Objective To explore the mechanism of baicalin mediating inflammatory response in rats with inflammatory bowel disease through microRNA(miR-21)/signal transducer and activator of transcription 3(STAT3)signaling pathway.Methods A total of 60 SD rats were selected to construct inflammatory bowel disease rat model by trinitro-benzene-sulfonic acid(TNBS)colon perfusion method,and randomly divided into 6 groups,with 10 rats in each group.They were divided into model group,low-dose group(gavage of 20 mg/kg baicalin),high-dose group(gavage of 80 mg/kg baicalin),high-dose+agomiR-NC group(gavage of 80 mg/kg baicalin+tail vein injection of 80 mg/kg miRNA negative control vector agomiR-NC),high-dose+agomiR-21 group(gavage of 80 mg/kg baicalin+tail vein injection of 80 mg/kg miR-21 agonist agomiR-21)and high-dose+agomiR-21+colivelin group(gavage of 80 mg/kg baicalin+tail vein injection of 80 mg/kg agomiR-21,along with intraperitoneal injection of 1 mg/kg STAT3 activator colivelin).Another 10 SD rats were selected as control group without any treatment.The body mass of rats in each group was measured every two days during administration,and the status of rats in each group was observed after administration.Hematoxylin and eosin(HE)staining was used to evaluate the pathological damage.The myeloperoxidase(MPO)activity,inflammatory factors and oxidative stress indexes were detected by the test kit.The mRNA levels of miR-21,STAT3 were detected by qRT-PCR.The expression of STAT3 and p-STAT3 protein was detected by Western blot.Results Compared with model group,the status of inflammatory bowel disease and pathological damage degree of colon tissue in low-dose group and high-dose group were significantly improved,the levels of interleukin-13(IL-13),superoxide dismutase(SOD)and glutathione peroxidase(GSH)were increased(P<0.05),while the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),malondialdehyde(MDA),reactive oxygen species(ROS),and miR-21 mRNA,STAT3 mRNA,p-STAT3/STAT3 protein expression were decreased(P<0.05)in a dose-dependent manner.Compared with high-dose+agomiR-NC group,the status of inflammatory bowel disease and pathological damage degree of colon tissue were aggravated in high-dose+agomiR-21 group,the levels of IL-13,SOD and GSH were decreased(P<0.05),while the levels of TNF-α,IL-6,MDA,ROS,and miR-21 mRNA,STAT3 mRNA,P-STAT3/STAT3 protein expression were increased(P<0.05).Compared with high-dose+agomiR-NC group,the status of inflammatory bowel disease and pathological damage degree of colon tissue were aggravated in high-dose+agomiR-21+colivelin group,the levels of IL-13,SOD and GSH were decreased(P<0.05),while the levels of TNF-α,IL-6,MDA,ROS,and miR-21 mRNA,STAT3 mRNA and P-STAT3/STAT3 protein expression were increased(P<0.05).Conclusion Baicalin reduces inflammatory factors and oxidative stress levels through miR-21/STAT3 signaling pathway,and thereby ameliorates colonic injury in rats with inflammatory bowel disease.

Objective:To evaluate long-term outcomes of endoscopic papillectomy (EP) for duodenal papillary adenomas and to identify risk factors for incomplete resection.Methods:Clinical data of 180 patients diagnosed as having duodenal papillary adenoma via postoperative pathology after EP in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from January 2010 to December 2022 were retrospectively analyzed. Patients were divided into two groups based on their postoperative margin status: the complete resection group (negative resection margins) and the incomplete resection group (positive/uncertain resection margins). Recurrence rates were compared between the two groups, and logistic regression analysis was performed to identify risk factors for incomplete resection.Results:Among the 180 patients included in the study, 137 underwent complete resection, and 43 had incomplete resections. Recurrence rate was significantly higher in the incomplete resection group than that in the complete resection group (30.2% VS 15.3%, χ2=4.75, P=0.029). logistic regression analysis indicated that high-grade intraepithelial neoplasia was an independent risk factor for incomplete resection ( OR=2.43, 95% CI:1.12-5.26, P=0.024). Conclusion:Patients with incomplete resection after EP have a higher recurrence rate in the long-term follow-up. High-grade intraepithelial neoplasia is an independent risk factor for incomplete resection. Close surveillance and aggressive management are warranted for patients with positive or uncertain resection margins to mitigate the recurrence risk.

