OBJECTIVE:Disorders in iron metabolism increase the risk of type 2 diabetes mellitus.Hepcidin play an important role in maintaining iron homeostasis in the body,but its level increases with increased inflammation.Changes in hepcidin and iron homeostasis and the extent of their association with inflammation in people with and without type 2 diabetes mellitus are unknown.Meta-analysis was used to evaluate the effect of inflammation on serum hepcidin and iron metabolism related parameters in patients with type 2 diabetes mellitus.METHODS:CNKI,PubMed,Web of Science and EBSCOhost databases were searched by computer to collect observational studies related to inflammatory index and hepcidin in patients with type 2 diabetes mellitus.The search time was from September 1,2000 to September 30,2024.Three researchers independently screened the literature,extracted data and evaluated the quality of the included literature.Meta-analysis was performed by Review Manager 5.3,Stata 17.0 and GraphPad Prism 8.0.2 software.RESULTS:A total of 15 articles(17 studies)involving 3 159 participants,including 1 357 patients with type 2 diabetes mellitus,were included.Meta-analysis results showed that compared with the control group,patients with type 2 diabetes mellitus had higher levels of serum hepcidin[standardized mean difference(SMD)=0.35,95％confidence interval(CI)(0.05,0.65),P＜0.05],serum ferritin(SMD=0.49,95％CI(0.21,0.78),P＜0.01)and serum transferrin(SMD=0.19,95％CI(0.00,0.37),P＜0.05).Subgroup analysis results indicated that inflammation had a significant effect on serum hepcidin(SMD=0.76,95％CI(0.17,1.34),P＜0.05)and serum ferritin(SMD=0.77,95％CI(0.06,1.47),P＜0.05)in patients with type 2 diabetes mellitus.CONCLUSION:Hepcidin concentration is positively correlated with type 2 diabetes mellitus.Inflammation is one of the risk factors of type 2 diabetes mellitus.Early prevention of inflammation has certain significance in preventing iron metabolism disorder in patients with type 2 diabetes mellitus.

OBJECTIVE:Disorders in iron metabolism increase the risk of type 2 diabetes mellitus.Hepcidin play an important role in maintaining iron homeostasis in the body,but its level increases with increased inflammation.Changes in hepcidin and iron homeostasis and the extent of their association with inflammation in people with and without type 2 diabetes mellitus are unknown.Meta-analysis was used to evaluate the effect of inflammation on serum hepcidin and iron metabolism related parameters in patients with type 2 diabetes mellitus.METHODS:CNKI,PubMed,Web of Science and EBSCOhost databases were searched by computer to collect observational studies related to inflammatory index and hepcidin in patients with type 2 diabetes mellitus.The search time was from September 1,2000 to September 30,2024.Three researchers independently screened the literature,extracted data and evaluated the quality of the included literature.Meta-analysis was performed by Review Manager 5.3,Stata 17.0 and GraphPad Prism 8.0.2 software.RESULTS:A total of 15 articles(17 studies)involving 3 159 participants,including 1 357 patients with type 2 diabetes mellitus,were included.Meta-analysis results showed that compared with the control group,patients with type 2 diabetes mellitus had higher levels of serum hepcidin[standardized mean difference(SMD)=0.35,95％confidence interval(CI)(0.05,0.65),P＜0.05],serum ferritin(SMD=0.49,95％CI(0.21,0.78),P＜0.01)and serum transferrin(SMD=0.19,95％CI(0.00,0.37),P＜0.05).Subgroup analysis results indicated that inflammation had a significant effect on serum hepcidin(SMD=0.76,95％CI(0.17,1.34),P＜0.05)and serum ferritin(SMD=0.77,95％CI(0.06,1.47),P＜0.05)in patients with type 2 diabetes mellitus.CONCLUSION:Hepcidin concentration is positively correlated with type 2 diabetes mellitus.Inflammation is one of the risk factors of type 2 diabetes mellitus.Early prevention of inflammation has certain significance in preventing iron metabolism disorder in patients with type 2 diabetes mellitus.

