expression of polypeptide N-acety lgalactosaminyltransferases 1(GALNT1),lysosomal adaptor MTOR activator 5(LAMTOR5),and epithelial mesenchymal transition(EMT)in gastric cancer.Methods 102 gastric cancer patients admitted to Nantong Tumor Hospital from January 2018 to January 2020 were selected.Immunohistochemistry(IHC)and real-time fluorescence quantitative PCR(RT-PCR)were used to detect the expression of GALNT1,LAMTOR5 mRNA and protein,as well as the expression of EMT indicators Snail mRNA,N-cad mRNA and Vimentin mRNA in cancer and adjacent tissues.Pearson correlation analysis was performed to investigate the correlation between markers.Kaplan Meier curve analysis was used to investigate the relationship between GALNT1 mRNA,LAMTOR5 mRNA and the prognosis of gastric cancer patients.COX regression analysis was used to identify factors that affect the prognosis of gastric cancer patients.Results GALNT1 mRNA(3.38±0.29)and LAMTOR5 mRNA(3.17±0.26)in gastric cancer tissue were higher than those in adjacent tissues(0.72±0.16,0.65±0.13),and the differences were statistically significant(t=81.111,87.553,all P<0.001).The positive rates of GALNT1(92.16%),LAMTOR5(90.20%)proteins in gastric cancer tissues were higher than those in adjacent tissues(7.84%,11.76%),and the differences were statistically significant(χ2=145.020,125.538,P<0.001).The expression of GALNT1 mRNA and LAMTOR5 mRNA in gastric cancer was positively correlated(r=0.757,P<0.001).The expression of GALNT1 mRNA and LAMTOR5 mRNA in gastric cancer was significantly positively correlated with Snail mRNA,N-cad mRNA and Vimentin mRNA expression(r=0.654,0.712,0.689;0.706,0.645,0.723,all P<0.001).The expression of GALNT1 mRNA and LAMTOR5 mRNA was correlated with TNM stage and lymph node metastasis in gastric cancer patients.The expression of GALNT1 mRNA and LAMTOR5 mRNA in cancer tissues with TNM stage III and lymph node metastasis was higher than that in TNM stage I~II and no lymph node metastasis,and the differences were statistically significant(χ2=29.417~290.104,all P<0.001).The 3-year overall survival rate of the high expression group of GALNT1 mRNA was 40.00%(20/50),which was lower than 76.92%(40/52)of the low expression group,the 3-year overall survival rate of the high expression group of LAMTOR5 mRNA was 38.78%(19/49),which was lower than the 77.36%(41/53)of the low expression group,and the differences were statistically significant(Log-Rank χ2=7.327,5.197,P=0.009,0.023).TNM stage III,lymph node metastasis,GALNT1 mRNA was highly expressed,and high LAMTOR5 mRNA was highly expressed were risk factors affecting the prognosis of gastric cancer(Wald χ2=6.409~16.805,all P<0.001).Conclusion The expression of GALNT1 and LAMTOR5 are elevated in gastric cancer tissues.Both of them are related to EMT indicators and adverse clinicopathological features.They are biomarkers for evaluating the prognosis of gastric cancer patients.
6.Predicting the invasion degree of subsolid nodule lung adenocarcinoma by artificial intelligence quantitative parameters combined with imaging signs
Kejia NING ; Rui WU ; Jinfeng GU ; Junbo SONG ; Lei MA ; Huiping CAO
Journal of Practical Radiology 2025;41(8):1299-1303
Objective To predict the invasion degree of subsolid nodule(SSN)lung adenocarcinoma using a combined model incorporating artificial intelligence(AI)quantitative parameters and imaging signs,and to validate the predictive efficacy of this model.Methods A total of 281 SSN lung adenocarcinoma CT images in 243 patients were retrospectively collected and randomly divided into training set(224 cases)and validation set(57 cases)in an 8∶2 ratio,with atypical adenomatous hyperplasia(A AH)+adenocarcinoma in situ(AIS)+minimally invasive adenocarcinoma(MIA)(191 cases)as the non-invasive adenocarcinoma(I AC)group and I AC(90 cases)as the IAC group.Multivariate logistic regression analysis was performed based on the AI quantitative parameters and CT signs in the training set to obtain independent predictors of IAC.A combined model and nomogram were then constructed and validated.The diagnostic efficacy and clinical applicability of the model were evaluated by the receiver operating characteristic(ROC)curve,calibration curve,and clinical decision curve analysis(DCA).Results Multivariate logistic regression analysis of the training set showed nodule type,spicule sign,vascular abnormality,long diameter>11.5 mm,median CT value>—426.25 HU,and mass>391.5 mg were independent predictors of IAC(P<0.05).The area under the curve(AUC)of the training set model,based on these independent predictive factors,was 0.915[95%confidence interval(CI)0.875-0.954],and the AUC of the validation set model was 0.903(95%CI 0.824-0.982),indicating both the training set and validation set models had high efficacy in distinguishing IAC.The nomogram model,which quantified these independent factors,demonstrated enhanced predictive power for IAC.The calibration curve indicated good fit of the prediction model,and the clinical DCA showed the model had good clinical applicability.Conclusion The model combining AI quantitative parameters and imaging signs has a higher ability to predict the risk of IAC,compared to a single indicator.It helps clinicians in determining the appropriate surgical timing,formulating surgical methods,and reducing overtreatment.
