[摘 要] 目的：探究包被蛋白复合体β1亚基（COPB1）在食管鳞状细胞癌（ESCC）中的表达，及其对ESCC细胞恶性生物学行为的影响、作用机制及临床意义。方法：采用2014～2018年间在河北医科大学第四医院生物样本库中82例ESCC组织及癌旁组织，常规培养正常食管鳞状上皮细胞HEEC和食管癌细胞KYSE-150、KYSE-170、Eca109、TE1、KYSE-30、KYSE-450，用转染试剂将pcDNA3.1-vector（空载体）、pcDNA3.1-COPB1载体，si-NC和si-COPB1转染至KYSE-150、TE1细胞中，记为NC、COPB1-OE、si-NC和si-COPB1组。用数据库数据分析COPB1 mRNA在泛癌组织中的表达及其表达与免疫细胞浸润的关系，qPCR法检测ESCC组织和细胞中COPB1、PIK3CB、CD68、CD163、CD206、ARG1、IL-10 mRNA水平表达情况，WB法检测ESCC组织和各组细胞中的COPB1、PI3K、CD68、CD163、CD206、p-AKT蛋白表达，克隆形成实验和MTS实验检测各组细胞的增殖能力，划痕愈合实验和Transwell实验检测各组细胞的迁移和侵袭能力，免疫组织化学染色（IHC）法检测ESCC组织中COPB1和CD206蛋白表达。以人单核细胞白血病细胞（THP-1）构建巨噬细胞模型，用佛波酯（PMA）和IL-3和IL-4和ESCC细胞上清液诱导巨噬细胞转型，用qPCR和WB法检测CD68和CD206m RNA和蛋白的表达。结果：COPB1在泛癌组织和ESCC组织中均呈高表达且与淋巴结转移和TNM分期有关联（均P < 0.01），COPB1高表达的ESCC患者总生存期短（P < 0.05），COPB1是潜在的ESCC的诊断标志物。COPB1在KYSE-150和TE1细胞中也呈高表达（均P < 0.05），过表达或敲减COPB1可明显抑制或促进KYSE-150和TE1细胞的增殖能力、迁移和侵袭能力（均P < 0.05）。COPB1表达变化诱导的差异表达基因主要富集于PI3K/AKT通路（均P < 0.001）, COPB1可促进PI3K/AKT通路的活化（P < 0.05），COPB1高表达可导致M2型巨噬细胞浸润增加（P < 0.05），COPB1高表达促进TAM/M2极化（P < 0.05）。结论：COPB1在ESCC组织中呈高表达，其可激活PI3K/AKT通路及调控肿瘤免疫微环境促进 ESCC发生发展，COPB1有望成为ESCC诊断和预后的生物标志物及治疗靶点。

Objective:To investigate the correlation between whether the left colonic artery(LCA) is preserved intraoperatively and the incidence of severe low anterior resection syndrome(LARS) in patients with rectal cancer.Methods:Clinical data of 255 rectal cancer patients undergoing low anterior resection from Jan 2020 to Jan 2022 at the First Affiliated Hospital of Xi'an Jiaotong University were retrospectively analysed, and the occurrence of LARS in patients with or without preserving the LCA was compared.Results:The LARS scores and severity in patients with intact LCA were better than those without preserved LCA at 12 months postoperatively ( P=0.017, 0.002). Bowel function at 6 months versus 12 months postoperatively in both groups was mainly reflected in a reduction in the number of bowel movements per day ( P=0.003, 0.001) as well as a reduction in re-voiding of the bowel within 1 hour after defecation ( P<0.001, P=0.001). Univariate and multivariate analyses showed that the distance of the lower edge of the tumour from the anal verge was ≤6 cm ( OR=2.530, 95% CI:1.307-4.900, P=0.006), preoperative neoadjuvant therapy ( OR=13.968, 95% CI: 4.969-39.260, P<0.001), prophylactic stoma ( OR=4.051, 95% CI: 2.042-8.040, P<0.001) were also independent risk factors for severe LARS after anterior resection of rectal cancer, and preservation of the left colonic artery ( OR=0.283, 95% CI: 0.142-0.563, P<0.001) was a protective factor against severe LARS after low anterior resection in rectal cancer patients. Conclusions:Intraoperative preservation of the LCA reduces the incidence and severity of postoperative LARS in patients with rectal cancer undergoing anterior resection. The distance of the lower edge of thetumour from the anal verge and prophylactic stoma are independent risk factors affecting the occurrence of severe LARS after anterior resection of rectal cancer.

