Abstract To systematically investigate the childhood obesogenic environment from environmental and institutional perspectives, the study reviews the historical evolution of the commercial determinants of health (CDoH) theory. Focusing on three dimensions—products, marketing, and the social environment, it characterizes the contemporary childhood obesogenic environment, summarizes and compares relevant international regulatory policies, and proposes future research priorities and practical policy directions. The study aims to provide a system based theoretical foundation and actionable policy pathways for childhood obesity prevention and control in China.

Benign and low-grade malignant tumors of the pancreatic head have distinct clinicopathological features and a relatively indolent biological behavior, leading to favorable prognoses and high surgical cure rates. When indicated, enucleation enables maximal preservation of pancreatic function with minimal trauma, demonstrating considerable clinical promise. This article focused on recent technical advances in enucleation for pancreatic head tumors and postoperative pancreatic fistula (POPF) prevention strategies, offering a systematic review of current concepts and clinical practices in the field. In the context of advancing precision surgery and minimally invasive techniques, enucleation—as a pancreatic function-preserving procedure—continues to present challenges in indication selection, intraoperative technique, and perioperative management. Covered topics included preoperative multimodal imaging and three-dimensional reconstruction for tumor localization, the application of intraoperative ultrasound and fluorescence navigation, comparison and selection of surgical approaches (such as anterior, posterior, and retroperitoneal laparoscopic routes), and the advantages and limitations of minimally invasive techniques including robotic and laparoscopic surgery. Proactive strategies for POPF prevention and management were also discussed. Finally, the importance of multidisciplinary collaboration and individualized decision-making was emphasized, with the goal of improving surgical safety, reducing complications, and enhancing patient prognosis.

Transarterial radioembolization (TARE) is a widely utilized therapeutic approach for hepatocellular carcinoma (HCC), however, the clinical implementation is constrained by the stringent preparation conditions of radioembolization agents. Herein, we incorporated the superstable homogeneous iodinated formulation technology (SHIFT), simultaneously utilizing an enhanced solvent form in a carbon dioxide supercritical fluid environment, to encapsulate radionuclides (such as ¹³¹I,¹⁷⁷Lu, or ¹⁸F) with lipiodol for the preparation of radiolipiodol. The resulting radiolipiodol exhibited exceptional stability and ultra-high labeling efficiency (≥99%) and displayed notable intratumoral radionuclide retention and in vivo stability more than 2 weeks following locoregional injection in subcutaneous tumors in mice and orthotopic liver tumors in rats and rabbits. Given these encouraging findings, ¹⁸F was authorized as a radiotracer in radiolipiodol for clinical trials in HCC patients, and showed a favorable tumor accumulation, with a tumor-to-liver uptake ratio of ≥50 and minimal radionuclide leakage, confirming the feasibility of SHIFT for TARE applications. In the context of transforming from preclinical to clinical screening, the preparation of radiolipiodol by SHIFT represents an innovative physical strategy for radionuclide encapsulation. Hence, this work offers a reliable and efficient approach for TARE in HCC, showing considerable promise for clinical application (ChiCTR2400087731).