With the continuous deepening of the concept of precision diagnosis and treatment for lung cancer, how to achieve higher efficiency and accuracy in the screening, diagnosis, and treatment pathways in clinical practice has become an important issue that urgently needs to be overcome. The current clinical difficulty lies in the fact that despite continuous advancements in imaging and molecular diagnostic technologies, there are still limitations in manual efficiency and subjective experience when it comes to massive data analysis and multi-scale feature extraction. Artificial intelligence (AI), especially algorithm systems based on deep learning, is an innovative technology capable of deeply empowering medical big data. This method utilizes algorithms such as convolutional neural networks, combined with radiomics, pathomics, and multi-modal data fusion analysis, demonstrating immense potential in early precise detection and benign-malignant differentiation of pulmonary nodules, digital pathological subtype recognition and non-invasive prediction of driver genes, precise 3D surgical planning and automatic delineation of radiotherapy target volumes, as well as dynamic risk warning during follow-up. This innovative technology provides a brand-new solution for realizing intelligent and individualized lung cancer diagnosis and treatment models. This consensus, based on the latest evidence from evidence-based medicine and combined with the development trends in the AI field and real-world clinical needs, was ultimately formed by gathering the consensus opinions of multidisciplinary experts in radiology, pathology, thoracic surgery, and other fields. The main content covers the application specifications of AI in the three core scenarios of lung cancer screening, diagnosis, and treatment, the technical standards for data collection and algorithm validation, as well as the ethical and regulatory challenges faced at the current stage. It aims to clarify the applicable boundaries of AI as a clinical auxiliary decision support tool, providing scientific guidance and standardized exploration directions for peers currently engaged in or planning to carry out AI-assisted clinical diagnosis, treatment, and translation of lung cancer.

The incidence of adenocarcinoma of the esophagogastric junction (AEG) continues to rise globally, with surgical resection representing the primary curative approach. Due to the complex anatomy and heterogeneous metastatic pathways of AEG, lymphadenectomy has become a critical focus in modern surgical oncology. However, traditional TNM staging and Siewert classification exhibit limitations in precisely guiding the optimal extent of lymphadenectomy. Consequently, this review integrated emerging evidence from membrane anatomy theory - a field experiencing breakthrough advances - to systematically explore lymphadenectomy strategies for AEG. Specifically, we analyzed the application of membrane anatomy principles to delineate lymphadenectomy strategies, dissection scope, and key surgical techniques tailored to each Siewert subtype (I, II, III) and varying degrees of esophageal involvement. Based on membrane anatomy, the review proposed specific, anatomically guided lymph node dissection strategies. Furthermore, we evaluated the feasibility, standardization, and clinical significance of membrane anatomy-guided dissection strategies considering recent advances, while also addressing current challenges and future directions for development and validation. Membrane anatomy is anticipated to serve as a novel and essential anatomical foundation for optimizing surgical approaches. Its application thus may hold significant promise for optimizing surgical pathways, enhancing the quality and precision of lymph node dissection, and ultimately improving oncological outcomes.

Objective: : The objective of this study was to assess the relationship between spermine synthase (SMS) expression, tumor occurrence, and prognosis in lower-grade gliomas (LGGs). Methods: : A total of 523 LGG patients and 1152 normal brain tissues were included as controls. Mann-Whitney U test was performed to evaluate SMS expression in the LGG group. Functional annotation analysis was conducted to explore the biological processes associated with high SMS expression. Immune cell infiltration analysis was performed to examine the correlation between SMS expression and immune cell types. The association between SMS expression and clinical and pathological features was assessed using Spearman correlation analysis. In vitro experiments were conducted to investigate the effects of overexpressing or downregulating SMS on cell proliferation, apoptosis, migration, invasion, and key proteins in the protein kinase B (AKT)/epithelialmesenchymal transition signaling pathway. Results: : The study revealed a significant upregulation of SMS expression in LGGs compared to normal brain tissues. High SMS expression was associated with certain clinical and pathological features, including older age, astrocytoma, higher World Health Organization grade, poor disease-specific survival, disease progression, non-1p/19q codeletion, and wild-type isocitrate dehydrogenase. Cox regression analysis identified SMS as a risk factor for overall survival. Bioinformatics analysis showed enrichment of eosinophils, T cells, and macrophages in LGG samples, while proportions of dendritic (DC) cells, plasmacytoid DC (pDC) cells, and CD8+ T cells were decreased. Conclusion : High SMS expression in LGGs may promote tumor occurrence through cellular proliferation and modulation of immune cell infiltration. These findings suggest the prognostic value of SMS in predicting clinical outcomes for LGG patients.

