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 Exploring the clinical efficacy of using autologous rib cartilage grafting to reconstruct finger hemiarticular defects.Methods From August 2022 to February 2024,for 6 patients with hemiarticular surface defects in the metacarpophalangeal joints and interphalangeal joints of 8 fingers,costal cartilage was used for joint remodeling and transplantation to reconstruct the hemiarticular surface defects of the fingers.All 8 joint transplants in 6 patients were two-stage surgeries.In the first stage,antibiotic bone cement was used to fill the space-occupying lesions,and in the second stage,costal cartilage joint remodeling was performed to reconstruct the finger joint defects.Postoperative follow-up and assessment of fracture healing according to Paley fracture healing scoring criteria.Outpatient and WeChat follow-up,upper limb function is evaluated according to the upper limb functional assessment standards of the Chinese Medical Association Hand Surgery Society.Record VAS pain score.Results In this group,there were a total of 6 patients with 8 cases of hemiarticular defects.Among them,2 patients had two joint surgical sites,while the remaining 4 patients had a single joint surgical site.There were 2 cases of metacarpophalangeal joint head defects,2 cases of proximal articular surface defects,3 cases of proximal articular head defects,and 1 case of thumb proximal articular head defect.After surgery,8 out of 6 patients'hand wounds healed successfully.All patients were followed up for 6-12 months postoperatively,with an average of 9 months.The VAS pain score(affected finger)for the last follow-up was 0-2 points,with an average of 0.6 points.According to Paley's scoring criteria,all 6 patients had excellent fracture healing.According to the evaluation criteria for upper limb functional assessment of the Chinese Medical Association Hand Surgery Society,3 cases were rated as excellent,3 cases were rated as good,and 2 cases were rated as fair.Conclusion For patients with half joint defects on one side of the finger,rib rib cartilage was used for joint reconstruction,which significantly improved the joint shape and function at the defect site,and reduced joint pain scores.

Objective:To observe the preventive and treatment effects of warming needle therapy on peripheral neuropathy after albumin-bound paclitaxel plus cisplatin chemotherapy.Methods:Eighty patients who received albumin-bound paclitaxel plus cisplatin chemotherapy after being diagnosed with cancer were divided into an observation group and a control group using the simple random allocation table method,with 40 cases in each group.The control group received methylcobalamin dispersible tablets via oral administration,and the observation group received warming needle therapy.They were observed for the incidence of chemotherapy-induced peripheral neuropathy(CIPN),Levi's specific sensory neurotoxicity grading,brief pain inventory(BPI)score,nerve conduction velocities of the limbs,and traditional Chinese medicine(TCM)symptom scores before treatment,at the 21st day of the first cycle of chemotherapy(D1),and the 21st day of the second chemotherapy cycle(D2).The clinical efficacy was assessed at D2.Results:The incidence of CIPN was 92.5%in the control group,higher than 75.0%in the observation group(P<0.05).At D2,the number of people graded 0 on Levi's specific sensory neurotoxicity grading was larger in the observation group than in the control group,and the number of those graded 2 was smaller in the observation group(P<0.05);the observation group had a higher markedly effective rate than the control group(P<0.05).At D2,the BPI general score,BPI pain intensity score,and BPI pain interference score significantly dropped in the observation group compared to those before treatment(P<0.05).At D1,the motor nerve conduction velocity(MNCV)and sensory nerve conduction velocity(SNCV)of the limbs decreased in both groups compared to those before treatment;at D2,the MNCV and SNCV increased in the two groups compared to D1 and were higher in the observation group than in the control group(P<0.05).At D1,the TCM symptom scores increased in both groups compared to those before treatment,and the observation group was lower than the control group in comparing the scores of numbness in the extremities and poor appetite(P<0.05).At D2,the observation group showed decreases in all TCM symptom scores compared to D1 except for the scores of nausea and vomiting and poor appetite(P<0.05),while the control group had no significant changes in the TCM symptom scores compared to D1(P>0.05);the observation group was lower than the control group in comparing each symptom score(P<0.05).There were no significant adverse reactions in either group over the study period.Conclusion:Compared to oral administration of methylcobalamin dispersible tablets,warming needle therapy shows certain strengths in managing CIPN after albumin-bound paclitaxel plus cisplatin chemotherapy,and it can better improve chemotherapy-induced gastrointestinal reactions.