Background::An evidence gap still exists regarding the efficacy and safety of tegoprazan in patients with erosive esophagitis (EE) in China. This study aimed to verify the efficacy and safety of tegoprazan vs. esomeprazole in patients with EE in China. Methods::This study was a multicenter, randomized, double-blind, parallel, active-controlled, non-inferiority phase III trial of patients with EE randomized 1:1 to tegoprazan 50 mg/day vs. esomeprazole 40 mg/day. This study was conducted in 32 sites between October 24, 2018 and October 18, 2019. The primary endpoint was the cumulative endoscopic healing rate at week 8. The secondary endpoint included endoscopic healing rate at week 4, changes in the reflux disease questionnaire (RDQ) and gastroesophageal reflux disease health-related quality of life (GERD-HRQL) scores, and symptom improvement. Results::A total of 261 patients were randomized: 132 to the tegoprazan group and 129 to the esomeprazole group. The cumulative endoscopic healing rate at 8 weeks in the tegoprazan group was non-inferior to that of the esomeprazole group (91.1% vs. 92.8%, difference: -1.7%, 95% confidence interval [CI]: -8.5%, 5.0%, P = 0.008). There were no statistically significant differences in the changes in RDQ (total, severity, and frequency) and GERD-HRQL scores between the two groups (all P >0.05). The percentages of days without symptoms, including daytime and nighttime symptoms based on patients' diaries, were similar between the two groups (all P >0.05). In the tegoprazan and esomeprazole groups, 71.5% (93/130) and 61.7% (79/128) of the participants reported adverse events (AEs), 2.3% and 0 experienced serious AEs, while 70.0% and 60.2% had treatment-emergent AEs, respectively. Conclusion::Tegoprazan 50 mg/day demonstrated non-inferior efficacy in healing EE, symptom improvement, and quality of life, and it has similar tolerability compared with esomeprazole 40 mg/day.

Background::An evidence gap still exists regarding the efficacy and safety of tegoprazan in patients with erosive esophagitis (EE) in China. This study aimed to verify the efficacy and safety of tegoprazan vs. esomeprazole in patients with EE in China. Methods::This study was a multicenter, randomized, double-blind, parallel, active-controlled, non-inferiority phase III trial of patients with EE randomized 1:1 to tegoprazan 50 mg/day vs. esomeprazole 40 mg/day. This study was conducted in 32 sites between October 24, 2018 and October 18, 2019. The primary endpoint was the cumulative endoscopic healing rate at week 8. The secondary endpoint included endoscopic healing rate at week 4, changes in the reflux disease questionnaire (RDQ) and gastroesophageal reflux disease health-related quality of life (GERD-HRQL) scores, and symptom improvement. Results::A total of 261 patients were randomized: 132 to the tegoprazan group and 129 to the esomeprazole group. The cumulative endoscopic healing rate at 8 weeks in the tegoprazan group was non-inferior to that of the esomeprazole group (91.1% vs. 92.8%, difference: -1.7%, 95% confidence interval [CI]: -8.5%, 5.0%, P = 0.008). There were no statistically significant differences in the changes in RDQ (total, severity, and frequency) and GERD-HRQL scores between the two groups (all P >0.05). The percentages of days without symptoms, including daytime and nighttime symptoms based on patients' diaries, were similar between the two groups (all P >0.05). In the tegoprazan and esomeprazole groups, 71.5% (93/130) and 61.7% (79/128) of the participants reported adverse events (AEs), 2.3% and 0 experienced serious AEs, while 70.0% and 60.2% had treatment-emergent AEs, respectively. Conclusion::Tegoprazan 50 mg/day demonstrated non-inferior efficacy in healing EE, symptom improvement, and quality of life, and it has similar tolerability compared with esomeprazole 40 mg/day.

Objective To explore the clinical application value of simple resection in the treatment of pancreatic solid pseudopapillary tumor(SPT).Methods Retrospective analysis of clinical and follow-up data of pancreatic SPT patients who underwent simple pancreatectomy and conventional pancreatectomy from January 2015 to December 2022 in the pancreatic cystic tumor database of Huashan Hospital,Fudan University.A total of 87 patients with pancreatic SPT,including 14 cases underwent simple resection and 73 cases underwent conventional resection,were included.The average age was(36.2±11.7)years old,and females accounting for 87.4％.Results The accuracy of preoperative imaging diagnosis reached 88.5％.Simple resection had a significant advantage over conventional resection in terms of surgical time[(138.3± 56.4)min vs.(241.2±89.2)min,P＜0.05].Simple resection was not inferior to conventional resection in terms of common postoperative complications.Out of 87 cases,only 3 patients in conventional resection group experienced postoperative recurrence and metastasis,and all recurrent patients were still alive.There was no statistically significant difference in postoperative pancreatic endocrine and exocrine dysfunction,and quality of life between simple resection group and conventional resection group.Conclusions Simple resection of pancreatic SPT is reasonable and feasible,but the risks in actual clinical work cannot be ignored.Therefore,selective simple resection of SPT has certain clinical application value.

