Cancer-related anorexia (CRA) is a common and severe complication of malignant tumors. It is characterized by persistent appetite loss, early satiety, and reduced food intake. It directly leads to malnutrition, decreased treatment tolerance, reduced quality of life, and worsened prognosis. Its pathogenesis is complex, involving a multilayered network of interactions, including the dysregulation of the hypothalamic feeding center, imbalance of peripheral appetite hormones and systemic inflammatory mediators, and actions of tumor-derived factors. It is also highly influenced by anticancer treatments, such as chemotherapy, radiotherapy, and surgery. Current clinical management is dominated by multimodal comprehensive therapy based on progestogens, glucocorticoids and prokinetic agents, combined with nutritional support, rehabilitation exercise, psychological intervention and traditional Chinese medicine. However, highly effective approaches capable of fundamentally reversing the disease course of CRA are still lacking. This article provides a systematic review of the pathophysiological mechanisms, clinical assessment tools, and comprehensive treatment strategies for CRA. It also presents a discussion on future research directions based on the latest advances to provide a theoretical basis and reference for optimizing clinical practice and developing novel intervention strategies.

Objective: To investigate the longitudinal associations between dietary patterns in early childhood and myopia among children, so as to provide evidence for improving early childhood dietary patterns and promoting healthy ocular development among children. Methods: Participants were derived from the Ma-anshan Birth Cohort (MABC). A total of 1 432 children were included. Dietary patterns at 2.5 years of age were collected in 2017 using a food frequency questionnaire completed by parents. In 2022, cycloplegic refraction and ocular biometric parameters were measured in children aged 7-8 years. Food components were grouped into tertiles ( T1-T 3), and latent class analysis (LCA) was used to identify dietary pattern at the age of 2.5. Log-binomial regression and multiple linear regression model were applied to examine the associations of dietary patterns and their latent classes with myopia, spherical equivalent (SE), and axial length (AL). Results: The prevalence of myopia among children was 23.9%. After adjusting for covariates, the T 2 group of cereals and tubers was negatively associated with myopia rate ( RR=0.72, 95%CI =0.57-0.90) and AL ( β=-0.15, 95%CI =-0.24 to -0.05), and positively associated with SE ( β=0.21, 95%CI =0.06-0.35)(all P ＜0.05). Linear regression models showed that the T 2 group of fruits and vegetables was positively associated with AL ( β=0.09, 95%CI =0.00- 0.19 ); the T 3 group of high sugar foods ( β=0.11, 95%CI =0.00-0.21) and the T 3 group of processed foods ( β= 0.10 , 95%CI =0.00-0.19) were positively associated with AL; total scores for high sugar foods ( β=0.07, 95%CI =0.00-0.14) and processed foods ( β=0.09, 95%CI =0.01-0.17) were positively associated with AL (all P <0.05). After adjusting for sex, age, and parental myopia, the comprehensive high intake pattern was positively associated with AL ( β=0.12, 95%CI =0.00-0.23, P <0.05). After further adjusting for daily screen time and daily outdoor activity time, the association was no longer statistically significant ( β= 0.11 , 95%CI =-0.00-0.23, P >0.05). Conclusions Moderate consumption of cereals and tubers in early childhood may reduce the risk of myopia and delay AL growth. In contrast, high sugar and highly processed diets may promote AL and increase myopia risk. Establishing healthy dietary habits in early childhood and limiting intake of high sugar and processed foods is crucial for promoting ocular development in children.