Objective To develop a gas chromatography-tandem mass spectrometry(GC-MS/MS)method for the simultaneous determination of ephedrine and pseudoephedrine in urine.Methods Urine samples containing ephedrine and pseudoephedrine components were extracted with ethyl acetate,centrifuged to collect the supernatant and evaporated to dryness under a nitrogen stream and then derivatized with heptafluorobutyric anhydride 60 μL at 70 ℃ for 30 min,and re-evaporated under nitrogen,and then solubilized with 50 μL of methanol,and then analyzed by GC-MS/MS.Results The method demonstraed excellent linearity for ephedrine(0.05～10 μg/mL,r=0.999 8)and pseudoephedrine(0.02～5 μg/mL,r=0.999 5).Extraction recoveries ranged from 89.4％～95.8％(ephedrine)and 90.3％～93.8％(pseudoephedrine).Limits of detection and quantification of ephedrine and pseudoephedrine were 0.005 μg/mL and 0.01 μg/mL,the intra-day precision and accuracy were less than 5.87％and 9.56％,respectively,and the inter-day precision and accuracy were less than 7.54％and 9.27％,respectively.The stability of ephedrine and pseudoephedrine in urine in 15 d was good under the conditions of room temperature and-20 ℃.Conclusion The GC-MS/MS analytical method for the analysis of ephedrine and pseudoephedrine components in urine established in this study is accurate,stable and sensitive,which can provide data technical support for the forensic toxicological analysis of amphetamine-type drugs or new psychoactive substances in the cathinone group.

Objective To explore the efficacy and safety of side-to-side anastomosis(SS)and end-to-side anastomosis(ES)of the ileocolon in laparoscopic right hemicolectomy of colon cancer,so as to provide evidence-based evidence for surgical selection.Methods PubMed,Embase,Web of Science,Cochrane Library,China National Knowledge Infrastructure,Wanfang Data,VIP database,Chinese BioMedical Literature database were searched from inception to November 2024 to collect relevant clinical studies of SS versus ES.The Newcastle-Ottawa Scale(NOS)was used to evaluate the literature quality of retrospective studies,and the Cochrane system was used to evaluate the literature quality of randomized controlled trials(RCT).Rev Man 5.3 software was used for Meta-analysis,sensitivity analysis,and publication bias analysis.Results 9 retrospective studies and 4 RCTs with a total of 2 632 patients were included.The Meta-analysis results of the retrospective study show that:Compared with SS,ES has a shorter tolerance time for liquid diet(MD=-0.20,95%CI:-0.40～0.00,P<0.05),fewer daily episodes of diarrhea(MD=-1.06,95%CI:-1.79～0.23,P<0.05),but a higher pain score at 12 hours post-surgery(MD=0.95,95%CI:0.50～1.40,P<0.05).Comparison of the overall complication rates of the two anastomosis methods showed no statistically significant difference((OR)=1.05,95%CI:0.22～5.14,P>0.05).Sensitivity analysis of the retrospective study shows:the incidence of ES bowel obstruction was higher than that of SS,with a statistically significant difference((OR)=2.18,95%CI:1.15～4.14,P<0.05);The sensitivity analysis of the RCT shows:the overall incidence of complications at the anastomotic site of SS was significantly higher than that of ES,with a statistically significant difference((OR)=5.26,95%CI:1.91～14.48,P<0.05),and the results of other outcome indicators did not show reversal.The analysis of publication bias risk showed no significant publication bias.Conclusion Ileocolonic ES has a slight advantage over SS in laparoscopic right hemicolectomy of colon cancer,both anastomoses are safe and effective,and the surgeon can choose the appropriate anastomosis technique according to the patient's specific situation,in order to improve the postoperative recovery.