Objective:To evaluate the safety and feasibility of Da Vinci robot-assisted proximal gastrectomy (PG) for proximal gastric cancer (PGC) and adenocarcinoma of the esophagogastric junction (AEG).Method:Twenty-five patients (PGC: n=7; AEG: n=18) undergoing Da Vinci-assisted PG at the First Affiliated Hospital of Dalian Medical University from Jan 2021 to Mar 2025 were divided into (indocyanine green ,ICG) ( n=9) and non-ICG ( n=16) groups based on whether intraoperative ICG navigation was used. Perioperative outcomes and pathological data were compared. Results:All operations were successfully completed without conversion to open surgery. The median proximal resection margin was 3.0 cm (2.5-3.0) cm, and the median distal resection margin was 4.0 cm (3.0-5.0) cm. Operative time in the ICG and non-ICG groups was (294.4±41.3) min and (354.4±67.4) min, respectively, with a statistically significant difference ( t=2.760， P< 0.05). The total number of lymph nodes harvested, as well as D 1 and D 2 LN stations, was (29.3±14.8) vs. (21.8±6.3), 17.0 (10.0-24.8) vs. 14.0 (11.0-22.5), and 10.0 (2.0-17.0) vs. 7.2 (2.0-7.5) in the ICG and non-ICG groups, respectively. Although the ICG group showed a trend toward higher LN yield, the difference was not statistically significant ( P>0.05). Conclusions:Da Vinci robotic assisted proximal gastrectomy is safe and feasible for treating PGC and AEG. ICG fluorescence imaging demonstrates promising clinical value.

This study was aimed at investigating the effects of demethylase fat mass and obesity-associated protein(FTO)and methyltransferase methyltransferase like protein 3(METTL3),key molecules in N6-methyladenosine(m6A)modification,on the replication and proliferation of Japanese encephalitis virus(JEV).Recombinant lentiviruses were generated by packaging the FTO and green fluorescent protein into lentiviral vectors.Neuro2a cells,a mouse neuroblastoma cell line,were infected with the lentivirus,and stable FTO-expressing cell lines were obtained through puromycin selection.Successful overexpression of FTO was confirmed through fluorescence microscopy,real-time quantitative PCR,and western blot analysis.When Neuro2a cells overexpressing FTO were infected with JEV,the overexpression of FTO decreased JEV replication in the cells,and increased the expression of interferon(IFN)and related molecules.Additionally,treatment of JEV-infected Neuro2a cells with the METTL3-specific inhibitor STM2457 resulted in a dose-dependent decrease in JEV replication and viral protein expression.These findings suggested that lowering m6A methylation levels inhibits JEV replication,thus shedding light on the regulatory role of methylation modification in JEV replication.

This study was aimed at investigating the effects of demethylase fat mass and obesity-associated protein(FTO)and methyltransferase methyltransferase like protein 3(METTL3),key molecules in N6-methyladenosine(m6A)modification,on the replication and proliferation of Japanese encephalitis virus(JEV).Recombinant lentiviruses were generated by packaging the FTO and green fluorescent protein into lentiviral vectors.Neuro2a cells,a mouse neuroblastoma cell line,were infected with the lentivirus,and stable FTO-expressing cell lines were obtained through puromycin selection.Successful overexpression of FTO was confirmed through fluorescence microscopy,real-time quantitative PCR,and western blot analysis.When Neuro2a cells overexpressing FTO were infected with JEV,the overexpression of FTO decreased JEV replication in the cells,and increased the expression of interferon(IFN)and related molecules.Additionally,treatment of JEV-infected Neuro2a cells with the METTL3-specific inhibitor STM2457 resulted in a dose-dependent decrease in JEV replication and viral protein expression.These findings suggested that lowering m6A methylation levels inhibits JEV replication,thus shedding light on the regulatory role of methylation modification in JEV replication.