BACKGROUND:Anybody musculoskeletal modeling system uses mathematical modeling techniques to simulate the relationship between human bones,muscles,and the environment,allowing for the study of inverse dynamics of the human body and obtaining indicators such as lower limb joint forces.OBJECTIVE:To analyze the stress distribution patterns of lower limb joints during the practice of Tai Chi movements,thereby exploring the scientific training and exercise value of Tai Chi.METHODS:Eight Tai Chi master-level athletes were selected from the Wushu College of Beijing Sport University for data collection,including seven sets of stepping movements and CT scans of the right femur.The BTS infrared capture system and Kistler three-dimensional force platform were used to collect kinematic and mechanical data of the seven sets of stepping movements in Tai Chi(Eight Methods and Five Steps).The Anybody 7.2 musculoskeletal model's multi-body dynamics simulation technology was utilized to calculate lower limb joint dynamic parameters,and Workbench 19.2 was used to perform stress analysis on the femur.RESULTS AND CONCLUSION:(1)Using Workbench software,the stress results of the femur for seven sets of movements were obtained.The peak stress values of the seven sets of movements in descending order were:Retreat and Rollback(22.00 MPa),Retreat and Pluck(19.379 MPa),Left and Right Shift Step Squeeze and Press(9.35 MPa),Left and Right Shift Step Elbow Lean(6.30 MPa),Forward Step and Expand(4.68 MPa),Forward Step and Pull(2.57 MPa),and Middle Fixed Standalone Position(0.31 MPa).(2)In the seven sets of stepping movements,the two backward stepping movements resulted in the greatest stress on the femur(P＜0.05),and the maximum stress positions on the femur were different during the movement of the seven sets of actions.(3)It is concluded that during the seven sets of stepping movements in Tai Chi(Eight Methods and Five Steps),stress threshold and maximum stress position of the femur will vary with different movements in five directions(seven sets of movements).Continuous training can comprehensively stimulate the femoral body.Forward stepping movements have a greater impact on the front and upper lateral side of the femoral body,while backward stepping movements have a greater impact on the back and inner side of the femoral body.Left and right lateral stepping movements mainly involve symmetrical stress on both sides of the femoral body.(4)Beginners should train targeted according to the stress characteristics of different stepping movements.During forward and backward stepping movements,attention should be paid to the rotational force of Tai Chi,and during left and right lateral stepping movements,attention should be paid to the medial counterforce.Beginners should focus on the Tai Chi training steps that correspond to their own weaknesses to achieve better exercise outcomes.

BACKGROUND:Anybody musculoskeletal modeling system uses mathematical modeling techniques to simulate the relationship between human bones,muscles,and the environment,allowing for the study of inverse dynamics of the human body and obtaining indicators such as lower limb joint forces.OBJECTIVE:To analyze the stress distribution patterns of lower limb joints during the practice of Tai Chi movements,thereby exploring the scientific training and exercise value of Tai Chi.METHODS:Eight Tai Chi master-level athletes were selected from the Wushu College of Beijing Sport University for data collection,including seven sets of stepping movements and CT scans of the right femur.The BTS infrared capture system and Kistler three-dimensional force platform were used to collect kinematic and mechanical data of the seven sets of stepping movements in Tai Chi(Eight Methods and Five Steps).The Anybody 7.2 musculoskeletal model's multi-body dynamics simulation technology was utilized to calculate lower limb joint dynamic parameters,and Workbench 19.2 was used to perform stress analysis on the femur.RESULTS AND CONCLUSION:(1)Using Workbench software,the stress results of the femur for seven sets of movements were obtained.The peak stress values of the seven sets of movements in descending order were:Retreat and Rollback(22.00 MPa),Retreat and Pluck(19.379 MPa),Left and Right Shift Step Squeeze and Press(9.35 MPa),Left and Right Shift Step Elbow Lean(6.30 MPa),Forward Step and Expand(4.68 MPa),Forward Step and Pull(2.57 MPa),and Middle Fixed Standalone Position(0.31 MPa).(2)In the seven sets of stepping movements,the two backward stepping movements resulted in the greatest stress on the femur(P＜0.05),and the maximum stress positions on the femur were different during the movement of the seven sets of actions.(3)It is concluded that during the seven sets of stepping movements in Tai Chi(Eight Methods and Five Steps),stress threshold and maximum stress position of the femur will vary with different movements in five directions(seven sets of movements).Continuous training can comprehensively stimulate the femoral body.Forward stepping movements have a greater impact on the front and upper lateral side of the femoral body,while backward stepping movements have a greater impact on the back and inner side of the femoral body.Left and right lateral stepping movements mainly involve symmetrical stress on both sides of the femoral body.(4)Beginners should train targeted according to the stress characteristics of different stepping movements.During forward and backward stepping movements,attention should be paid to the rotational force of Tai Chi,and during left and right lateral stepping movements,attention should be paid to the medial counterforce.Beginners should focus on the Tai Chi training steps that correspond to their own weaknesses to achieve better exercise outcomes.

Objective:To perform clinical acceptance tests of an optical surface imaging (OSI) system to ensure its accuracy and reliability in clinical applications.Methods:Based on the AAPM TG147 and AAPM TG302 reports, clinical tests were conducted for various performance indicators of the AlignRT system using phantoms, followed by the quantitative assessment of the system′s overall operational accuracy. Additionally, gating tests were performed on the radiotherapy plans of 13 patients to characterize the overall dosimetric accuracy of gated delivery under the guidance of the AlignRT system.Results:The camera units of the AlignRT system exhibited average relative positional deviations of 0.34 and 0.47 mm, respectively. The positional deviations from the radiation isocenter can be corrected through calibration with a phantom. Thermal drift primarily occurred in the vertical ( y) and longitudinal ( z) directions, measuring 0.2 and 0.3 mm, respectively. The accuracy deviation caused by differences in ambient light intensity was approximately 0.04 mm. When a camera unit was obstructed, the primary deviation was found in the lateral ( x) direction, about 0.15 mm. In the translational direction, the maximum deviation in positioning accuracy was 0.4 mm. During couch rotation, primary deviation occurred in the direction of YAW rotation, averaging 0.38°. There was a strong correlation between system monitoring deviations and cone-beam CT (CBCT) registration deviations, with correlation coefficients exceeding 0.8. In the case of gated delivery, the relative gamma pass rate for dose distribution exceeded 99% compared to the non-gated delivery. Conclusions:The AlignRT system provides sub-millimeter monitoring accuracy, meeting the demand for patient position verification and real-time monitoring in clinical treatment. Given that the introduction of a linear accelerator into gating did not result in significant dosimetric deviations, clinical plans can be performed reliably using gated treatment.