Objective To explore the differences of brain regions and behaviors in cerebral ischemia mouse models caused by 3 suture-occluded models.Methods A total of 120 ICR mice were randomly divided into 4 groups:sham operation group,method A group(common carotid artery to internal carotid artery 8 mm),method B group(external carotid artery to internal carotid artery 10 mm),and method C group(common carotid artery to internal carotid artery 10 mm),with 30 mice in each group.After 1.5 h of cerebral ischemia and 24 of reperfusion,mice were stained with 2,3,5-triphenyltetrazolium chloride(TTC)to observe the site of cerebral ischemia and to calculate the area of ischemia.The neuromotor function of the mice was evaluated by the Longa score.The strength of the forelimb was measured by the grip test.The stamina of the mice was evaluated by the swimming test.The permeability of the blood-brain barrier was determined by the Evans blue staining.The cerebral edema was evaluated by the calculation of brain water content.Pathological changes of brain tissues were observed by hematoxylin-eosin(H-E)staining.Results TTC staining showed different sites and areas of cerebral infarcts caused by the 3 methods in mice.No significant difference was found in the infarct area between groups A and B(P>0.05),but the infarct area of method C was significantly different from that of groups A and B(all P<0.05).No infarct was detected in the sham operation group.The results of behavioral experiments of A,B,and C groups were significantly different from those of the sham operation group(all P<0.05).No significant difference was found in the Longa score between B and C groups(P>0.05),but the Longa score in A group was significantly different from that in B and C groups(both P<0.05).There was significant difference in the result of forelimb grip strength experiment between method A and C groups(P<0.05).No significant difference was found in the swimming time between B and C groups(P>0.05),but the swimming time in A group was significantly different from that in B and C groups(both P<0.05).The results of Evans blue staining,brain water content testing,and H-E staining revealed that cerebral ischemia caused by method C resulted in more severe brain damage in mice compared with methods A and B.Conclusion The 3 suture-occluded models can cause ischemia in different brain regions of cerebral ischemia mouse models,and ischemia in the cortex is more likely to cause motor dysfunction.

