Gastrointestinal (GI) cancers are prevalent globally, with leading incidence and mortality rates among malignant tumors. Despite notable advancements in surgical resection, radiotherapy, and chemotherapy, the overall survival rates remain low. Hence, it is imperative to explore alternative approaches that enhance patient outcomes. Cluster of differentiation 47 (CD47), serving as an early diagnostic marker, is predominantly overexpressed in GI cancers and associated with poor prognosis. Targeting the CD47-signal regulatory protein alpha (SIRPα) signaling pathway may provide a novel strategy for GI cancers treatment. This study summarizes current knowledge of the structure and function of CD47 and SIRPα, their roles in signaling pathways, the prognostic significance of CD47, therapeutic strategies targeting the CD47-SIRPα signaling pathway in GI cancer, and highlights key issues for future investigations.

Gastrointestinal(GI)cancers are prevalent globally,with leading incidence and mortality rates among malignant tumors.Despite notable advancements in surgical resection,radiotherapy,and chemotherapy,the overall survival rates remain low.Hence,it is imperative to explore alternative approaches that enhance patient outcomes.Cluster of differentiation 47(CD47),serving as an early diagnostic marker,is predominantly overexpressed in GI cancers and associated with poor prognosis.Targeting the CD47-signal regulatory protein alpha(SIRPα)signaling pathway may provide a novel strategy for GI cancers treatment This study summarizes current knowledge of the structure and function of CD47 and SIRPα,their roles in signaling pathways,the prognostic significance of CD47,therapeutic strategies targeting the CD47-SIRPα signaling pathway in GI cancer,and highlights key issues for future investigations.

Objective:To investigate the application value of Bama miniature pig model in endoscopic retrograde cholangiopancreatography (ERCP) training.Methods:The experimental study was conducted. Six Bama miniature pigs were selected to establish animal model for ERCP operation. The experimental equipments were the EP-6000 image processing system and ED-580T therapeutic duodenoscopy, and the surgery was performed by two experienced chief physicians. Observation indicators: (1) surgical operation status; (2) preoperative and postoperative physiological and biochemical indicators of experimental animals; (3) experimental endpoint indicators. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were expressed as absolute numbers. Results:(1) Surgical operation status. During the operation, the time required for the duodenoscope to pass from the esophageal inlet to the pylorus of the six experimental animals was 151(range, 46-227)seconds, the insertion length of the endoscope at the pylorus was 85(range, 80-90)cm, and the straightened length of the endoscope shaft was 47(range, 45-50)cm. For bile duct cannulation, the total number of cannulation attempts was 2.0(range, 1.0-3.0), the number of successful cannulation was 1.5(range, 1.0-2.0), and the time of successful cannulation was 44(range, 13-80)seconds. For pancreatic duct cannulation, the total number of cannulation attempts was 3.0(range, 1.0-8.0), and only one successful intubation was performed for each experimental animal, with the time of successful cannulation as 100(range, 53-320)seconds. (2) Preoperative and postoperative physiological and biochemical indicators of experimental animals. For six experimental animals, the preoperative body temperature was (38.8±0.1)℃, serum amylase was (55.3±0.2)U/dL, serum lipase was 232.9(range, 29.4-547.3)U/L, alanine aminotransferase was (51±10)U/L, aspartate aminotransferase was (38±12)U/L, and total bilirubin was (3.2±0.7)μmol/L. At 24 hours postoperatively, the body temperature was (38.6±0.1)℃, serum amylase was (53.0±6.0)U/dL, serum lipase was 62.4(range, 29.4-94.1)U/L, alanine amino-transferase was (54±5)U/L, aspartate aminotransferase was (67±27)U/L, and total bilirubin was (3.5±1.9)μmol/L. (3) Experimental endpoint indicators. At the experimental endpoint of 14 days after surgery, the bile duct length in the six experimental animals was (8.6±1.2)cm, and the bile duct inner diameter was (2.5±0.5)mm. The pancreatic duct length was 12.9(range, 3.7-20.8)cm, and the inner diameter was (1.6±0.2)mm. Results of histopathological examination revealed that both CD3 and CD68 staining were negative in the bile duct and surrounding hepatic tissue, as well as in the pancreatic duct and adjacent pancreatic tissue at the experimental endpoint of 14 days after surgery.Conclusion:Bama miniature pig model can be used for ERCP training.

