Background/Aims: Anti-reflux mucosal ablation (ARMA) is a promising endoscopic intervention for proton pump inhibitor (PPI)-dependent gastroesophageal reflux disease (GERD). However, the effect of ARMA on esophageal motility remains unclear. Methods: Twenty patients with PPI-dependent GERD receiving ARMA were prospectively enrolled. Comprehensive self-report symptom questionnaires, endoscopy, 24-hour impedance-pH monitoring, and high-resolution impedance manometry were performed and analyzed before and 3 months after ARMA. Results: All ARMA procedures were performed successfully. Symptom scores, including GerdQ (11.16 ± 2.67 to 9.11 ± 2.64, P = 0.026) and reflux symptom index (11.63 ± 5.62 to 6.11 ± 3.86, P = 0.001), improved significantly, while 13 patients (65%) reported discontinuation of PPI. Total acid exposure time (5.84 ± 4.63% to 2.83 ± 3.41%, P = 0.024) and number of reflux episodes (73.05 ± 19.34 to 37.55 ± 22.71, P < 0.001) decreased significantly after ARMA. Improved esophagogastric junction (EGJ) barrier function, including increased lower esophageal sphincter resting pressure (13.89 ± 10.78 mmHg to 21.68 ± 11.5 mmHg, P = 0.034), 4-second integrated relaxation pressure (5.75 ± 6.42 mmHg to 9.99 ± 5.89 mmHg, P = 0.020), and EGJ-contractile integral(16.42 ± 16.93 mmHg · cm to 31.95 ± 21.25 mmHg · cm, P = 0.016), were observed. Esophageal body contractility also increased significantly (distal contractile integral, 966.85 ± 845.84 mmHg · s · cm to 1198.8 ± 811.74 mmHg · s · cm, P = 0.023). Patients with symptom improvement had better pre-AMRA esophageal body contractility. Conclusions ARMA effectively improves symptoms and reflux burden, EGJ barrier function, and esophageal body contractility in patients with PPIdependent GERD during short-term evaluation. Longer follow-up to clarify the sustainability of ARMA is needed.

Background/Aims: Anti-reflux mucosal ablation (ARMA) is a promising endoscopic intervention for proton pump inhibitor (PPI)-dependent gastroesophageal reflux disease (GERD). However, the effect of ARMA on esophageal motility remains unclear. Methods: Twenty patients with PPI-dependent GERD receiving ARMA were prospectively enrolled. Comprehensive self-report symptom questionnaires, endoscopy, 24-hour impedance-pH monitoring, and high-resolution impedance manometry were performed and analyzed before and 3 months after ARMA. Results: All ARMA procedures were performed successfully. Symptom scores, including GerdQ (11.16 ± 2.67 to 9.11 ± 2.64, P = 0.026) and reflux symptom index (11.63 ± 5.62 to 6.11 ± 3.86, P = 0.001), improved significantly, while 13 patients (65%) reported discontinuation of PPI. Total acid exposure time (5.84 ± 4.63% to 2.83 ± 3.41%, P = 0.024) and number of reflux episodes (73.05 ± 19.34 to 37.55 ± 22.71, P < 0.001) decreased significantly after ARMA. Improved esophagogastric junction (EGJ) barrier function, including increased lower esophageal sphincter resting pressure (13.89 ± 10.78 mmHg to 21.68 ± 11.5 mmHg, P = 0.034), 4-second integrated relaxation pressure (5.75 ± 6.42 mmHg to 9.99 ± 5.89 mmHg, P = 0.020), and EGJ-contractile integral(16.42 ± 16.93 mmHg · cm to 31.95 ± 21.25 mmHg · cm, P = 0.016), were observed. Esophageal body contractility also increased significantly (distal contractile integral, 966.85 ± 845.84 mmHg · s · cm to 1198.8 ± 811.74 mmHg · s · cm, P = 0.023). Patients with symptom improvement had better pre-AMRA esophageal body contractility. Conclusions ARMA effectively improves symptoms and reflux burden, EGJ barrier function, and esophageal body contractility in patients with PPIdependent GERD during short-term evaluation. Longer follow-up to clarify the sustainability of ARMA is needed.