OBJECTIVE: To evaluate early effectiveness of posterior 180-degree decompression via unilateral biportal endoscopy (UBE) in the treatment of lumbar spinal stenosis (LSS) combined with Michigan State University (MSU)-1 lumbar disc herniation (LDH). METHODS: A retrospective analysis was conducted on clinical data from 33 patients with LSS combined with MSU-1 LDH, who met selection criteria and were treated between March 2022 and January 2024. All patients underwent UBE-assisted 180-degree spinal canal decompression. The cohort comprised 17 males and 16 females, aged 37-82 years (mean, 67.1 years). Preoperative presentations included bilateral lower limbs intermittent claudication and radiating pain, with disease duration ranging from 5 to 13 months (mean, 8.5 months). Affected segments included L _{3, 4} in 4 cases, L _{4, 5} in 28 cases, and L ₅, S ₁ in 1 case. LSS was rated as Schizas grade A in 4 cases, grade B in 5 cases, grade C in 13 cases, and grade D in 11 cases. LDH was categorized as MSU-1A in 24 cases, MSU-1B in 2 cases, and MSU-1AB in 7 cases. Intraoperative parameters (operation time, blood loss) and postoperative hospitalization length were recorded. The visual analogue scale (VAS) score and Oswestry Disability Index (ODI) were used to assess the lower limb pain and functional outcomes after operation. Clinical efficacy was evaluated at last follow-up via modified MacNab criteria. Quantitative radiological assessments included dural sac cross-sectional area (DSCA) measurements and spinal stenosis grading on lumbar MRI. Morphological classification of lumbar canal stenosis was determined according to the Schizas grading, categorized into four grades. RESULTS: The operation time was 60.4-90.8 minutes (mean, 80.3 minutes) and intraoperative blood loss was 13-47 mL (mean, 29.9 mL). The postoperative hospitalization length was 3-5 days (mean, 3.8 days). All patients were followed up 12-16 months (mean, 13.8 months). The VAS score and ODI improved at immediate and 3, 6, and 12 months after operation compared to before operation, and the differences between different time points were significant ( P<0.05). At last follow-up, the clinical efficacy assessed by the modified MacNab criteria were graded as excellent in 23 cases, good in 9 cases, and poor in 1 case, with an excellent and good rate of 96.97%. Postoperative lumbar MRI revealed the significant decompression of the dural sac in 32 cases, with 1 case showing inadequate dural expansion. DSCA measurements confirmed progressive enlargement and stenosis reduction over time. The differences were significant ( P<0.05) before operation, immediately after operation, and at 6 months after operation. At 6 months after operation, Schizas grading of spinal stenosis improved to grade A in 27 cases and grade B in 6 cases. CONCLUSION Posterior 180-degree decompression via UBE is a safe and feasible strategy for treating LSS combined with MSU-1 LDH, achieving effective neural decompression while preserving intervertebral disc integrity.
Humans ; Spinal Stenosis/diagnostic imaging* ; Male ; Female ; Aged ; Lumbar Vertebrae/surgery* ; Middle Aged ; Intervertebral Disc Displacement/complications* ; Decompression, Surgical/methods* ; Retrospective Studies ; Endoscopy/methods* ; Adult ; Aged, 80 and over ; Treatment Outcome

As the global population ages and cancer diagnostic and treatment technologies improve, the number of elderly cancer survivors continues to increase, and their complex care needs challenge the traditional mono-disciplinary care model. This paper explores the dilemmas of implementing a long-term care system and suggestions for future research through a comprehensive overview of the care needs of elderly cancer survivors and the progress of interdisciplinary research, with the aim of providing a theoretical basis and practical reference for improving the long-term care system and enhancing patients' quality of life.

As the global population ages and cancer diagnostic and treatment technologies improve, the number of elderly cancer survivors continues to increase, and their complex care needs challenge the traditional mono-disciplinary care model. This paper explores the dilemmas of implementing a long-term care system and suggestions for future research through a comprehensive overview of the care needs of elderly cancer survivors and the progress of interdisciplinary research, with the aim of providing a theoretical basis and practical reference for improving the long-term care system and enhancing patients' quality of life.

