Neuroendocrine carcinoma (NEC) represents a category of malignant tumors originating from neuroendocrine cells. Given that NEC cells exhibit characteristics of both neural and endocrine cells, they can hijack neuronal signaling pathways and dynamically regulate the expression of neuronal lineage markers during tumor metastasis, thereby constructing a microenvironment conducive to tumor growth and metastasis. Conversely, alterations in the tumor microenvironment can enhance the interactions between neurons and tumor cells, ultimately synergistically promoting the metastasis of NEC. This review highlights recent advancements in the field of cancer neuroscience, uncovering neuronal lineage markers in NEC that facilitate tumor dissemination through mediating crosstalk, bidirectional communication, and synergistic interactions between tumor cells and the nervous system. Consequently, the latest findings in tumor neuroscience have enriched our understanding of the biological mechanisms underlying tumor metastasis, opening new research avenues for a deeper comprehension of the complex biological processes involved in tumor metastasis, particularly brain metastasis. This review provides a comprehensive review of the crosstalk between tumor cells and neural signaling in the metastasis of NEC.
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Humans ; Carcinoma, Neuroendocrine/metabolism* ; Signal Transduction ; Animals ; Neoplasm Metastasis ; Neurons/pathology* ; Tumor Microenvironment ; Cell Communication

Objective To summarize the experience in carotid endarterectomy(CEA)for the treatment of carotid artery stenosis,in order to decrease postoperative complications and enhance clinical efficacy.Methods The clinical data of 64 cases receiving surgical treatment for carotid artery stenosis from January 2022 to December 2024 were analyzed retrospectively.Clinical data including age,gender,condition of underlying diseases,degree of carotid artery stenosis,degree of coronary artery stenosis,cerebral blood flow before operation,characteristics of carotid plaques before operation,usage of antiplatelet drugs during perioperative period,usage of carotid shunt during operation,intraoperative carotid artery occlusion time,operation time,postoperative complications and follow-up results were collected.Results All 64 patients underwent CEA successfully.Among them,14 cases underwent shunt during operation,48 cases received single antiplatelet therapy during perioperative period and 16 cases received dual antiplatelet therapy.The median operation time was 161.50(138.00,186.50)min,the clamping time was(28.42±10.72)min.The incidence of postoperative complications included 1 case of incisional infection(1.56%),1 case of incisional hematoma(1.56%),1 case of internal carotid artery occlusion(1.56%),1 case of cerebral hypoperfusion(1.56%).There were no cerebral infarction,no cerebral hyperperfusion,no cardiac events and no brain nerve injury.There was no one case of postoperative complications in the patients who underwent shunt during operation.All patients were followed up for 3～38 months.Among them,there were 2 cases of stroke and there was no death during the fellow-up period.The clamping time was significantly shorter in shunting group than in non-shunting group[(18.43±6.64)min vs.(31.22±9.98)min,P<0.05)],there were no significant differences in remaining clinical data between two groups(P>0.05).The degree of carotid artery stenosis was more severe in the dual antiplatelet group than in the single antiplatelet group[on operation side(χ2=-2.377,P<0.05),on contralaternal side(χ2=-2.261,P<0.05)],there were no significant differences in remaining clinical data between two groups(P>0.05).Conclusions CEA is an effective treatment for carotid artery stenosis,shunting during CEA is safe.Meticulous perioperative management and operative procedures could help to reduce the rate of postoperative complications.

Breast cancer-related lymphedema(BCRL)is a common and severe complication of axillary lymph node dissection,with its patho-genesis closely linked to the disruption of axillary lymphatic drainage.This article systematically reviews the preventive strategies for BCRL(de-escalation of axillary surgery,non-surgical interventions,and prophylactic microsurgical techniques),along with treatment modalities(non-surgical complex decongestive therapy,lymphatic reconstruction surgery,and debulking procedures).Current clinical controversies and future research directions have also been discussed,by integrating the latest evidence-based medical data,to provide a reference for stand-ardized BCRL management.