Summarizing the nursing experience of nutritional support therapy during the perioperative period for a child with short bowel syndrome undergoing small intestine transplantation.Nursing key points:dynamic assessment of nutritional risk,development and timely adjustment of nutritional support programs;implementation of nutritional support strategies to promote growth and development;combination with exercise interventions to improve nutritional status;to strengthen the monitoring of rejection,to promote the recovery of intestinal function;to strengthen the continuity of care,and do a good job of nutritional monitoring and guidance.After 141 days of careful treatment and nursing care,the child was discharged successfully.

Objective:To observe the preventive and treatment effects of warming needle therapy on peripheral neuropathy after albumin-bound paclitaxel plus cisplatin chemotherapy.Methods:Eighty patients who received albumin-bound paclitaxel plus cisplatin chemotherapy after being diagnosed with cancer were divided into an observation group and a control group using the simple random allocation table method,with 40 cases in each group.The control group received methylcobalamin dispersible tablets via oral administration,and the observation group received warming needle therapy.They were observed for the incidence of chemotherapy-induced peripheral neuropathy(CIPN),Levi's specific sensory neurotoxicity grading,brief pain inventory(BPI)score,nerve conduction velocities of the limbs,and traditional Chinese medicine(TCM)symptom scores before treatment,at the 21st day of the first cycle of chemotherapy(D1),and the 21st day of the second chemotherapy cycle(D2).The clinical efficacy was assessed at D2.Results:The incidence of CIPN was 92.5%in the control group,higher than 75.0%in the observation group(P<0.05).At D2,the number of people graded 0 on Levi's specific sensory neurotoxicity grading was larger in the observation group than in the control group,and the number of those graded 2 was smaller in the observation group(P<0.05);the observation group had a higher markedly effective rate than the control group(P<0.05).At D2,the BPI general score,BPI pain intensity score,and BPI pain interference score significantly dropped in the observation group compared to those before treatment(P<0.05).At D1,the motor nerve conduction velocity(MNCV)and sensory nerve conduction velocity(SNCV)of the limbs decreased in both groups compared to those before treatment;at D2,the MNCV and SNCV increased in the two groups compared to D1 and were higher in the observation group than in the control group(P<0.05).At D1,the TCM symptom scores increased in both groups compared to those before treatment,and the observation group was lower than the control group in comparing the scores of numbness in the extremities and poor appetite(P<0.05).At D2,the observation group showed decreases in all TCM symptom scores compared to D1 except for the scores of nausea and vomiting and poor appetite(P<0.05),while the control group had no significant changes in the TCM symptom scores compared to D1(P>0.05);the observation group was lower than the control group in comparing each symptom score(P<0.05).There were no significant adverse reactions in either group over the study period.Conclusion:Compared to oral administration of methylcobalamin dispersible tablets,warming needle therapy shows certain strengths in managing CIPN after albumin-bound paclitaxel plus cisplatin chemotherapy,and it can better improve chemotherapy-induced gastrointestinal reactions.

Summarizing the nursing experience of nutritional support therapy during the perioperative period for a child with short bowel syndrome undergoing small intestine transplantation.Nursing key points:dynamic assessment of nutritional risk,development and timely adjustment of nutritional support programs;implementation of nutritional support strategies to promote growth and development;combination with exercise interventions to improve nutritional status;to strengthen the monitoring of rejection,to promote the recovery of intestinal function;to strengthen the continuity of care,and do a good job of nutritional monitoring and guidance.After 141 days of careful treatment and nursing care,the child was discharged successfully.

Objective To develop a Nomogram clinical prediction model for the pathological occurrence of extraprostatic extension(EPE)after radical prostatectomy in prostate cancer patients,using simplified site-specific magnetic resonance imaging(MRI)indicators and other clinical parameters.Methods A total of 181 prostate cancer patients[mean age(69.0±7.3)years]who underwent radical prostatectomy were included.These patients had received 3-Tesla multi-parametric magnetic resonance imaging(3-T mpMRI)within 6 months prior to surgery.Based on mpMRI measurements[capsular contact length(CCL)>15 mm,capsular bulging/irregularities,diameter of index lesion(dIL),and evident extraprostatic extension(eEPE)],the dIL?sEPE grading system was derived.The optimal cut-off value of dIL(denoted as dIL)was determined using the Youden J index,and categorized it into a binary variable.A Logistic regression model was established based on the dIL?sEPE grading and clinical scores.The predictive performance of clinical indicators,MRI indicators,and combined clinical and MRI indicators were compared.Finally,a clinical prediction model integrating both clinical and MRI data was developed.Results Pathological EPE was found in 46 out of 181 cases(25.4% ).A Nomogram prediction model for EPE was established with a combination of the dIL?sEPE grading and clinical indicators.Conclusion The combination of dIL?sEPE grading with clinical indicators accurately predicts extracapsular extension in prostate cancer.The Nomogram model that established,based on MRI imaging characteristics and clinical indicators has good performance and is easy to use.It is beneficial to stratifying management for prostate cancer patients,and it provides valuable guidance for patients suitable for nerve-sparing surgery.