Objective:To investigate the correlation between whether the left colonic artery(LCA) is preserved intraoperatively and the incidence of severe low anterior resection syndrome(LARS) in patients with rectal cancer.Methods:Clinical data of 255 rectal cancer patients undergoing low anterior resection from Jan 2020 to Jan 2022 at the First Affiliated Hospital of Xi'an Jiaotong University were retrospectively analysed, and the occurrence of LARS in patients with or without preserving the LCA was compared.Results:The LARS scores and severity in patients with intact LCA were better than those without preserved LCA at 12 months postoperatively ( P=0.017, 0.002). Bowel function at 6 months versus 12 months postoperatively in both groups was mainly reflected in a reduction in the number of bowel movements per day ( P=0.003, 0.001) as well as a reduction in re-voiding of the bowel within 1 hour after defecation ( P<0.001, P=0.001). Univariate and multivariate analyses showed that the distance of the lower edge of the tumour from the anal verge was ≤6 cm ( OR=2.530, 95% CI:1.307-4.900, P=0.006), preoperative neoadjuvant therapy ( OR=13.968, 95% CI: 4.969-39.260, P<0.001), prophylactic stoma ( OR=4.051, 95% CI: 2.042-8.040, P<0.001) were also independent risk factors for severe LARS after anterior resection of rectal cancer, and preservation of the left colonic artery ( OR=0.283, 95% CI: 0.142-0.563, P<0.001) was a protective factor against severe LARS after low anterior resection in rectal cancer patients. Conclusions:Intraoperative preservation of the LCA reduces the incidence and severity of postoperative LARS in patients with rectal cancer undergoing anterior resection. The distance of the lower edge of thetumour from the anal verge and prophylactic stoma are independent risk factors affecting the occurrence of severe LARS after anterior resection of rectal cancer.

Objective To investigate the efficiency and cost-effectiveness of multi-station drug dispensing robots.Methods The study selected 4 pharmacists with comparable experience and skills,and 3 commonly used medications from our hospital's pharmacy intravenous admixture service.A crossover design was employed to compare the manual and robotic dispensing efficiency.Cost-effectiveness analysis was conducted for the economic evaluation,comparing the costs,benefits,and net profits of both dispensing modes,and sensitivity analysis was performed on the evaluation results.Results The dispensing efficiency,cost and net profits of the robotic dispensing were significantly higher than manual dispensing(P＜0.001).Sensitivity analysis results revealed that even after adjusting labor and material costs,the net profit of robotic dispensing was still significantly higher than that of manual dispensing(P＜0.001),indicating strong robustness.Conclusion Compared to manual dispensing,multi-station drug dispensing robots exhibit significant advantages in dispensing efficiency and cost-effectiveness,showing broad clinical application prospects.

Objective To investigate the efficiency and cost-effectiveness of multi-station drug dispensing robots.Methods The study selected 4 pharmacists with comparable experience and skills,and 3 commonly used medications from our hospital's pharmacy intravenous admixture service.A crossover design was employed to compare the manual and robotic dispensing efficiency.Cost-effectiveness analysis was conducted for the economic evaluation,comparing the costs,benefits,and net profits of both dispensing modes,and sensitivity analysis was performed on the evaluation results.Results The dispensing efficiency,cost and net profits of the robotic dispensing were significantly higher than manual dispensing(P＜0.001).Sensitivity analysis results revealed that even after adjusting labor and material costs,the net profit of robotic dispensing was still significantly higher than that of manual dispensing(P＜0.001),indicating strong robustness.Conclusion Compared to manual dispensing,multi-station drug dispensing robots exhibit significant advantages in dispensing efficiency and cost-effectiveness,showing broad clinical application prospects.

T cell immunoglobulin and mucin domain-containing protein 3(Tim-3)is a member of the Tim family,which is widely expressed on the surface of various cells and can be involved in the occurrence and development of diseases such as autoimmune,infection and cancer.Clinical trials have found that a combination of blocking Tim-3 and programmed cell death 1(PD-1)can improve the anti-cancer immune response and regression of tumors in patients with advanced cancer.This arti-cle reviewed the basic biological structure of Tim-3,corresponding ligand and its role in tumor micro-environment,and summarized the ongoing clinical trials of TIM-3.These data suggested that Tim-3 could be used as a potentially significant checkpoint receptor for future anti-tumor therapy,and sum-marized the ongoing clinical trials of drugs,indicating that Tim-3 can be used as a potential check-point receptor for future anti-tumor therapy.

T cell immunoglobulin and mucin domain-containing protein 3(Tim-3)is a member of the Tim family,which is widely expressed on the surface of various cells and can be involved in the occurrence and development of diseases such as autoimmune,infection and cancer.Clinical trials have found that a combination of blocking Tim-3 and programmed cell death 1(PD-1)can improve the anti-cancer immune response and regression of tumors in patients with advanced cancer.This arti-cle reviewed the basic biological structure of Tim-3,corresponding ligand and its role in tumor micro-environment,and summarized the ongoing clinical trials of TIM-3.These data suggested that Tim-3 could be used as a potentially significant checkpoint receptor for future anti-tumor therapy,and sum-marized the ongoing clinical trials of drugs,indicating that Tim-3 can be used as a potential check-point receptor for future anti-tumor therapy.