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.

ObjectiveTo develop a community-family management model for older adults with mild cognitive impairment (MCI) and to formulate detailed application specifications, and to fully leverage the initiative of communities and families under limited resource conditions, for achieving community-based early detection and early intervention for older adults with MCI. MethodsA systematic literature review was conducted to identify pertinent publications. Corpus-based research methodologies were employed to extract, refine, integrate and synthesize management elements, thereby establishing the specific content and service processes for each stage of the management model. Utilizing the 5W2H analytical framework, essential elements such as management stakeholders, target populations, content and methods for each stage were delineated. The model and its application guidelines were finalized through expert consultation and demonstration. ResultsAn expert evaluation of the management model yielded mean scores of 4.84, 4.32 and 4.84 for acceptability, feasibility and systematicity, respectively. By integrating the identified core elements with expert ratings and feedback, the final iteration of the community-family management model for older adults with MCI was formulated. This model comprised of five stages: screening and identification, comprehensive assessment, intervention planning, monitoring and referral pathways to ensure implementation, and enhanced support for communities, family members and caregivers. Additionally, it included 18 specific application guidelines. ConclusionThe proposed management model may theoretically help delay cognitive decline, improve cognitive function and potentially promote reversal from MCI to normal cognition. It may also enhance the awareness and coping capacity of older adults and their families, strengthen community healthcare professionals' ability to early identify and manage MCI.

Objective To elucidate the changes in the gut microbiota and molecular mechanism of huaier in enhancing the efficacy of oxaliplatin (OXA) chemotherapy in gastric cancer (GC). Methods The effects of huaier on the gut microbiota structure and intestinal barrier function in MKN45-bearing mice were analyzed by using 16S rRNA sequencing, RT-qPCR, and IHC. UPLC-MS and network pharmacology, as well as in vivo experimental approaches, were employed to investigate the key bioactive constituents of huaier systematically and elucidate the underlying mechanisms by which huaier exerts therapeutic effects against GC. The expression of the PI3K/AKT/SREBP pathway was detected in cancer cells and tissues via Western blot analysis. The safety profile of huaier combined with OXA was verified through serum biochemistry and HE-stained tissue section analyses. Results Huaier inhibited the PI3K/AKT/SREBP pathway by increasing the abundance of Akkermansia muciniphila, reduced lipid droplet deposition, and ultimately enhanced the sensitivity to OXA in the treatment of GC. Conclusion This study demonstrates the value of huaier in gastric cancer treatment by enhancing chemosensitivity and provides novel insights into its systemic therapeutic effects through molecular mechanisms and gut microbiota modulation.

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 role of HEN methyltransferase 1(HENMT1)in the proliferation and migration of gastric cancer(GC)and its potential molecular mechanisms.Methods·The expression of HENMT1 in GC was examined using bioinformatics databases,Western blotting and quantitative real-time PCR(qPCR).Kaplan-Meier Plotter and BEST online tools were used to analyze the correlations between HENMT1 expression and overall survival,perineural invasion,subtypes,tumor location and Lauren classification in clinical GC patients.GC cells were cultured in vitro and treated with small interfering RNA(siRNA)targeting HENMT1 and HENMT1 overexpression vectors,in combination with a PI3K activator(740 Y-P)or PI3K inhibitor(3-MA).The roles of HENMT1 in GC cell proliferation and migration were assessed using cell counting kit-8(CCK-8)assay,colony formation assay,wound healing assay and Transwell migration assay.Results·HENMT1 was significantly upregulated in GC and positively associated with perineural invasion.Its expression was closely related to GC subtypes,being most pronounced in the proliferative subtype,and was higher in intestinal-type GC according to the Lauren classification.However,HENMT1 expression showed no significant correlation with overall survival or tumor location(including gastric body,cardia,antrum and whole stomach).Functional experiments demonstrated that silencing HENMT1 inhibited GC cell proliferation and migration,whereas overexpression of HENMT1 enhanced these capabilities.Mechanistically,silencing HENMT1 reduced the levels of phosphorylated PI3K,AKT and mTOR,as well as their total protein expression.Conversely,HENMT1 overexpression upregulated these proteins.Moreover,siHENMT1 combined with the PI3K activator 740 Y-P effectively reversed the proliferation and migration effects induced by 740 Y-P,while overexpressed HENMT1 combined with the PI3K inhibitor 3-MA reversed the suppressive effects of 3-MA on GC cell proliferation and migration.Conclusion·HENMT1 is highly expressed in GC and positively regulates the proliferation and migration of gastric cancer cells by activating the PI3K-AKT-mTOR signaling pathway.