7.Proteomic analysis of serum proteins in mice with carbapenem-resistant hypervirulent Klebsiella pneumoniae bloodstream infection
Jinfeng BAO ; Yating MA ; Yin XU ; Yanjuan HE ; Yuyue WANG ; Luoluo SHI ; Chengbin WANG
Chinese Journal of Nosocomiology 2025;35(6):823-828
OBJECTIVE To observe the changes of serum proteins in the mice with carbapenem-resistant hyperviru-lent Klebsiella pneumoniae(CR-hvKP)bloodstream infection by using liquid chromatogram-mass spectrometer(LC-MS),find out the differentially expressed proteins and carry out corresponding biological function analysis.METHODS The models of ICR mice with CR-hvKP and classical Klebsiella pneumoniae(cKP)bloodstream infec-tions were established,the serum specimens were collected from the mice at 12 hours of establishment of the in-fection models and were detected by using LC-MS.The result of LC-MS was identified by using Maxquant soft-ware.The corresponding bioinformatics analysis was performed for the differentially expressed proteins.RESULTS As compared with the normal control group,there were 24 upregulated proteins and 20 downregulated proteins in CR-hvKP group.As compared with cKP group,there were 107 upregulated proteins in the CR-hvKP group.The 134 differentially expressed proteins were retrieved one by one from Uniprot database,it was found that the pro-teins were involved in biological regulation,immune process,biological interaction,movement,metabolic process,response to stimulation,signal transduction,inflammatory response,oxidative stress and angiogenesis.The signal pathway analysis involved multiple metabolism-related pathways,including complement and coagula-tion cascades,cholesterol metabolism,bacterial infection,heme clearance,and assembly,remodeling and clear-ance of plasma lipoprotein.In terms of the proteins being attached great importance,the expression levels of kal-likrein B1(KLKB1)and serpin family A(Serpina)1b were downregulated as compared with the normal control group and were upregulated as compared with the cKP group;the expression levels of serum amyloid A protein(SAA)1,SAA2,Vanin-3(VNN3)and hemoglobinβpolypeptide chain b2(HBB-b2)were upregulated as com-pared with both the cKP group and the normal control group.CONCLUSIONS The CR-hvKP bloodstream infection involves the activation and action of multiple proteins.The rise of SAA1,SAA2,VNN3 and HBB-b2 or the de-cline of KLKB1 and Serpina1b may indicate the CR-hvKP bloodstream infection.
8.A real-world study of 15,644 patients undergoing D2 radical gastrectomy over 11 years at Shanxi provincial cancer hospital
Baoping JIAO ; Kai TAO ; Gang ZHAI ; Zefeng GAO ; Feng LI ; Kaiqing GUO ; Yutao ZHANG ; Nan QIAO ; Yi JIA ; Zongliang GUO ; Erli WANG ; Zhe BAI ; Xiangnan ZHAO ; Haoruo ZHANG ; Yuye GAO ; Jinfeng MA
Chinese Journal of Gastrointestinal Surgery 2025;28(11):1302-1313
Objective:To summarize the clinicopathological features, evolving trends in treatment and surgical approaches, and survival outcomes of patients who underwent D2 radical gastrectomy for gastric cancer in Shanxi Provincial Cancer Hospital over the past 11 years with the goal of providing a reference for the clinical practice of gastric cancer in this region.Methods:A retrospective observational study was conducted to analyze the clinicopathological data of patients who underwent D2 radical gastrectomy for pathologically confirmed gastric malignancy at the Department of Gastrointestinal Surgery, Shanxi Provincial Cancer Hospital from January, 2013 to December, 2023. Exclusion criteria consisted of: (1) residual gastric cancer or recurrent gastric cancer after surgery; (2) emergency gastric cancer resection due to bleeding, perforation, obstruction, or other causes; (3) comorbidity with other primary malignant tumors; (4) severe preoperative cardiopulmonary insufficiency or hepatic and renal insufficiency who cannot tolerate radical surgery; and (5) inconsistent main diagnosis information across the medical record system, pathological system, and gastric cancer-specific database. Patients were divided into three groups based on treatment methods: the surgery-only group, the perioperative chemotherapy group, and the adjuvant chemotherapy group. Endpoints included: (1) baseline patient characteristics; (2) trends in tumor location and pathological features; (3) evolution of treatment modalities; and (4) survival outcomes.Results:A total of 15,644 patients were included in the analysis, with 12,591 males and 3,053 females, the male-to-female gender ration was approximately 4∶1; the mean age was (61.2±9.5) years. The