Objective:To perform clinical acceptance tests of an optical surface imaging (OSI) system to ensure its accuracy and reliability in clinical applications.Methods:Based on the AAPM TG147 and AAPM TG302 reports, clinical tests were conducted for various performance indicators of the AlignRT system using phantoms, followed by the quantitative assessment of the system′s overall operational accuracy. Additionally, gating tests were performed on the radiotherapy plans of 13 patients to characterize the overall dosimetric accuracy of gated delivery under the guidance of the AlignRT system.Results:The camera units of the AlignRT system exhibited average relative positional deviations of 0.34 and 0.47 mm, respectively. The positional deviations from the radiation isocenter can be corrected through calibration with a phantom. Thermal drift primarily occurred in the vertical ( y) and longitudinal ( z) directions, measuring 0.2 and 0.3 mm, respectively. The accuracy deviation caused by differences in ambient light intensity was approximately 0.04 mm. When a camera unit was obstructed, the primary deviation was found in the lateral ( x) direction, about 0.15 mm. In the translational direction, the maximum deviation in positioning accuracy was 0.4 mm. During couch rotation, primary deviation occurred in the direction of YAW rotation, averaging 0.38°. There was a strong correlation between system monitoring deviations and cone-beam CT (CBCT) registration deviations, with correlation coefficients exceeding 0.8. In the case of gated delivery, the relative gamma pass rate for dose distribution exceeded 99% compared to the non-gated delivery. Conclusions:The AlignRT system provides sub-millimeter monitoring accuracy, meeting the demand for patient position verification and real-time monitoring in clinical treatment. Given that the introduction of a linear accelerator into gating did not result in significant dosimetric deviations, clinical plans can be performed reliably using gated treatment.

OBJECTIVE To provide reference for clinically safe and rational drug use through mining and analyzing adverse drug event （AE） signals induced by valproic acid （VPA）. METHODS Reporting Odds Ratio （ROR） and Bayesian Confidence Propagation Neural Network （BCPNN） methods of Measures of Disproportionality were performed to mine and analyze the data of VPA-related AE reports in the US FDA Adverse Event Reporting System （FAERS） database from the first quarter of 2013 to the fourth quarter of 2022. RESULTS A total of 1 253 （ROR） and 1 109 （BCPNN） valid signals of preferred terms （PT） were obtained after data processing by the two analysis methods， involving 27 system organs （SOC）， mainly focusing on nervous system disorders， psychiatric disorders， general disorders and administration site conditions. Signals that did not appear in the instruction were associated with 2 SOCs： ear and labyrinth disorders， infections and infestations. CONCLUSIONS As a first-line broad-spectrum anti-epileptic drug， attention should also be paid to eye toxicity and infection risk in the clinical application in addition to paying attention to common adverse events in the instruction.

Objective: To investigate epidermal growth factor receptor (EGFR) and thymidylate synthase (TS) expression in primary liver cancer, and analyze its clinicopathological features and prognostic significance. Methods: Immunohistochemistry was performed using EnVision method to detect EGFR and TS expression in 41 cases of liver cancer. Correlation coefficient between EGFR and TS was calculated by Spearman method. Fisher's exact probability method or χ² test was used to analyze the clinicopathological features of EGFR and TS. Kaplan-Meier method was used to calculate the survival rate of patients in conjunction with the log-rank test.COX proportional hazard regression model was used to analyze the prognostic factors of patients. ROC curve was used to analyze the predictive accuracy of EGFR and TS for prognosis. Results: The positive rates of EGFR and TS in liver cancer tissues were 34.15% and 39.02%, respectively. There was a positive correlation between EGFR and TS expressions, and the difference was statistically significant (P < 0.05). EGFR was associated with tumor size and tissue differentiation (P < 0.05) in HCC patients, whereas TS was associated with tissue differentiation (P < 0.05). There was no significant difference in prognostic effect of EGFR on survival rate (P > 0.05). TS prognostic effect on survival rate was statistically significant (P < 0.05). HR of EGFR was 0.210 with 95% CI, 0.052-0.852, P = 0.029; indicating that the risk of death in patients with negative EGFR was 0.210 times higher than that in patients with positive EGFR. HR of TS was 2.496, with 95% CI, 1.325-4.701, P = 0.005, indicating that the risk of death increased by 2.496 times with the same level of EGFR. The area under the EGFR curve was 0.553 and its approximate reference confidence interval was 95% (0.355, 0.751), indicating that EGFR was a risk factor for death and the area under the TS curve was 0.695, and its approximate reference confidence interval was 95% (0.513, 0.878), indicating that TS was a risk factor for death. Conclusion EGFR and TS were equally expressed in primary liver cancer, and EGFR and TS expressions were positively correlated. EGFR and TS had an effect on the degree of tissue differentiation in patients with liver cancer. EGFR and TS were risk factors for prognosis, and TS may assist EGFR.