Methods:This study was a cross-sectional study. A prospective cohort study enrolled 42 patients with clinically suspected acute cerebrovascular disease and those undergoing follow-up examinations after intracranial vascular stenting at the First Affiliated Hospital of Zhengzhou University from June 2024 to May 2025. All patients underwent UHR PCD-CT examinations of the head and neck. Reconstructions were performed based on raw data, yielding conventional standard resolution (SR group) reconstructions and UHR images reconstructed using four distinct convolution kernels (Hv40, Hv48, Hv56, Hv64) in separate groups (Hv40 UHR group, Hv48 UHR group, Hv56 UHR group, Hv64 UHR group). Regions of interest were selected in the anterior cerebral artery, middle cerebral artery, posterior cerebral artery, posterior communicating artery, and anterior communicating artery. CT values and standard deviation (SD) values were measured for each artery, and signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Additionally, the sharpness of the vessel edges and the full-width-half-maximum (FWHM) of each artery were measured. One-way analysis of variance or the nonparametric Kruskal-Wallis test was used to compare the subjective and objective image quality metrics across the five groups. Pairwise comparisons were performed using the LSD test or Dunn method.Results:Statistically significant differences were observed in the overall comparison of vascular imaging SD, SNR, CNR, vascular edge sharpness, and FWHM among the SR group, Hv40 UHR group, Hv48 UHR group, Hv56 UHR group, and Hv64 UHR group ( P<0.05). No statistically significant differences in CT values were found ( P>0.05). Pairwise comparisons revealed statistically significant differences between all groups ( P<0.05), except that no significant differences were observed in image SD, SNR, CNR, vascular edge sharpness, or FWHM between the Hv56 UHR and Hv64 UHR groups ( P>0.05). Conclusions:UHR PCD-CT provides better image quality for neurovascular imaging. For the display of small intracranial vessels, the Hv64 provides sharper vessel walls and better subjective image quality compared to the less sharp convolutional cores.Objective:To explore the value of ultra-high resolution (UHR) photon-counting detector CT (PCD-CT) to improve the quality of neurovascular images.

Objective:To investigate the clinical value of the Nomogram model based on two-dimensional shear wave elastography(2D-SWE)combined with biochemical indicators in the diagnosis of moderate and severe metabolic-associated fatty liver disease(MAFLD).Methods:A total of 170 patients with MAFLD diagnosed by ultrosound image in the health management center of the Second People's Hospital of Wuhu from Jan 2023 to Dec 2023 were divided into mild,moderate and severe groups according to two-dimensional ultrasound images,and 111 healthy volunteers were recruited as control group in the same period.Multivariate logistic regression analysis was used to screen independent risk factors for moderate and severe MAFLD and construct a predictive model.The diagnostic efficacy of the ROC model was plotted,and the Nomogram model was used to conduct internal verification.Results:Multivariate logistic regression analysis showed that liver stiffness measurement(LSM),platelet count(PLT)and hepatic steatosis index(HSI)were the independent risk factors for the diagnosis of moderate and severe MAFLD.The area under the curve(AUC)of LSM,PLT and HSI was 0.940(95%CI:0.911-0.969),with a sensitivity was 87.5%and a specificity was 88.1%.The internal validation showed that the model had high accuracy and stability.Conclusion:The Nomogram model based on LSM combined with PLT and HSI can effectively diagnose moderate and severe MAFLD,providing a reliable evidence for early clinical intervention and adjustment of therapeutic measures.