Objective:To analyze the anatomical characteristics and surgical management measures of acute Stanford type A aortic dissection (AAD) involving coronary arteries, and to preliminarily explore the clinical efficacy of different coronary artery treatment techniques.Methods:A retrospective analysis was conducted on the clinical data of 42 patients who underwent surgery for AAD involving coronary arteries in Hunan Provincial People′s Hospital from January 2022 to May 2025. They were divided into the MI group (14 cases) and the nMI group (28 cases) according to whether they had acute myocardial infarction before surgery. The clinical data such as the actual surgical methods and mortality in the two groups were summarized.Results:Among 294 surgeries, 42 cases (14.3%) had definite coronary artery involvement, including 14 cases in the MI group and 28 cases in the nMI group; 1 case had bilateral coronary artery involvement and 41 cases had right coronary artery involvement. Regarding injury types: 16 cases were of the coronary trunk compression type, 12 cases were of the sinus intimal tear neal to ostium type, and 14 cases were of the coronary trunk intimal type. There was no statistically significant difference in the types of coronary artery involvement between the two groups ( P>0.05). There were 18 cases of Sun′s procedure with preserved aortic sinus and aortic valve, 7 cases of Bentall procedure without bypass, and 17 cases of Bentall procedure plus bypass. There was no statistically significant difference in the surgical plans between the two groups ( P>0.05). There were 4 deaths within 30 days (2 cases in each group). Conclusions:AAD involving coronary arteries is a critical condition, and accurate diagnosis is somewhat difficult. Myocardial ischemia is not significantly associated with the type of coronary artery involvement. The surgical plan depends on the type of coronary artery involvement. The classification method in this study is conducive to selecting appropriate surgical methods and improving surgical prognosis.

Objective To test the hypothesis that backward crawling and forward crawling share similar inter-joint coordination patterns,thus providing potential evidence for the application of backward crawling in rehabilitation training.Methods The acceleration signals in the X,Y,and Z directions for 9 joints(including bilateral wrists,elbows,shoulders,knees,and hips)in 9 volunteers during forward and backward crawling were collected using a custom signal acquisition system,and the pressure signals were also recorded when the palms contacted the ground.The collected acceleration signals were preprocessed,segmented into cycles,and vectorized.Based on the pressure signals,a single crawling cycle was divided into support phase and swing phase.In addition,principal component analysis was applied to extract inter-joint coordination in limbs at various scales(sagittal,coronal,and transverse planes).Pearson correlation coefficients of inter-joint coordination patterns were compared between forward and backward crawling in support period,swing period,and full cycle.Results The correlation coefficients for coordination patterns in the full cycle at the transverse plane scale were 0.813 5(PC1)and 0.837 5(PC2),and the correlation coefficient of the support period PC2 was 0.901 8.At the sagittal plane scale,the correlation coefficient of the support period PC1 was 0.948 5.Conclusion The study provides preliminary evidence that limb motion coordination patterns during backward crawling are similar to those observed during forward crawling.Future research will further explore the effects of backward crawling on functional rehabilitation in individuals with motor impairments.

Gastric cancer has relatively high disease burden worldwide. With the advancement of endoscopic technology and increased public health awareness, the detection rate of early gastric cancer has gradually risen globally. Conventional total or distal gastrectomy frequently results in postoperative complications, including malnutrition and digestive disorders, which can significantly impair the patient's quality of life. Function-preserving gastrectomy (FPG), which aims to minimize the extent of resection and preserve the functional anatomy of the stomach while ensuring radical removal of the tumor, has shown significant advantages in improving postoperative quality of life. This review summarizes the indications for various FPG techniques and the challenges currently faced, emphasizing the necessity of cautious promotion of FPG to improve treatment outcomes and the quality of life for patients with gastric cancer.