Objective To explore the dosimetric influence of tetrahydrocurcumin(THC),a metabolite derived from the Chi-nese herbal compound curcumin,on the antitumor Hormesis effect observed in breast cancer.Methods Human breast cancer MCF-7 and mouse breast cancer 4T1 cell lines were exposed to THC of various concentrations.Cellular responses were evalua-ted through a series of assays,including cell viability assessments,cell cycle phase distribution analysis,measurement of intracel-lular reactive oxygen species(ROS)levels,wound healing migration assays,and invasion assays.Results In comparison to the untreated control group,low concentrations of THC(4,8 μmol/L)exhibited a stimulatory effect on the proliferative activity of both MCF-7 and 4T1 cells.Conversely,the proliferative capacity of MCF-7 cells was significantly suppressed under higher con-centrations of THC(16,32 μmol/L).The accumulation of cells in the G0/G1 phase reduced and the number of cells in the S and G2/M phases increased for both cell lines under low doses of THC(2,4,8 μmol/L).However,G0/G1 phase cells were increased in MCF-7 cells under high doses of THC(16 μmol/L and 32 μmol/L),and this effect showed a concentration-dependent manner.Additionally,as the THC dose escalated,ROS levels in both MCF-7 and 4T1 cells increased.Following treatment with a low dose of THC(4 μmol/L),the migratory and invasive capabilities of both cell lines were enhanced.In contrast,the migration and invasion of both cell lines were inhibited in a dose-dependent manner after high doses THC treatment(16 μmol/L and 32 μmol/L).Conclusion The effects of THC on breast cancer cells demonstrate a pronounced concentration-dependent pat-tern.Lower concentrations of THC may exhibit pro-growth and pro-metastatic properties,whereas higher concentrations of THC inhibits cell proliferation,migration,and invasion,and induces cell cycle arrest.

Objective To construct large medical model named by "Huaxi HongYi"and explore its application effectiveness in assisting medical record generation. Methods By the way of a full-chain medical large model construction paradigm of "data annotation - model training - scenario incubation", through strategies such as multimodal data fusion, domain adaptation training, and localization of hardware adaptation, "Huaxi HongYi" with 72 billion parameters was constructed. Combined with technologies such as speech recognition, knowledge graphs, and reinforcement learning, an application system for assisting in the generation of medical records was developed. Results Taking the assisted generation of discharge records as an example, in the pilot department, after using the application system, the average completion times of writing a medical records shortened (21 min vs. 5 min) with efficiency increased by 3.2 time, the accuracy rate of the model output reached 92.4%. Conclusion It is feasible for medical institutions to build independently controllable medical large models and incubate various applications based on these models, providing a reference pathway for artificial intelligence development in similar institutions.

Objective To summarize the experience in carotid endarterectomy(CEA)for the treatment of carotid artery stenosis,in order to decrease postoperative complications and enhance clinical efficacy.Methods The clinical data of 64 cases receiving surgical treatment for carotid artery stenosis from January 2022 to December 2024 were analyzed retrospectively.Clinical data including age,gender,condition of underlying diseases,degree of carotid artery stenosis,degree of coronary artery stenosis,cerebral blood flow before operation,characteristics of carotid plaques before operation,usage of antiplatelet drugs during perioperative period,usage of carotid shunt during operation,intraoperative carotid artery occlusion time,operation time,postoperative complications and follow-up results were collected.Results All 64 patients underwent CEA successfully.Among them,14 cases underwent shunt during operation,48 cases received single antiplatelet therapy during perioperative period and 16 cases received dual antiplatelet therapy.The median operation time was 161.50(138.00,186.50)min,the clamping time was(28.42±10.72)min.The incidence of postoperative complications included 1 case of incisional infection(1.56%),1 case of incisional hematoma(1.56%),1 case of internal carotid artery occlusion(1.56%),1 case of cerebral hypoperfusion(1.56%).There were no cerebral infarction,no cerebral hyperperfusion,no cardiac events and no brain nerve injury.There was no one case of postoperative complications in the patients who underwent shunt during operation.All patients were followed up for 3～38 months.Among them,there were 2 cases of stroke and there was no death during the fellow-up period.The clamping time was significantly shorter in shunting group than in non-shunting group[(18.43±6.64)min vs.(31.22±9.98)min,P<0.05)],there were no significant differences in remaining clinical data between two groups(P>0.05).The degree of carotid artery stenosis was more severe in the dual antiplatelet group than in the single antiplatelet group[on operation side(χ2=-2.377,P<0.05),on contralaternal side(χ2=-2.261,P<0.05)],there were no significant differences in remaining clinical data between two groups(P>0.05).Conclusions CEA is an effective treatment for carotid artery stenosis,shunting during CEA is safe.Meticulous perioperative management and operative procedures could help to reduce the rate of postoperative complications.