Objective·To investigate the role of HEN methyltransferase 1(HENMT1)in the proliferation and migration of gastric cancer(GC)and its potential molecular mechanisms.Methods·The expression of HENMT1 in GC was examined using bioinformatics databases,Western blotting and quantitative real-time PCR(qPCR).Kaplan-Meier Plotter and BEST online tools were used to analyze the correlations between HENMT1 expression and overall survival,perineural invasion,subtypes,tumor location and Lauren classification in clinical GC patients.GC cells were cultured in vitro and treated with small interfering RNA(siRNA)targeting HENMT1 and HENMT1 overexpression vectors,in combination with a PI3K activator(740 Y-P)or PI3K inhibitor(3-MA).The roles of HENMT1 in GC cell proliferation and migration were assessed using cell counting kit-8(CCK-8)assay,colony formation assay,wound healing assay and Transwell migration assay.Results·HENMT1 was significantly upregulated in GC and positively associated with perineural invasion.Its expression was closely related to GC subtypes,being most pronounced in the proliferative subtype,and was higher in intestinal-type GC according to the Lauren classification.However,HENMT1 expression showed no significant correlation with overall survival or tumor location(including gastric body,cardia,antrum and whole stomach).Functional experiments demonstrated that silencing HENMT1 inhibited GC cell proliferation and migration,whereas overexpression of HENMT1 enhanced these capabilities.Mechanistically,silencing HENMT1 reduced the levels of phosphorylated PI3K,AKT and mTOR,as well as their total protein expression.Conversely,HENMT1 overexpression upregulated these proteins.Moreover,siHENMT1 combined with the PI3K activator 740 Y-P effectively reversed the proliferation and migration effects induced by 740 Y-P,while overexpressed HENMT1 combined with the PI3K inhibitor 3-MA reversed the suppressive effects of 3-MA on GC cell proliferation and migration.Conclusion·HENMT1 is highly expressed in GC and positively regulates the proliferation and migration of gastric cancer cells by activating the PI3K-AKT-mTOR signaling pathway.

Objective To develop a toolkit suitable for assisting community health institutions in the early identification and inter-vention of mild cognitive impairment(MCI)among older adults.Methods A literature review was conducted to construct a draft of the identification and intervention toolkit.Tools with an expert approval rate above 70%were included after expert consultation.The final version of the toolkit was developed by integrating these tools with officially recommended tools in China.Results The expert consultation yielded an authority coefficient of 0.84.The finalized toolkit included the assessment tools of Mini-Mental State Examination,Montreal Cognitive Assessment,General Practitioner Assessment of Cognition,Cognitive Abilities Screening Instrument and Clock Drawing Test,and 18 intervention measures in-cluding pharmacological treatment,cognitive training and psychological interventions,etc.Conclusion The MCI Identification-Intervention Toolkit may serve as a reference for guiding the identification and inter-vention of MCI among older adults for community health institutions.

Objective:To explore the efficacy of letrozole combined with palbociclib in the treatment of hormone receptor +/human epidermal growth factor receptor-2 - (HR +/HER2 -) advanced breast cancer and its influence on serum thymidine kinase 1 (TK1) and proliferating cell nuclear antigen (Ki67) levels. Methods:A total of 82 patients with HR +/HER2 - advanced breast cancer, all admitted from Jan. 2022 to Jan. 2024 from Department of Oncology, Affiliated Hospital of Jining Medical University, were assigned to the control group ( n=41, letrozole) and the study group ( n=41, letrozole + palbociclib) according to the random number table. The therapeutic effect, tumor markers, immune function and serum TK1 and Ki67 levels were compared between the two groups. Results:The study group higher objective response rate and disease control rate than the other group [14.63% (6/41) and 85.37% (35/41) vs. 0.00% (0/41) and 58.54% (24/41) ] (Continuity correction χ2/χ2=4.50, 7.31, P<0.05). After treatment, carbohydrate antigen 153 (CA153), CA125 and carcinoembryonic antigen (CEA) in the study group were lower than the control group [ (12.17±3.19) U/mL, (23.57±3.35) U/mL and (19.51±4.13) ng/mL vs (24.37±5.25) U/mL, (35.16±5.08) U/mL, (34.28±5.72) ng/mL] ( t=12.72, 12.20, 13.41, P<0.05), serum TK1 and Ki67 levels were also lower [ (3.61±0.75) pmol/L and (7.89±1.16) ng/mL vs. (4.76±0.88) pmol/L and (10.85±1.94) ng/mL] ( t=6.37, 8.39, P<0.05). After treatment, CD3 +, CD4 +, CD4 +/CD8 + higher than the control group [ (48.64±5.88) %, (31.34±4.06) %, (1.22±0.27) vs. (43.16±6.09) %, (27.04±3.35) %, (0.87±0.35) ] ( t=4.15, 5.23, 5.07, P<0.05), while CD8 + was lower [ (25.73±4.11) % vs. (30.94±4.47) %] ( t = 5.49, P<0.05) . Conclusions:Letrozole combined with palbociclib is effective in the treatment of HR +/HER2 - advanced breast cancer and can reduce tumor markers and serum TK1 and Ki67 levels in patients.