Background/Aims: Anti-reflux mucosal ablation (ARMA) is a promising endoscopic intervention for proton pump inhibitor (PPI)-dependent gastroesophageal reflux disease (GERD). However, the effect of ARMA on esophageal motility remains unclear. Methods: Twenty patients with PPI-dependent GERD receiving ARMA were prospectively enrolled. Comprehensive self-report symptom questionnaires, endoscopy, 24-hour impedance-pH monitoring, and high-resolution impedance manometry were performed and analyzed before and 3 months after ARMA. Results: All ARMA procedures were performed successfully. Symptom scores, including GerdQ (11.16 ± 2.67 to 9.11 ± 2.64, P = 0.026) and reflux symptom index (11.63 ± 5.62 to 6.11 ± 3.86, P = 0.001), improved significantly, while 13 patients (65%) reported discontinuation of PPI. Total acid exposure time (5.84 ± 4.63% to 2.83 ± 3.41%, P = 0.024) and number of reflux episodes (73.05 ± 19.34 to 37.55 ± 22.71, P < 0.001) decreased significantly after ARMA. Improved esophagogastric junction (EGJ) barrier function, including increased lower esophageal sphincter resting pressure (13.89 ± 10.78 mmHg to 21.68 ± 11.5 mmHg, P = 0.034), 4-second integrated relaxation pressure (5.75 ± 6.42 mmHg to 9.99 ± 5.89 mmHg, P = 0.020), and EGJ-contractile integral(16.42 ± 16.93 mmHg · cm to 31.95 ± 21.25 mmHg · cm, P = 0.016), were observed. Esophageal body contractility also increased significantly (distal contractile integral, 966.85 ± 845.84 mmHg · s · cm to 1198.8 ± 811.74 mmHg · s · cm, P = 0.023). Patients with symptom improvement had better pre-AMRA esophageal body contractility. Conclusions ARMA effectively improves symptoms and reflux burden, EGJ barrier function, and esophageal body contractility in patients with PPIdependent GERD during short-term evaluation. Longer follow-up to clarify the sustainability of ARMA is needed.

Objective To compare the application effect of intermittent androgen deprivation(IAD)and continued androgen deprivation(CAD)on advanced prostate cancer and influence on prognosis.Methods The patients with advanced prostate cancer were divided into treatment group(86 cases)and control group(62 cases)according to the cohort method.The treatment group was given IAD regimen(subcutaneous injection of 3.6 mg goserelin once every 28 days)combined with oral administration of flutamide(250 mg every 3 times a day)or combined with oral administration of bicalutamide(50 mg once a day),and the control group was treated with CAD regimen(bilateral orchiectomy combined with continuous flutamide or bicalutamide orally,with the same dosage as the treatment group).The observation follow-up time of both groups was ≥9 months.Efficacy,serum total testosterone(TT),prostate specific antigen(PSA)and vascular endothelial growth factor(VEGF)were compared between the two groups after treatment,and the side effects of treatment,quality of life[Functional Assessment of Cancer Therapy-Prostate(FACT-P)]and disease progression were evaluated.Results At 9 months after treatment,the objective response rates(ORR)in treatment group and control group were 30.99％(22 cases/71 cases)and 29.09％(16 cases/55 cases),and the disease control rates(DCR)were 71.83％(51 cases/71 cases)and 69.09％(38 cases/55 cases)respectively(P＞0.05).Serum TT levels in treatment group and control group were(25.53±9.44)and(22.51±8.28)ng·dL-1,PSA levels were(4.48±1.02)and(4.32±0.95)ng·mL-1,and VEGF levels were(121.03±35.26)and(118.65±33.42)pg·mL-1 respectively(all P＞0.05).The incidence rates of hot flash in treatment group and control group were 21.13％and 56.36％,the incidence rates of breast swelling pain were 16.90％and 34.55％,and the incidence rates of osteoporosis were 8.45％and 25.45％respectively(all P＜0.05).The scores of physical condition of FACT-P in treatment group and control group were(24.15±4.22)and(20.28±3.71)points,the scores of life condition were(20.28±2.94)and(17.81±2.84)points,scores of prostate cancer specific(PCS)module were(33.21±6.32)and(28.42±5.43)points,respectively,the difference were all statistically significant(all P＜0.05).The cumulative progression-free survival rates in treatment group and control group were 61.97％and 58.18％(P＞0.05).Conclusion IAD is as effective as CAD in the treatment of advanced prostate cancer and has a similar effect on the prognosis of patients,but the former one has fewer side effects of treatment and helps to improve the quality of life of patients.

