Objective:To investigate the diagnostic value of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for biopsy-negative esophageal strictures suspected for malignancy.Methods:Patients who underwent EUS-FNA for esophageal strictures with negative endoscopic biopsies in Nanjing Drum Tower Hospital from January 2014 to March 2022 were analyzed retrospectively. The final diagnosis was based on the pathological outcomes of EUS-FNA or surgery, complemented by follow-up data. Diagnostic efficacy and complication rates of EUS-FNA were analyzed.Results:A total of 64 patients were included in this study,with 54 ultimately diagnosed with malignant lesions and 10 with benign lesions. Malignant lesions were diagnosed by EUS-FNA in 50 cases, suspected malignant lesions in 3 cases, and no clear basis for malignancy was observed in 11 cases. The diagnostic accuracy of EUS-FNA was 98.4% (63/64), with the malignant tumor detection rate of 98.1% (53/54). No post-procedure complications such as bleeding, perforation, or infection were observed in any patient.Conclusion:EUS-FNA is safe and effective for the diagnosis of biopsy-negative suspected malignant esophageal stricture with a high malignant lesion detection rate.

Lactylation, a newly discovered post-translational modification, has been reported to be involved in various physiological and pathological processes. Recent studies have found that lactylation is potentially linked to the pathological processes and repair mechanisms of ischemic stroke. This article explores the impact and role of lactylation after the occurrence of ischemic stroke on neuroinflammation, energy metabolism regulation, oxidative stress, signaling pathway modulation, and angiogenesis. It may serve as a bridge connecting lactylation and ischemic stroke, offering insights and guidance for future research and clinical strategies in ischemic stroke.

Objective To investigate the knowledge of tuberculin skin test(TST)among healthcare workers and provide evidence for improving the standardization of TST screening in primary healthcare staff.Methods A questionnaire survey was conducted among 248 licensed physicians or nurses who were qualified as licensed physicians or nurses and responsible for TST work from 27 districts/counties of Chongqing in 2023.The awareness of TST-related knowledge and its influencing factors were statistically analyzed.Results The average TST knowledge score of 248 healthcare workers was(78.3±10.6)points.The overall awareness rate was 78.9%(8 213/10 416),with specific rates as follows:65.4%(1 135/1 736)for tubercu-losis knowledge,87.3%(3 248/3 720)for TST general knowledge,53.4%(795/1 488)for TST principles,88.0%(1 964/2 232)for TST procedures,and 86.4%(1 071/1 240)for TST result interpretation.Nurses showed higher awareness rates than physicians and other staff(P＞0.05).Healthcare workers from medium-epidemic areas demonstrated significantly higher awareness rates than those from high-and low-epidemic are-as(P＜0.001).No statistically significant differences were observed in gender,age,occupation type,institu-tion type,or regional epidemic level between the qualified group and non-qualified group about TST-related knowl-edge(P＞0.05).Conclusion Healthcare workers exhibit incomplete mastery of TST-related knowledge.Strengthening TST-related knowledge training for standardizing TST implementation.

Objective The present study was designed to explore the inhibitory effects of the ADC drug Disitamab Vedotin(RC-48)on breast cancer cells with different HER-2 expression levels by utilizing a tumor organoid culture system.Methods Within the framework of the tumor organoid culture system,the breast cancer cell lines MCF-7(characterized by low HER-2 expression,Luminal A subtype)and BT-474(exhibiting high HER-2 expression,HER-2 positive subtype)were cultured independently and in various mixed ratios.The histological characteristics,as well as the expression levels and distribution of HER-2 in MCF-7 and BT-474 organoids,were analyzed via immunohistochemistry and immunofluorescence techniques.MCF-7 and BT-474 organoids were separately treated with Vedotin(RC-48),Disitamab,and Monomethyl auristatin E(MMAE).Additionally,a drug sensitivity test of Disitamab Vedotin(RC-48)was carried out on mixed MCF-7 and BT-474 cell ratios and on patient-derived breast cancer organoids,with the assessment conducted using the 3D-Glo method.Results In the tumor organoid culture system,immunohistochemistry and immunofluorescence analyses demonstrated that HER-2 was predominantly localized in the cell membrane.Specifically,BT-474 organoids exhibited robust HER-2 expression,while MCF-7 organoids displayed relatively low expression levels.When compared with MCF-7 organoids,RC48-ADC exerted a more pronounced inhibitory effect on BT-474 organoids,with IC50 values of 109.7 μg/mL and 2.792 μg/mL,respectively.The co-culture model further confirmed the bystander effect of RC-48,revealing that the ratio of HER-2-positive to HER-2-negative cells significantly influenced drug efficacy.Additionally,treatment with RC-48 led to a reduction in HER-2 expression in breast cancer organoids with diverse HER-2 expression levels.Conclusions The tumor organoid model can accurately mirror drug sensitivity and bystander effects.Within this model,RC-48 effectively inhibited HER-2 highly-expressing breast cancer cells,augmented the killing effect through the bystander mechanism,and downregulated HER-2 expression,thereby suggesting its potential for targeting HER2-associated breast cancer.