tumor sites were mainly concentrated in the esophagogastric junction (EGJ) (57.4%), followed by the antrum (25.9%). The incidence of EGJ cancer initially rose and then declined. However, gastric antrum tumors remained stable, and gastric body tumors showed a slow upward trend after 2020, accounting for 16.7%. In terms of pathological types, poorly differentiated carcinoma was the most prevalent, accounting for 55.9%, followed by moderately differentiated carcinoma (24.2%), mucinous adenocarcinoma (or signet ring cell carcinoma,14.1%), neuroendocrine carcinoma (4.8%), and well-differentiated carcinoma (0.9%). The proportion of poorly differentiated adenocarcinoma showed a significant upward trend overall as well, peaking at 65.6% in 2022 and decreasing to 57.5% in 2023. Mucinous adenocarcinoma (or signet ring cell carcinoma) exhibited fluctuations with a first increase followed by a decrease: it peaked at 17.3% in 2018, dropped sharply to 8.4% in 2022, and rose back to 13.8% in 2023. The proportions of well-differentiated adenocarcinoma, moderately differentiated adenocarcinoma, and neuroendocrine tumors remained stable year by year. In terms of pathological staging, the overall proportions of gastric cancer at Stage 0, Stage I, Stage II, Stage III, and Stage IVa were 0.5%, 17.3%, 25.1%, 54.9%, and 2.3%, respectively. For Stage III, its proportion was 74.6% in 2013, which decreased to 46.4% by 2023. Stages I and II gastric cancer showed an upward trend, with their proportions rising from 10.2% and 12.1% in 2013 to nearly 21.0% and 29.6% in 2023, respectively. Between 2013 and 2023, the proportion of patients who received surgery alone continued to decrease, with this proportion dropping to 34.7% in 2023. In contrast, the number of patients who received adjuvant chemotherapy increased year by year, reaching 54.2% in 2023. Since 2017, the application of perioperative chemotherapy has gradually increased, rising to 11.1% in 2023. Immunotherapy showed an almost synchronous growth trend with perioperative chemotherapy. However, targeted therapy exhibited a downward trend after a period of growth. There were 10,704 cases of open surgery (68.4%), 4,744 cases of laparoscopic surgery (30.3%), and 193 cases of transthoracic surgery (1.2%). Pathological margin positivity was observed in 443 cases (2.8%), and the volume of gastric cancer surgeries gradually increased, peaked in 2021 before subsequently decreasing gradually. However, the volume of laparoscopic surgeries did not decrease; instead, it showed an upward trend. The main resection method for EGJ tumors was total gastrectomy, accounting for 78.5% of the total, followed by proximal gastrectomy, which accounted for 21.5%. After total gastrectomy, esophagojejunal Roux-en-Y anastomosis was the primary anastomotic method, and for proximal gastrectomy, the main anastomotic method was esophagogastric anastomosis, which accounted for 68.0% of the total. For distal gastrectomy, Billroth II anastomosis was the most common anastomotic technique, accounting for 92.7% of these procedures. The overall incidence of postoperative complications was 14.5% (2,264/15,644), among which the incidence of severe complications (grades III-IV) was 4.5% (706/15,644). The entire cohort was followed up with for (47.1±36.8) months, and the 1-year, 3-year, and 5-year overall survival rates were 86.4%, 65.9%, and 58.1%, respectively. For patients with stage 0, I, II, III, and IV gastric adenocarcinoma, the 1-year overall survival rates were 95.7%, 98.0%, 89.4%, 81.0%, and 49.1%, respectively; the 3-year overall survival rates were 92.1%, 94.6%, 81.9%, 51.4%, and 14.7%, respectively; and the 5-year overall survival rates were 89.4%, 91.7%, 75.1%, 41.5%, and 10.0%, respectively. For patients with stage I, II, III, and IV gastric neuroendocrine carcinoma, the 1-year overall survival rates were 96.7%, 91.1%, 73.8%, and 52.6%, respectively; the 3-year overall survival rates were 87.2%, 69.6%, 46.1%, and 32.1%, respectively; and the 5-year overall survival rates were 87.2%, 62.2%, 36.7%, and 32.1%, respectively.Conclusions:Gastric cancer in Shanxi Province is characterized by a male predominance, a high prevalence of tumors at the esophagogastric junction, a large proportion of poorly differentiated adenocarcinoma, and presentation at advanced stages (predominantly Stage III). The detection rate of early gastric cancer has been increasing year by year, the volume of laparoscopic surgeries has been on the rise annually, and the treatment model has shifted from single surgery to comprehensive treatment.