BACKGROUND: Accurate evaluation of lymph node metastasis in bladder cancer (BCa) is important for disease staging, treatment selection, and prognosis prediction. In this study, we aimed to evaluate the diagnostic accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) for metastatic lymph nodes in BCa and establish criteria of imaging diagnosis. METHODS: We retrospectively assessed the imaging characteristics of 191 BCa patients who underwent radical cystectomy. The data regarding size, shape, density, and diffusion of the lymph nodes on CT and/or MRI were obtained and analyzed using Kruskal-Wallis test and χ test. The optimal cutoff value for the size of metastatic node was determined using the receiver operating characteristic (ROC) curve analysis. RESULTS: A total of 184 out of 3317 resected lymph nodes were diagnosed as metastatic lymph nodes. Among 82 imaging-detectable lymph nodes, 51 were confirmed to be positive for metastasis. The detection rate of metastatic nodes increased along with more advanced tumor stage (P < 0.001). Once the ratio of short- to long-axis diameter ≤ 0.4 or fatty hilum was observed in lymph nodes on imaging, it indicated non-metastases. Besides, lymph nodes with spiculate or obscure margin or necrosis indicated metastases. Furthermore, the short diameter of 6.8 mm was the optimal threshold to diagnose metastatic lymph node, with the area under ROC curve of 0.815. CONCLUSIONS The probability of metastatic nodes significantly increased with more advanced T stages. Once lymph nodes are detected on imaging, the characteristic signs should be paid attention to. The short diameter > 6.8 mm may indicate metastatic lymph nodes in BCa.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; diagnostic imaging ; pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Staging ; Pelvic Neoplasms ; diagnostic imaging ; pathology ; secondary ; surgery ; Pelvis ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed ; Urinary Bladder Neoplasms ; diagnostic imaging ; pathology ; surgery

Objective To investigate the expressions of 4 drug resistance gene proteins P-glycoprotein (Pgp), Glutathionine-S-Transferase π (GST-π), topoisomerase Ⅱ (TopoⅡ) and thymidylate synthase (TS) and Ki67 in primary liver cancer (PLC) and their value in the prognosis of patients. Methods Samples were collected from 41 patients with PLC in the Third Affiliated Hospital of Nantong University between March 2008 and December 2016. The informed consents of all patients were obtained and the local ethical committee approval was received. There were 26 males and 15 females, with an average age of (56±10) years old. The expressions of Pgp, GST-π, Topo Ⅱ, TS and Ki67 in PLC tissues were detected by immunohistochemistry. Correlation analysis was conducted using Spearman correlation analysis. Survival rate was analyzed using Kaplan-Meier method and Log-rank test. Prognostic factors of these patients were analyzed by Cox proportional hazard regression model. Results Positive expressions of Pgp, GST-π, Topo Ⅱ, TS and Ki67 were detected in PLC tissues, and the positive expression rate was 73% (30/41),7% (3/41), 61% (25/41), 39% (16/41) and 51% (21/41), respectively. The expression of TS was positively correlated with those of Pgp and Topo Ⅱ (rs=0.484, 0.333; P<0.05). Survival analysis showed that there were significant differences in the survival between TS, Ki67 positive and negative patients (χ2=4.695, 5.784;P<0.05).Cox multivariate regression analysis showed that TS and Ki67 were the independent risk factors for the overall prognosis(HR=3.007,17.108;P<0.05).Conclusions Expressions of Pgp,GST-π,TopoⅡand TS can be detected in PLC. The expression of TS is positively correlated with those of Pgp and Topo Ⅱ. TS and Ki67 are the independent risk factors for the prognosis of patients.