Objective To explore the dosimetric influence of tetrahydrocurcumin(THC),a metabolite derived from the Chi-nese herbal compound curcumin,on the antitumor Hormesis effect observed in breast cancer.Methods Human breast cancer MCF-7 and mouse breast cancer 4T1 cell lines were exposed to THC of various concentrations.Cellular responses were evalua-ted through a series of assays,including cell viability assessments,cell cycle phase distribution analysis,measurement of intracel-lular reactive oxygen species(ROS)levels,wound healing migration assays,and invasion assays.Results In comparison to the untreated control group,low concentrations of THC(4,8 μmol/L)exhibited a stimulatory effect on the proliferative activity of both MCF-7 and 4T1 cells.Conversely,the proliferative capacity of MCF-7 cells was significantly suppressed under higher con-centrations of THC(16,32 μmol/L).The accumulation of cells in the G0/G1 phase reduced and the number of cells in the S and G2/M phases increased for both cell lines under low doses of THC(2,4,8 μmol/L).However,G0/G1 phase cells were increased in MCF-7 cells under high doses of THC(16 μmol/L and 32 μmol/L),and this effect showed a concentration-dependent manner.Additionally,as the THC dose escalated,ROS levels in both MCF-7 and 4T1 cells increased.Following treatment with a low dose of THC(4 μmol/L),the migratory and invasive capabilities of both cell lines were enhanced.In contrast,the migration and invasion of both cell lines were inhibited in a dose-dependent manner after high doses THC treatment(16 μmol/L and 32 μmol/L).Conclusion The effects of THC on breast cancer cells demonstrate a pronounced concentration-dependent pat-tern.Lower concentrations of THC may exhibit pro-growth and pro-metastatic properties,whereas higher concentrations of THC inhibits cell proliferation,migration,and invasion,and induces cell cycle arrest.

Breast cancer-related lymphedema(BCRL)is a common and severe complication of axillary lymph node dissection,with its patho-genesis closely linked to the disruption of axillary lymphatic drainage.This article systematically reviews the preventive strategies for BCRL(de-escalation of axillary surgery,non-surgical interventions,and prophylactic microsurgical techniques),along with treatment modalities(non-surgical complex decongestive therapy,lymphatic reconstruction surgery,and debulking procedures).Current clinical controversies and future research directions have also been discussed,by integrating the latest evidence-based medical data,to provide a reference for stand-ardized BCRL management.