Objective To observe the complication incidences after percutaneous lung biopsy and sealed the tract with different sealants.Methods A total of 129 patients with solitary pulmonary nodule who underwent CT-guided percutaneous lung biopsy were retrospectively included and divided into group A(n=37),B(n=47)and C(n=45).The biopsy tract was sealed with sealant A(1 g gelatin sponge particles mixed with 10 ml 50％glucose solution)in group A,with sealant B(1 g gelatin sponge particles mixed with 10 ml normal saline)in group B,while with sealant C(1 g gelatin sponge particles mixed with the coagulant enzyme from Bothrops atrox venom and 10 ml normal saline)in group C.The incidence rate of complications such as pneumothorax and hemoptysis were comparatively observed among groups.Binary logistic regression was performed to screen the independent influencing factors associated with complications of percutaneous lung biopsy.Results No significant difference of gender,age,proportion of smoking history nor emphysema,diameter of pulmonary nodules,depth of puncture into lung parenchyma nor times of puncture was found among groups(all P＞0.05).Complications occurred in 43 cases(43/129,33.33％),i.e.27 cases in group B(27/47,57.45％),11 cases in group A(11/37,29.73％)and 5 cases in group C(5/45,11.11％),and the complication rates decreased order of group B,A and C(all P＜0.05).Compared with sealant A,sealant B was associated with increased risk(OR[95％CI]=3.190[1.183,8.598],P=0.022),whereas sealant C was associated with reduced risk(OR[95％CI]=0.266[0.079,0.889],P=0.031)of complications.Conclusion After percutaneous lung biopsy,the complication incidences decreased sequentially when the needle tract was sealed with saline B,A and C.

Objective Electrocardiogram(ECG)signal quality degrades when the level of activity is high and motion artifacts are severe.Poor quality signals may result in false alarms,poor patient monitoring,imprecise measurement,and misleading diagnosis.The quantitative assessment of ECG signal quality forms the basis of automatic ECG noise reduction and heart disease diagnosis.Methods The ECG signal quality index(SQI)was obtained by statistically analyzing the heartbeat similarity and the slope character,respectively,namely rSQI and kSQI.Results Using MIT-BIH Noise Stress Test Database to test,both rSQI and kSQI decreased when the Signal Noise Ratio(SNR)decreased,which revealed the ECG signal quality.Based on the quasiperiodic property,the waveform similarity,as a beat-to-beat index,is obtained by cross correlation between two ECG cycles with high precision but heavy computation.Slope-based method dispenses with QRS detection and is very simple and real-time,but its sensitivity is lower than similarity-based method and it only get statistical data.Conclusion Both morphology similarity and slope character algorithms could provide objective estimation of ECG quality.Slope-based method is an attractive measure due to its simplicity and mathematical convenience,while similarity-based method is more accurate and robust for ECG quality assessment.

Objective To observe hierarchical differences in brain functional networks in unilateral mesial temporal lobe epilepsy(mTLE)patients with different outcomes after surgery.Methods A total of 69 unilateral mTLE patients who underwent resection of epileptogenic lesion on the affected side were retrospectively enrolled.Based on Engel classification 1 year after surgery,the patients were divided into seizure free(SF)group and non-seizure free(NSF)group.Functional connectivity gradient analysis was employed to extract principal gradient explaining the highest variance on preoperative resting-state functional MRI(rs-fMRI),then the whole-brain gradient characteristics and principal gradient values within specific functional networks were compared between groups.Results Principal gradient connected default mode network(DMN)with sensorimotor network(SMN)along a continuous axis.Compared to SF group,NSF group showed a contracted gradient range at both ends(DMN and SMN)of the functional network and weakened hierarchical differentiation,and principal gradient value of DMN was higher,while that of SMN was lower than those in SF group(both P＜0.05).Conclusion Hierarchical differences in brain functional networks in unilateral mTLE patients with different outcomes after surgery mainly present as enhanced DMN and weakened SMN in NSF ones,and the latter two might serve as important neuroimaging markers for evaluating postoperative seizure recurrence.