Objective:To develop a robotic digestive endoscope system (RDES) and to evaluate its feasibility, safety and control performance by experiments.Methods:The RDES was designed based on the master-slave control system, which consisted of 3 parts: the integrated endoscope, including a knob and button robotic control system integrated with a gastroscope; the robotic mechanical arm system, including the base and arm, as well as the endoscopic advance-retreat control device (force-feedback function was designed) and the endoscopic axial rotation control device; the control console, including a master manipulator and an image monitor. The operator sit far away from the endoscope and controlled the master manipulator to bend the end of the endoscope and to control advance, retract and rotation of the endoscope. The air supply, water supply, suction, figure fixing and motion scaling switching was realized by pressing buttons on the master manipulator. In the endoscopy experiments performed on live pigs, 5 physicians each were in the beginner and advanced groups. Each operator operated RDES and traditional endoscope (2 weeks interval) to perform porcine gastroscopy 6 times, comparing the examination time. In the experiment of endoscopic circle drawing on the inner wall of the simulated stomach model, each operator in the two groups operated RDES 1∶1 motion scaling, 5∶1 motion scaling and ordinary endoscope to complete endoscopic circle drawing 6 times, comparing the completion time, accuracy (i.e. trajectory deviation) and workload.Results:RDES was operated normally with good force feedback function. All porcine in vivo gastroscopies were successful, without mucosal injury, bleeding or perforation. In beginner and advanced groups, the examination time of both RDES and ordinary endoscopy tended to decrease as the number of operations increased, but the decrease in time was greater for operating RDES than for operating ordinary endoscope (beginner group P=0.033; advanced group P=0.023). In the beginner group, the operators operating RDES with 1∶1 motion scaling or 5∶1 motion scaling to complete endoscopic circle drawing had shorter completion time [1.68 (1.40, 2.17) min, 1.73 (1.47, 2.37) min VS 4.13 (2.27, 5.16) min, H=32.506, P<0.001], better trajectory deviation (0.50±0.11 mm, 0.46±0.11 mm VS 0.82±0.26 mm, F=38.999, P<0.001], and less workload [42.00 (30.00, 50.33) points, 43.33 (35.33, 54.00) points VS 52.67 (48.67, 63.33) points, H=20.056, P<0.001] than operating ordinary endoscope. In the advanced group, the operators operating RDES with 1∶1 or 5∶1 motion scaling to complete endoscopic circle drawing had longer completion time than operating ordinary endoscope [1.72 (1.37, 2.53) min, 1.57 (1.25, 2.58) min VS 1.15 (0.86, 1.58) min, H=13.233, P=0.001], but trajectory deviation [0.47 (0.13, 0.57) mm, 0.44 (0.39, 0.58) mm VS 0.52 (0.42, 0.59) mm, H=3.202, P=0.202] and workload (44.62±21.77 points, 41.24±12.57 points VS 44.71±17.92 points, F=0.369, P=0.693) were not different from those of the ordinary endoscope. Conclusion:The RDES enables remote control, greatly reducing the endoscopists' workload. Additionally, it gives full play to the cooperative motion function of the large and small endoscopic knobs, making the control more flexible. Finally, it increases motion scaling switching function to make the control of endoscope more flexible and more accurate. It is also easy for beginners to learn and master, and can shorten the training period. So it can provide the possibility of remote endoscopic control and fully automated robotic endoscope.

In the era of informatization, virtual teaching labs have emerged as a pivotal exploration in the construction of new teaching organizations at the primary level. Virtual labs of teaching research and reform require faculty members to collaboratively conduct teaching reform research and practice, thereby fostering new paradigms and achievements for teaching reforms. It serves as a vital foundation for supporting comprehensive reforms in curriculum teaching and specialty construction. This paper delves into the logical framework of virtual teaching research and reform labs from four dimensions (value orientation, construction principles, organizational structure, and operational safeguards), and elaborates on lab construction pathways from four aspects (technological platforms, behavioral relationships, knowledge management, and spiritual culture). Taking virtual teaching labs for medical education as an example, the paper summarizes practical experience in the innovative exploration of reform-oriented virtual teaching labs. Finally, we discuss the most constraining factors in the current construction of virtual teaching labs, and propose that research on virtual teaching labs should pay more attention to solving practical problems in major and curriculum reforms to promote the integration of medical education and practice, ultimately contributing to the realization of the Healthy China initiative.

Objective This study aims to discuss the research hotspot and development trend in the field of polycystic ovary syndrome(PCOS)through bibliometric statistics and visual analysis of long noncoding RNA(lncRNA)related studies.Methods Utilizing the Web of Science core database as the literature data source,we searched for PCOS lncRNA-related literature from 2015 to 2023.CiteSpace software was used to conduct a visual analysis,including the annual distribution,citation trends,countries,institutions,funding sources and key words,as well as co-occurrence and cluster analysis of key words.Results The visual analysis of 108 PCOS lncRNA literature revealed that China was the country with the highest number of publications.The first contributing institution was the Shandong University.The national natural science fund of China gave the biggest funding.The keyword cluster analysis suggested that PCOS lncRNA signal pathway regulation,related receptor activators,and the expression of regulatory factors were the research hotspots in ovary syndrome lncRNA research.Conclusion LncRNA related regulatory factors,bioinformatics analysis,and gene transcription in PCOS are new targetsfor PCOS treatment,providing valuable insights for clinical therapy and new strategies for the development of PCOS-related pharmaceuticals.