Objective To explore the mechanism of baicalin mediating inflammatory response in rats with inflammatory bowel disease through microRNA(miR-21)/signal transducer and activator of transcription 3(STAT3)signaling pathway.Methods A total of 60 SD rats were selected to construct inflammatory bowel disease rat model by trinitro-benzene-sulfonic acid(TNBS)colon perfusion method,and randomly divided into 6 groups,with 10 rats in each group.They were divided into model group,low-dose group(gavage of 20 mg/kg baicalin),high-dose group(gavage of 80 mg/kg baicalin),high-dose+agomiR-NC group(gavage of 80 mg/kg baicalin+tail vein injection of 80 mg/kg miRNA negative control vector agomiR-NC),high-dose+agomiR-21 group(gavage of 80 mg/kg baicalin+tail vein injection of 80 mg/kg miR-21 agonist agomiR-21)and high-dose+agomiR-21+colivelin group(gavage of 80 mg/kg baicalin+tail vein injection of 80 mg/kg agomiR-21,along with intraperitoneal injection of 1 mg/kg STAT3 activator colivelin).Another 10 SD rats were selected as control group without any treatment.The body mass of rats in each group was measured every two days during administration,and the status of rats in each group was observed after administration.Hematoxylin and eosin(HE)staining was used to evaluate the pathological damage.The myeloperoxidase(MPO)activity,inflammatory factors and oxidative stress indexes were detected by the test kit.The mRNA levels of miR-21,STAT3 were detected by qRT-PCR.The expression of STAT3 and p-STAT3 protein was detected by Western blot.Results Compared with model group,the status of inflammatory bowel disease and pathological damage degree of colon tissue in low-dose group and high-dose group were significantly improved,the levels of interleukin-13(IL-13),superoxide dismutase(SOD)and glutathione peroxidase(GSH)were increased(P<0.05),while the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),malondialdehyde(MDA),reactive oxygen species(ROS),and miR-21 mRNA,STAT3 mRNA,p-STAT3/STAT3 protein expression were decreased(P<0.05)in a dose-dependent manner.Compared with high-dose+agomiR-NC group,the status of inflammatory bowel disease and pathological damage degree of colon tissue were aggravated in high-dose+agomiR-21 group,the levels of IL-13,SOD and GSH were decreased(P<0.05),while the levels of TNF-α,IL-6,MDA,ROS,and miR-21 mRNA,STAT3 mRNA,P-STAT3/STAT3 protein expression were increased(P<0.05).Compared with high-dose+agomiR-NC group,the status of inflammatory bowel disease and pathological damage degree of colon tissue were aggravated in high-dose+agomiR-21+colivelin group,the levels of IL-13,SOD and GSH were decreased(P<0.05),while the levels of TNF-α,IL-6,MDA,ROS,and miR-21 mRNA,STAT3 mRNA and P-STAT3/STAT3 protein expression were increased(P<0.05).Conclusion Baicalin reduces inflammatory factors and oxidative stress levels through miR-21/STAT3 signaling pathway,and thereby ameliorates colonic injury in rats with inflammatory bowel disease.

Objective:To evaluate long-term outcomes of endoscopic papillectomy (EP) for duodenal papillary adenomas and to identify risk factors for incomplete resection.Methods:Clinical data of 180 patients diagnosed as having duodenal papillary adenoma via postoperative pathology after EP in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from January 2010 to December 2022 were retrospectively analyzed. Patients were divided into two groups based on their postoperative margin status: the complete resection group (negative resection margins) and the incomplete resection group (positive/uncertain resection margins). Recurrence rates were compared between the two groups, and logistic regression analysis was performed to identify risk factors for incomplete resection.Results:Among the 180 patients included in the study, 137 underwent complete resection, and 43 had incomplete resections. Recurrence rate was significantly higher in the incomplete resection group than that in the complete resection group (30.2% VS 15.3%, χ2=4.75, P=0.029). logistic regression analysis indicated that high-grade intraepithelial neoplasia was an independent risk factor for incomplete resection ( OR=2.43, 95% CI:1.12-5.26, P=0.024). Conclusion:Patients with incomplete resection after EP have a higher recurrence rate in the long-term follow-up. High-grade intraepithelial neoplasia is an independent risk factor for incomplete resection. Close surveillance and aggressive management are warranted for patients with positive or uncertain resection margins to mitigate the recurrence risk.

Objective:To evaluate the safety and feasibility of Da Vinci robot-assisted proximal gastrectomy (PG) for proximal gastric cancer (PGC) and adenocarcinoma of the esophagogastric junction (AEG).Method:Twenty-five patients (PGC: n=7; AEG: n=18) undergoing Da Vinci-assisted PG at the First Affiliated Hospital of Dalian Medical University from Jan 2021 to Mar 2025 were divided into (indocyanine green ,ICG) ( n=9) and non-ICG ( n=16) groups based on whether intraoperative ICG navigation was used. Perioperative outcomes and pathological data were compared. Results:All operations were successfully completed without conversion to open surgery. The median proximal resection margin was 3.0 cm (2.5-3.0) cm, and the median distal resection margin was 4.0 cm (3.0-5.0) cm. Operative time in the ICG and non-ICG groups was (294.4±41.3) min and (354.4±67.4) min, respectively, with a statistically significant difference ( t=2.760， P< 0.05). The total number of lymph nodes harvested, as well as D 1 and D 2 LN stations, was (29.3±14.8) vs. (21.8±6.3), 17.0 (10.0-24.8) vs. 14.0 (11.0-22.5), and 10.0 (2.0-17.0) vs. 7.2 (2.0-7.5) in the ICG and non-ICG groups, respectively. Although the ICG group showed a trend toward higher LN yield, the difference was not statistically significant ( P>0.05). Conclusions:Da Vinci robotic assisted proximal gastrectomy is safe and feasible for treating PGC and AEG. ICG fluorescence imaging demonstrates promising clinical value.