Objective:To investigate the application value of Bama miniature pig model in endoscopic retrograde cholangiopancreatography (ERCP) training.Methods:The experimental study was conducted. Six Bama miniature pigs were selected to establish animal model for ERCP operation. The experimental equipments were the EP-6000 image processing system and ED-580T therapeutic duodenoscopy, and the surgery was performed by two experienced chief physicians. Observation indicators: (1) surgical operation status; (2) preoperative and postoperative physiological and biochemical indicators of experimental animals; (3) experimental endpoint indicators. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were expressed as absolute numbers. Results:(1) Surgical operation status. During the operation, the time required for the duodenoscope to pass from the esophageal inlet to the pylorus of the six experimental animals was 151(range, 46-227)seconds, the insertion length of the endoscope at the pylorus was 85(range, 80-90)cm, and the straightened length of the endoscope shaft was 47(range, 45-50)cm. For bile duct cannulation, the total number of cannulation attempts was 2.0(range, 1.0-3.0), the number of successful cannulation was 1.5(range, 1.0-2.0), and the time of successful cannulation was 44(range, 13-80)seconds. For pancreatic duct cannulation, the total number of cannulation attempts was 3.0(range, 1.0-8.0), and only one successful intubation was performed for each experimental animal, with the time of successful cannulation as 100(range, 53-320)seconds. (2) Preoperative and postoperative physiological and biochemical indicators of experimental animals. For six experimental animals, the preoperative body temperature was (38.8±0.1)℃, serum amylase was (55.3±0.2)U/dL, serum lipase was 232.9(range, 29.4-547.3)U/L, alanine aminotransferase was (51±10)U/L, aspartate aminotransferase was (38±12)U/L, and total bilirubin was (3.2±0.7)μmol/L. At 24 hours postoperatively, the body temperature was (38.6±0.1)℃, serum amylase was (53.0±6.0)U/dL, serum lipase was 62.4(range, 29.4-94.1)U/L, alanine amino-transferase was (54±5)U/L, aspartate aminotransferase was (67±27)U/L, and total bilirubin was (3.5±1.9)μmol/L. (3) Experimental endpoint indicators. At the experimental endpoint of 14 days after surgery, the bile duct length in the six experimental animals was (8.6±1.2)cm, and the bile duct inner diameter was (2.5±0.5)mm. The pancreatic duct length was 12.9(range, 3.7-20.8)cm, and the inner diameter was (1.6±0.2)mm. Results of histopathological examination revealed that both CD3 and CD68 staining were negative in the bile duct and surrounding hepatic tissue, as well as in the pancreatic duct and adjacent pancreatic tissue at the experimental endpoint of 14 days after surgery.Conclusion:Bama miniature pig model can be used for ERCP training.

Objective To investigate the effect of whole-course empowerment health intervention on the psychological resilience and self-care ability of older patients with severe pneumonia.Methods A total of 210 older patients with severe pneumonia admitted to Sichuan Provincial People's Hospital between January 2020 and December 2023 were enrolled.The patients were sequentially numbered according to the order of admission.Then,they were assigned to a conventional care group(105 cases)and a whole-course empowerment group(105 cases)by a 1∶1 ratio using a random number table.The conventional care group received conventional clinical intervention,while the whole-course empowerment group received the whole-course empowerment health intervention regimen in addition to the intervention administered in the conventional care group.Psychological resilience was assessed with the Connor-Davidson Resilience Scale(CD-RISC),self-care ability with Exercise of Self-Care Agency Scale(ESCA),and quality of life with the World Health Organization Quality of Life Brief Version(WHOQOL-BREF).The evaluation results obtained before and after the interventions were compared.Results After intervention,the scores for all dimensions of CD-RISC in the whole-course empowerment group were higher than those in the conventional care group(t=10.326,P＜0.001;t=6.386,P＜0.001;t=9.581,P＜0.001).The scores for all dimensions of ESCA after intervention were higher in whole-course empowerment group than those in the conventional care group(t=1 1.599,P＜0.001;t=9.072,P＜0.001;t=4.353,P＜0.001;t=16.646,P＜0.001).After intervention,the scores for all dimensions of WHOQOL-BREF in the whole-course empowerment group were higher than those in the conventional care group(t=9.164,P＜0.001;t=13.809,P＜0.001;t=5.001,P＜0.001;t=6.695,P＜0.001).Conclusion Whole-course empowerment health intervention significantly enhances psychological resilience,self-care capacity,and quality of life in older patients with severe pneumonia.