Objective To provide reference for the clinical use of Baihui acupoint(GV20)in treating diseases,the rules of clinical application of GV20 in ancient literature through data mining technology was analyzed.Methods"Zhong Hua Yi Dian"was searched by computer for relevant papers involving GV20 in the main treatment of illnesses,the main treatment of illnesses by combining other acupoints,and the treatment methods.After organizing the included articles into a database,Microsoft Excel 2021 was used to analyze the frequency of diseases and the use of acupoint pairing,attribution to meridians and special points,and IBM SPSS STATISTIC 27 software was used to analyze the cluster analysis of high-frequency compatible acupoints.Results Valid prescriptions from 209 medical books,including Zhen Jiu Da Cheng(The Great Compendium of Acupuncture and Moxibustion),containing 311 compatible acupoints,were screened and summarized.The main treatment conditions of GV20 mainly included internal medicine,surgery,gynecology,pediatrics and other disciplines,with the brain and liver and gallbladder systems of internal medicine as the main diseases.The top 5 frequency acupoints were Quchi(LI11),Hegu(LI4),Shenting(GV24),Zusanli(ST36),and Shangxing(GV23),and the most frequently involved meridians were Bladder Meridian of Foot-Taiyang,Governor Vessel,and Gallbladder Meridian of Foot-Shaoyang.The compatible acupoints mainly distributed in the head and neck.The special points with the highest frequency of collocation were Five-Shu acupoints,confluent acupoints,and Back-Shu acupoints.In the cluster analysis,the icicle diagram showed 2 effective clusters and the dendrogram 4 clusters of acupoints.Conclusion The main treatment range of GV20 in ancient medical texts is wide,and the main treatment range can be enlarged by pairing,emphasizing the use of moxibustion,which can provide a reference for modern clinical treatment.

Objective To provide reference for the clinical use of Baihui acupoint(GV20)in treating diseases,the rules of clinical application of GV20 in ancient literature through data mining technology was analyzed.Methods"Zhong Hua Yi Dian"was searched by computer for relevant papers involving GV20 in the main treatment of illnesses,the main treatment of illnesses by combining other acupoints,and the treatment methods.After organizing the included articles into a database,Microsoft Excel 2021 was used to analyze the frequency of diseases and the use of acupoint pairing,attribution to meridians and special points,and IBM SPSS STATISTIC 27 software was used to analyze the cluster analysis of high-frequency compatible acupoints.Results Valid prescriptions from 209 medical books,including Zhen Jiu Da Cheng(The Great Compendium of Acupuncture and Moxibustion),containing 311 compatible acupoints,were screened and summarized.The main treatment conditions of GV20 mainly included internal medicine,surgery,gynecology,pediatrics and other disciplines,with the brain and liver and gallbladder systems of internal medicine as the main diseases.The top 5 frequency acupoints were Quchi(LI11),Hegu(LI4),Shenting(GV24),Zusanli(ST36),and Shangxing(GV23),and the most frequently involved meridians were Bladder Meridian of Foot-Taiyang,Governor Vessel,and Gallbladder Meridian of Foot-Shaoyang.The compatible acupoints mainly distributed in the head and neck.The special points with the highest frequency of collocation were Five-Shu acupoints,confluent acupoints,and Back-Shu acupoints.In the cluster analysis,the icicle diagram showed 2 effective clusters and the dendrogram 4 clusters of acupoints.Conclusion The main treatment range of GV20 in ancient medical texts is wide,and the main treatment range can be enlarged by pairing,emphasizing the use of moxibustion,which can provide a reference for modern clinical treatment.

Objective The present study was designed to explore the inhibitory effects of the ADC drug Disitamab Vedotin(RC-48)on breast cancer cells with different HER-2 expression levels by utilizing a tumor organoid culture system.Methods Within the framework of the tumor organoid culture system,the breast cancer cell lines MCF-7(characterized by low HER-2 expression,Luminal A subtype)and BT-474(exhibiting high HER-2 expression,HER-2 positive subtype)were cultured independently and in various mixed ratios.The histological characteristics,as well as the expression levels and distribution of HER-2 in MCF-7 and BT-474 organoids,were analyzed via immunohistochemistry and immunofluorescence techniques.MCF-7 and BT-474 organoids were separately treated with Vedotin(RC-48),Disitamab,and Monomethyl auristatin E(MMAE).Additionally,a drug sensitivity test of Disitamab Vedotin(RC-48)was carried out on mixed MCF-7 and BT-474 cell ratios and on patient-derived breast cancer organoids,with the assessment conducted using the 3D-Glo method.Results In the tumor organoid culture system,immunohistochemistry and immunofluorescence analyses demonstrated that HER-2 was predominantly localized in the cell membrane.Specifically,BT-474 organoids exhibited robust HER-2 expression,while MCF-7 organoids displayed relatively low expression levels.When compared with MCF-7 organoids,RC48-ADC exerted a more pronounced inhibitory effect on BT-474 organoids,with IC50 values of 109.7 μg/mL and 2.792 μg/mL,respectively.The co-culture model further confirmed the bystander effect of RC-48,revealing that the ratio of HER-2-positive to HER-2-negative cells significantly influenced drug efficacy.Additionally,treatment with RC-48 led to a reduction in HER-2 expression in breast cancer organoids with diverse HER-2 expression levels.Conclusions The tumor organoid model can accurately mirror drug sensitivity and bystander effects.Within this model,RC-48 effectively inhibited HER-2 highly-expressing breast cancer cells,augmented the killing effect through the bystander mechanism,and downregulated HER-2 expression,thereby suggesting its potential for targeting HER2-associated breast cancer.