Objective:To compare and analyze the short-term efficacy of the Da Vinci Xi (fourth generation) robotic surgical system and laparoscopic-assisted radical gastrectomy for gastric cancer.Method:In this retrospective cohort study, clinical pathological data of 190 patients with gastric cancer were collected from the clinical database of the First Affiliated Hospital of Dalian Medical University from 2020 Dec to 2023 May. The cohort comprised 136 men and 54 women aged 65 (30–85) years. Ninety of these patients had undergone robot assisted radical resection of gastric cancer and reconstruction of the digestive tract and were assigned to the robot-assisted group. The remaining 100 patients had undergone laparoscopic- assisted radical resection of gastric cancer and reconstruction of the digestive tract and were assigned to the laparoscopic control group. Variables investigated included surgical and postoperative factors and postoperative complications.Result:The procedure was successfully completed without the need to transition to open surgery in every patient in both groups. The median duration of surgery was 315 (270, 360) minutes and 240 (202, 280) minutes, median intraoperative blood loss 20 (10, 30) mL and 30 (10, 50) mL, median incision length 12.0 (10.8,13.0) cm and 10.0 (8.0, 10.8) cm, median time to first postoperative passage of flatus 4 (3, 5) days and 4 (4, 5) days, median time to first postoperative fluid intake 6 (4, 7) days and 8 (6, 9) days, time to gastric tube removal 4 (3, 7) days and 6 (5, 8) days, median time to drainage tube removal 8 (7, 10) days and 10 (9, 12) days, median duration of postoperative hospitalization 8 (7, 11) days and 12 (10, 14) days, and cost of surgery (7.6±1.2)×10 4 yuan and (4.0±0.6)×10 4 yuan in the robot-assisted and laparoscopic control groups, respectively. All the differences in the above indicators between the two groups of patients were statistically significant (all P<0.05). There were also significantly fewer complications in the robot-assisted than the laparoscopic control group (28.9% [26/90] vs. 44.0% [44/100], χ 2=0.31, P=0.031). Further subgroup analysis showed that the following factors were associated with greater improvement in the robot-assisted than laparoscopic control group: male sex (OR=0.41, 95%CI: 0.20–0.83, P=0.015), body mass index Conclusion:The Da Vinci robotic surgical system is safe and feasible for gastrectomy achieving a shorter recover period and fewer preoperative comorbidities.

Objective:To compare and analyze the short-term efficacy of the Da Vinci Xi (fourth generation) robotic surgical system and laparoscopic-assisted radical gastrectomy for gastric cancer.Method:In this retrospective cohort study, clinical pathological data of 190 patients with gastric cancer were collected from the clinical database of the First Affiliated Hospital of Dalian Medical University from 2020 Dec to 2023 May. The cohort comprised 136 men and 54 women aged 65 (30–85) years. Ninety of these patients had undergone robot assisted radical resection of gastric cancer and reconstruction of the digestive tract and were assigned to the robot-assisted group. The remaining 100 patients had undergone laparoscopic- assisted radical resection of gastric cancer and reconstruction of the digestive tract and were assigned to the laparoscopic control group. Variables investigated included surgical and postoperative factors and postoperative complications.Result:The procedure was successfully completed without the need to transition to open surgery in every patient in both groups. The median duration of surgery was 315 (270, 360) minutes and 240 (202, 280) minutes, median intraoperative blood loss 20 (10, 30) mL and 30 (10, 50) mL, median incision length 12.0 (10.8,13.0) cm and 10.0 (8.0, 10.8) cm, median time to first postoperative passage of flatus 4 (3, 5) days and 4 (4, 5) days, median time to first postoperative fluid intake 6 (4, 7) days and 8 (6, 9) days, time to gastric tube removal 4 (3, 7) days and 6 (5, 8) days, median time to drainage tube removal 8 (7, 10) days and 10 (9, 12) days, median duration of postoperative hospitalization 8 (7, 11) days and 12 (10, 14) days, and cost of surgery (7.6±1.2)×10 4 yuan and (4.0±0.6)×10 4 yuan in the robot-assisted and laparoscopic control groups, respectively. All the differences in the above indicators between the two groups of patients were statistically significant (all P<0.05). There were also significantly fewer complications in the robot-assisted than the laparoscopic control group (28.9% [26/90] vs. 44.0% [44/100], χ 2=0.31, P=0.031). Further subgroup analysis showed that the following factors were associated with greater improvement in the robot-assisted than laparoscopic control group: male sex (OR=0.41, 95%CI: 0.20–0.83, P=0.015), body mass index Conclusion:The Da Vinci robotic surgical system is safe and feasible for gastrectomy achieving a shorter recover period and fewer preoperative comorbidities.