Objective To understand the current status and trends of research on the TCM treatment for stable phase of chronic obstructive pulmonary disease(COPD);To provide references for relevant research.Methods Literature about TCM treatment for stable phase of COPD was retrieved from China National Knowledge Infrastructure,Wanfang Data,VIP Information Chinese Journal Service Platform,and SinoMed from the establishment of the databases to Sep 1,2022.NoteExpress 3.4 was used to sort out the basic data of papers.Excel 2016 was employed to count first authors,syndrome type,prescription and draw a run chart of publication,determine the number of journals in the core area according to Bradford law.Core authors statistically were analyzed according to Price law.Author collaboration network and keyword co-occurrence analysis were conducted using VOSviewer 1.6.18.CiteSpace 5.3.R4 was exploited to construct institutional collaboration network and study burst terms,and knowledge map was drawn.Results A total of 3 360 articles were included,involving 445 journals,with 2 691 first authors.The overall number of publications in this field showed an increasing trend,with clinical research being the main research type.There were 21 journals in the core region and the most frequently published journal was New Chinese Medicine.There were 125 core authors,with Li Zhuying and Li Jiansheng posting the most articles.Author collaboration network analysis showed 10 major research teams and the largest of which was Li Jiansheng's team.There were 1 451 institutions,mainly were universities and affiliated hospitals.There were 62 types of syndromes in the stable phase of COPD,the most common of which was the syndrome of qi deficiency of lung and spleen.There were 541 kinds of prescriptions in total,and the most commonly used was Bufei Decoction.Keyword co-occurrence analysis showed 8 subjects,and the high-frequency keywords included lung function,clinical efficacy,quality of life,clinical observation and TCM treatment.22 burst terms were obtained,with Budesonide Fumotro,six-word songs,Yupingfeng Powder and inflammatory factors highly concerned at present.Conclusion The research fever of TCM treatment for COPD in stable period shows an increasing trend,and clinical research accounts for the largest proportion,but the general quality is not high,and basic research is relatively lacking.The research focuses on the inhibition of airway inflammation and immune regulation,and lung function and quality of life are the most commonly used evaluation indicators.

[Objective]To investigate the depression status and its influencing factors in HIV/AIDS patients receiving antiviral therapy.[Methods]From July 2022 to September 2022,successive sampling method was used to recruit HIV/AIDS patients receiving antiviral therapy from antiviral treatment institutions in Nanjing,and they were instructed to fill out anonymous questionnaires.The questionnaire collected the basic information of patients,and depression,HIV stigma score and social support level were investigated by Patient Health Questionnaire-9(PHQ-9),Berger HIV stigma scale(BHSS)and Multidimensional Scale of Perceived Social Support(MSPSS).Multivariate Logistic regression was used to an-alyze the influencing factors of depression.[Results]A total of 1879 valid questionnaires were collected in this study,and the detection rate of depression was 50.1%.The results of multivariate logistic analysis showed that compared with patients with middle school or below,the risk of depression was lower for those with postgraduate or above[OR=0.534,95%CI(0.341,0.835),P=0.006].Compared with antiviral therapy duration<1 year,antiviral therapy duration for 1 to 5 years[OR=0.729,95%CI(0.536,0.991)],>5 to 10 years[OR=0.516,95%CI(0.379,0.702)],>10 years[OR=0.603,95%CI(0.375,0.969)]was associated with a lower risk of depression.High level of social support was a protective factor for depression in HIV/AIDS patients compared with middle and low level of social support[OR=0.430,95%CI(0.349,0.530),P<0.001].There was a higher risk of depression with side effects than without side effects[OR=2.260,95%CI(1.833,2.786),P<0.001].The higher the score on the HIV stigma scale,the higher the possibility of depression was.[Conclusion]The detection rate of depression of patients receiving antiviral therapy in Nanjing is high.After starting antivi-ral therapy,we should strengthen the monitoring of side effects and psychological status of patients,carry out psychologi-cal intervention,alleviate psychological problems,and improve the quality of life of patients receiving antiviral therapy.

Parkinson′s disease (PD) is a neurodegenerative disorder, and the abnormal levels of its pathological marker ɑ-synuclein (ɑ-syn) are often accompanied by imbalanced heavy metal homeostasis. However, the underlying mechanisms remain unclear, with limited research. This review explores the interactions between iron, copper, zinc, and manganese with pathological ɑ-syn′s abnormal expression, aggregation, and degradation in development and progression of PD. It also discusses potential therapeutic directions for addressing heavy metal imbalances in PD patients.