9.Expert Consensus on Clinical Diseases Responding Specifically to Traditional Chinese Medicine:Aural Vertigo
Yingdi GONG ; Zhanfeng YAN ; Wei FENG ; Daxin LIU ; Jiaxi WANG ; Jianhua LIU ; Yu ZHANG ; Shusheng GONG ; Guopeng WANG ; Chunying XU ; Xin MA ; Bo LI ; Shuzhen GUO ; Mingxia ZHANG ; Jinfeng LIU ; Jihua GUO ; Zhengkui CAO ; Xiaoxiao ZHANG ; Zhonghai XIN
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(8):215-222
Aural vertigo frequently encountered in the otolaryngology department of traditional Chinese medicine (TCM) mainly involves peripheral vestibular diseases of Western medicine, such as Meniere's disease, benign paroxysmal positional vertigo, vestibular neuritis, and vestibular migraine, being a hot research topic in both TCM and Western medicine. Western medical therapies alone have unsatisfactory effects on recurrent aural vertigo, aural vertigo affecting the quality of life, aural vertigo not relieved after surgery, aural vertigo with complex causes, and children's aural vertigo. The literature records and clinical practice have proven that TCM demonstrates unique advantages in the treatment of aural vertigo. The China Association of Chinese medicine sponsored the "17th youth salon on the diseases responding specifically to TCM: Aural vertigo" and invited vertigo experts of TCM and Western medicine to discuss the difficulties and advantages of TCM diagnosis and treatment of aural vertigo. The experts deeply discussed the achievements and contributions of TCM and Western medicine in the diagnosis and treatment of aural vertigo, the control and mitigation of the symptoms, and the solutions to disease recurrence. The discussion clarified the positioning and advantages of TCM treatment and provided guidance for clinical and basic research on aural vertigo.
10.Tear film stability and tarsal gland morphological characteristics in myopic children
Peiyan SHI ; Jinfeng LI ; Dandan ZHANG ; Xiaoman MA ; Zhaoxia ZHAI ; Zheng SUN ; Jinling GE
Recent Advances in Ophthalmology 2024;44(2):139-142
Objective To assess the tear film stability and morphological characteristics of the tarsal gland in myopic children.Methods In this prospective descriptive study,myopic children who performed refractive examinations in the Pediatric Ophthalmology & Refraction Clinic,Jinan Mingshui Eye Hospital from November 2021 to November 2022 were in-cluded.An Ocular Surface Disease Index(OSDI)questionnaire survey was carried out;tear meniscus height(TMH),non-invasive first breakup time(NIf-BUT)and images of the tarsal glands were obtained by OCULUS Keratograph 5M compre-hensive ocular surface analyzer.In addition,the atrophy and tortuosity of tarsal glands were scored to analyze the tear film stability and clinical characteristics of tarsal glands in myopic children.Results A total of 48 myopic children(91 eyes)aged from 7 to 16(10.25±2.23)years were recruited,including 27 males(56.25%)and 21 females(43.75%).The aver-age TMH was(0.19±0.04)mm(95%CI:0.18-0.19)and the average NIf-BUT was(5.40±2.62)s(95%CI:4.90-5.94);the TMH was positively correlated with NIf-BUT(r=0.223,P=0.034).The tarsal gland atrophy score was 1(0,1).The tortuosity score of the upper and lower tarsal gland was 0(0,1)and 0(0,0),respectively,with a statistically significant difference(Z=3.692,P<0.001).In all subjects,49 eyes(53.85%)had tarsal gland atrophy,and 37 eyes(40.66%)had tarsal gland tortuosity.There were significant differences in TMH and NIf-BUT between children aged<12 years and children aged ≥12 years(both P<0.05).There was a significant difference in TMH between children with an OSDI score<13 and children with an OSDI score ≥ 13(t=2.305,P=0.026).There was a significant difference in NIf-BUT between mild and moderate myopia children(t=2.300,P=0.024);the spherical equivalent was positively correlated with NIf-BUT(r=0.283,P=0.023).Conclusion Children with mild to moderate myopia show low tear film stability and a certain proportion of abnormal morphology in tarsal glands.In addition to the refractive status of children,attention should also be paid to ocular surface health in the refraction clinic.

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