Lactylation, a newly discovered post-translational modification, has been reported to be involved in various physiological and pathological processes. Recent studies have found that lactylation is potentially linked to the pathological processes and repair mechanisms of ischemic stroke. This article explores the impact and role of lactylation after the occurrence of ischemic stroke on neuroinflammation, energy metabolism regulation, oxidative stress, signaling pathway modulation, and angiogenesis. It may serve as a bridge connecting lactylation and ischemic stroke, offering insights and guidance for future research and clinical strategies in ischemic stroke.

Objective:To investigate the diagnostic value of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for biopsy-negative esophageal strictures suspected for malignancy.Methods:Patients who underwent EUS-FNA for esophageal strictures with negative endoscopic biopsies in Nanjing Drum Tower Hospital from January 2014 to March 2022 were analyzed retrospectively. The final diagnosis was based on the pathological outcomes of EUS-FNA or surgery, complemented by follow-up data. Diagnostic efficacy and complication rates of EUS-FNA were analyzed.Results:A total of 64 patients were included in this study,with 54 ultimately diagnosed with malignant lesions and 10 with benign lesions. Malignant lesions were diagnosed by EUS-FNA in 50 cases, suspected malignant lesions in 3 cases, and no clear basis for malignancy was observed in 11 cases. The diagnostic accuracy of EUS-FNA was 98.4% (63/64), with the malignant tumor detection rate of 98.1% (53/54). No post-procedure complications such as bleeding, perforation, or infection were observed in any patient.Conclusion:EUS-FNA is safe and effective for the diagnosis of biopsy-negative suspected malignant esophageal stricture with a high malignant lesion detection rate.

Objective:To examine the associations of pre-pregnancy body mass index (BMI), gestational weight gain, and gestational diabetes mellitus (GDM) with early childhood BMI trajectories.Methods:A total of 1 227 mother-child pairs from the Peking University Birth Cohort in Tongzhou were included in this study. In the cohort, maternal pre-pregnancy weight, height, gestational weight gain, and GDM diagnosis were collected. The children were followed up at birth and at 1, 3, 6, 9, 12, 18, 24, 30, and 36 months of age to obtain height/length and weight data. The longitudinal data-based k-means clustering algorithm was used to identify early childhood BMI trajectory groups. The associations of maternal pre-pregnancy BMI, gestational weight gain, and GDM with early childhood BMI trajectories were analyzed using the logistic regression model. We further explored whether there is an interaction effect between pre-pregnancy overweight/obesity and excessive gestational weight gain on the risk of the high BMI trajectory in early childhood through multiplicative and additive interaction analyses. Results:The prevalence rates of overweight and obesity before pregnancy were 21.2% (260 cases) and 6.6% (81 cases) respectively. The prevalence of excessive gestational weight gain and GDM was 57.7% (708 cases) and 30.9% (379 cases). The early childhood BMI trajectories were named low, medium, and high trajectories, accounting for 30.5%, 45.4% and 24.1%, respectively. After controlling potential confounding factors, it was found that pre-pregnancy overweight ( OR=1.54, 95% CI: 1.12-2.12), obesity ( OR=2.33, 95% CI: 1.41-3.85), and excessive gestational weight gain ( OR=1.47, 95% CI: 1.10-1.97) were risk factors for being in the high BMI trajectory in early childhood. GDM was not significantly associated with early childhood BMI trajectories ( P>0.05). Compared with the independent effects of pre-pregnancy overweight/obesity ( OR=1.90, 95% CI: 1.17-3.09) and excessive gestational weight gain ( OR=1.45, 95% CI: 1.03-2.04), the risk of being in the high BMI trajectory in early childhood was greater when the two factors coexisted ( OR=2.38, 95% CI: 1.60-3.54). However, both the multiplicative and additive models showed no interaction effect between pre-pregnancy overweight/obesity and excessive gestational weight gain. Conclusions:Maternal pre-pregnancy overweight/obesity and excessive gestational weight gain are independent risk factors for children being in the high BMI trajectory in early childhood, providing scientific evidence for obesity prevention.