Objective To observe the effect of Jinshui Liujun decoction on airway lesions in mice with COPD and explore its possible mechanism.Methods 48 C57BL/6 mice were randomly divided into blank group,model group,Jinshui Liujun decoction group and NAC group,with 12 in each group.The COPD mouse model was established by intranasal drip of LPS and smoking,and the corresponding drugs were given intragastric administration for 14 days after the model was established.Observe the general condition of the mice,measure the MV,PEF and PIF of the mice with the small animal lung function instrument,semi quantitatively evaluate the inflammation of the lung tissue,the thickness of the alveolar septum and the thickness of the airway wall with HE staining,and observe the airway mucus secretion and goblet cell proliferation with PAS staining.The content of MPO,SA and Urea in BALF was detected by the kit,and the ratio of SA and Urea was calculated.The content of MUC5AC in BALF was detected by ELISA.The levels of ROS,GSH,GSSG and GR in lung tissue were detected with the kit,and the ratio of GSH and GSSG was calculated.The expression level of CFTR mRNA in lung tissue was detected by qRT-PCR.Western blot was used to detect the expression level of CFTR protein in lung tissue.Results Compared with the control group,the growth of mice in the model group was poor.The body weight at each time point during the modeling period decreased(P<0.01),and the indexes of MV,PEF and PIF decreased(P<0.01).The lung tissue pathological score,alveolar septal thickness,airway wall thickness,airway mucus and goblet cell increased(P<0.01).The levels of SA,SA/Urea,MUC5AC and MPO in BALF increased(P<0.01),and the level of Urea decreased(P<0.01),The levels of ROS and GSSG in lung tissue increased(P<0.01),and the levels of GSH,GSH/GSSG,and GR decreased(P<0.01).The expression levels of CFTR mRNA and protein in lung tissue decreased(P<0.01).Compared with the model group,the growth condition of COPD mice improved,the body weight increased at each time point during the modeling period(P<0.05,P<0.01),the indexes of MV,PEF and PIF improved significantly(P<0.01),the pathological score of lung tissue,the thickness of alveolar septa,the thickness of airway wall,airway mucus and goblet cell decreased(P<0.01,P<0.05),and the levels of SA,SA/Urea,MUC5AC and MPO in BALF decreased(P<0.01),And an increase in Urea levels(P<0.01),a decrease in ROS and GSSG levels in lung tissue(P<0.01),and an increase in GSH,GSH/GSSG,and GR levels(P<0.01).The expression levels of CFTR mRNA and protein in lung tissue increased(P<0.01).Conclusion Jinshui Liujun decoction can correct CFTR acquired defects through antioxidant effects to improve airway lesions in COPD.

Objective To observe the value of CT radiomics nomogram for predicting Ki-67 expression of thymus epithelial tumors.Methods Totally 163 patients with thymus epithelial tumor,including 114 patients in training set and 49 patients in validation set were retrospectively enrolled.The patients were further divided into low expression(＜50％)and high expression(≥50％)subgroups according to Ki-67 index.Multivariate logistic regression analysis was performed to screen independent predicting factors of Ki-67 expression in thymus epithelial tumors,and clinical-CT model was constructed.The optimal radiomics features were extracted and screened based on chest plain and venous phase enhanced CT images,respectively.Then radiomics modelplain and radiomics modelenhanced were constructed,and Radscoreplain and Radscoreenhanced were calculated,respectively.The nomogram model was constructed based on clinical-CT model,Radscoreplain and Radscoreenhanced.Receiver operating characteristic curves were drawn,and the area under the curves(AUC)were calculated to evaluate the efficacy of each model for predicting Ki-67 expression of thymus epithelial tumors.Results Patient's gender and enhanced CT value of lesion were both independent predicting factors of Ki-67 expression in thymus epithelial tumors(both P＜0.05).The AUC of clinical-CT model,radiomics modelplain,radiomics modelenhanced and nomogram model for predicting Ki-67 expression was 0.736,0.814,0.836 and 0.857 in training set,which was 0.746,0.746,0.750 and 0.799 in validation set,respectively.Conclusion CT radiomics nomogram could be used to predict Ki-6 7 expression of thymus epithelial tumors.