BACKGROUND: Limited data are available on the comparison of clinical outcomes of complete vs. incomplete percutaneous coronary intervention (PCI) for patients with chronic total occlusion (CTO) and multi-vessel disease (MVD). The study aimed to compare their clinical outcomes. METHODS: A total of 558 patients with CTO and MVD were divided into the optimal medical treatment (OMT) group ( n = 86), incomplete PCI group ( n = 327), and complete PCI group ( n = 145). Propensity score matching (PSM) was performed between the complete and incomplete PCI groups as sensitivity analysis. The primary outcome was defined as the occurrence of major adverse cardiovascular events (MACEs), and unstable angina was defined as the secondary outcome. RESULTS: At a median follow-up of 21 months, there were statistical differences among the OMT, incomplete PCI, and complete PCI groups in the rates of MACEs (43.0% [37/86] vs. 30.6% [100/327] vs. 20.0% [29/145], respectively, P = 0.016) and unstable angina (24.4% [21/86] vs. 19.3% [63/327] vs. 10.3% [15/145], respectively, P = 0.010). Complete PCI was associated with lower MACE compared with OMT (adjusted hazard ratio [HR] = 2.00; 95% confidence interval [CI] = 1.23-3.27; P = 0.005) or incomplete PCI (adjusted HR = 1.58; 95% CI = 1.04-2.39; P = 0.031). Sensitivity analysis of PSM showed similar results to the above on the rates of MACEs between complete PCI and incomplete PCI groups (20.5% [25/122] vs. 32.6% [62/190], respectively; adjusted HR = 0.55; 95% CI = 0.32-0.96; P = 0.035) and unstable angina (10.7% [13/122] vs. 20.5% [39/190], respectively; adjusted HR = 0.48; 95% CI = 0.24-0.99; P = 0.046). CONCLUSIONS For treatment of CTO and MVD, complete PCI reduced the long-term risk of MACEs and unstable angina, as compared with incomplete PCI and OMT. Complete PCI in both CTO and non-CTO lesions can potentially improve the prognosis of patients with CTO and MVD.
Humans ; Treatment Outcome ; Percutaneous Coronary Intervention/methods* ; Coronary Occlusion/surgery* ; Prognosis ; Angina, Unstable/surgery* ; Chronic Disease ; Risk Factors

Objective:To analyze the curative effect of the modified sinus tarsi small incision and minimally invasive internal fixation in the treatment of Sander Ⅱand Ⅲ calcaneal fractures and its influence on inflammatory factors and immune function.Methods:From February 2018 to February 2020, 116 patients with Sander Ⅱand Ⅲ calcaneal fractures admitted to the First People′s Hospital of Linping District, Hangzhou City were prospectively selected and randomly divided into the control group and the observation group according to the digital table method. There were 58 cases in each group, the control group was treated with traditional lateral L-shaped incision internal fixation, and the observation group was treated with modified tarsal sinus small incision internal fixation and minimally invasive treatment. The clinical indicators, incision healing, postoperative complications, Bohler angle, Gissane angle, interleukin(IL)-1β, IL-6 , IL-22 and immunoglobulin (IgA, IgG, IgM) before and after surgery were compared between the two groups. The function of the hind foot and ankle were evaluated by American Foot and Ankle Society Ankle and Hindfoot Function Score (AOFAS) before and 6 months after surgery.Results:The operation time, intraoperative blood loss, hospital stay and fracture healing time in the observation group were lower than those in the control group: (61.08 ± 15.17) min vs. (85.82 ± 13.50) min, (27.51 ± 2.64) ml vs. (82.53 ± 3.81) ml, (7.14 ± 1.18) d vs. (10.76 ± 1.50) d, (46.44 ± 8.16) d vs.(52.28 ± 10.40) d, there were statistical differences ( P<0.05). The Bohler angle in the observation group at 3 months after the operation was greater than that in the control group: (26.46 ± 3.64)° vs. (24.55 ± 3.86)°; and Gissane angle was smaller than that in the control group: (113.73 ± 6.56)° vs. (117.09 ± 7.16)°, there were statistical differences ( P<0.05). The grade A healing rate in the observation group was higher than that in the control group: 89.66%(52/58) vs. 32.76%(19/58), χ2 = 39.54, P<0.05. The incidence of complications in the observation group was lower than that in the control group: 3.45%(2/58) vs. 20.69%(12/58), χ2 = 8.12, P<0.05. The levels of IL-1β, IL-6 and IL-22 in the observation group at 3 months after operation were lower than those in the control group, the levels of IgA, IgG and IgM in the observation group at 3 months after operation were higher than those in the control group, there were statistical differences ( P<0.05). Conclusions:The modified tarsal sinus small incision internal fixation and minimally invasive surgery have better curative effect in the treatment of Sander Ⅱ and Ⅲ calcaneal fractures. The function of the hind foot and ankle is restored.