BackgroundPatients demonstrating depressive disorder with psychotic symptoms often have increased risk of death and poor prognosis. A large amount of research has explored the factors influencing psychotic symptoms in adult patients with depressive disorder， but few has focused on adolescent patients. ObjectiveTo explore the influencing factors of psychotic symptoms in adolescent patients with depressive disorder， so as to provide references for early screening and intervention in clinic. MethodsA total of 96 adolescent patients who met the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） for depressive disorder and were seen in the psychiatry departments of Chaohu Hospital of Anhui Medical University and The Fourth People's Hospital of Hefei from September 2022 to January 2023 were included. Another 56 healthy individuals from the health examination center of Chaohu Hospital of Anhui Medical University were concurrently recruited as control group. Patients were assigned into psychotic group （n=32） and non-psychotic group （n=64） according to the presence or absence of psychotic symptoms. Hamilton Depression Scale-24 item （HAMD-24）， Positive and Negative Syndrome Scale （PANSS）， Positive and Negative Suicide Ideation （PANSI） and Childhood Trauma Questionnaire-Short Form （CTQ-SF） were used for evaluation. Plasma brain-derived neurotrophic factor （BDNF） concentration was obtained using Meso Scale Discovery electrochemiluminescence assay. Pearson and Spearman correlation analysis were adopted to determine the correlation of PANSS positive symptom subscale score with plasma BDNF concentration and clinical characteristics of adolescent depression patients with psychotic symptoms. Binary Logistic regression analysis was used to identify the factors influencing the presence of psychotic symptoms in adolescent patients with depressive disorder， and multiple linear regression analysis was utilized to screen the factors affecting the severity of psychotic symptoms. ResultsThe plasma BDNF concentration of adolescent patients with depressive disorder was lower than that of control group （t=-3.080， P<0.01）.The plasma BDNF concentration of psychotic group was lower than that of non-psychotic group （t=2.418， P<0.05）， while the body mass index （BMI） PANSI scores， CTQ-SF scores and HAMD-24 total scores were all higher than those of non-psychotic group （t=-2.024， -2.530， -2.187， -4.977， P<0.05 or 0.01）. Correlation analysis showed that PANSS positive symptom subscale scores were negatively correlated with anxiety/somatization factor score and weight factor score in HAMD-24 of psychotic group （r=-0.438， -0.498， P<0.05 or 0.01）. Binary Logistic regression showed that BMI， plasma BDNF concentration， HAMD-24 total scores and cognitive dysfunction factor score were the influencing factors of psychotic symptoms in adolescent patients with depressive disorder. Multiple linear regression analysis demonstrated that weight factor scores （β=-0.349， P<0.05） and anxiety/somatization factor score （β=-0.433， P<0.05） in HAMD-24 were the factors influencing the severity of psychotic symptoms. ConclusionHigh BMI， low plasma BDNF concentration， severe depressive symptoms and cognitive dysfunction may be the risk factors of psychotic symptoms in adolescent patients with depressive disorder， furthermore， BMI and anxiety symptoms are found to be associated with the severity of psychotic symptoms. ［Funded by Scientific Research Fund Project of Anhui Institute of Translational Medicine （number， 2022zhyx-B01）； Central Finance Supported Provincial Key Clinical Specialty Construction Project of Anhui Province in 2019］

Threatened abortion is a common disease of obstetrics and gynecology and one of the diseases responding specifically to traditional Chinese medicine （TCM）. The China Association of Chinese Medicine organized experts in TCM obstetrics and gynecology， Western medicine obstetrics and gynecology， and pharmacology to deeply discuss the advantages of TCM and integrated Chinese and Western medicine treatment as well as the medication plans for threatened abortion. After discussion， the experts concluded that chromosome， endocrine， and immune abnormalities were the key factors for the occurrence of threatened abortion， and the Qi and blood disorders in thoroughfare and conception vessels were the core pathogenesis. In the treatment of threatened abortion， TCM has advantages in preventing miscarriages， alleviating clinical symptoms and TCM syndromes， relieving anxiety， regulating reproductive endocrine and immune abnormalities， personalized and diversified treatment， enhancing efficiency and reducing toxicity， and preventing the disease before occurrence. The difficulty in diagnosis and treatment of threatened abortion with traditional Chinese and Western medicine lies in identifying the predictors of abortion caused by maternal factors and the treatment of thrombophilia. Recurrent abortion is the breakthrough point of treatment with integrated traditional Chinese and Western medicine. It is urgent to carry out high-quality evidence-based medicine research in the future to improve the modern diagnosis and treatment of threatened abortion with TCM.

Nanozymes, a groundbreaking discovery by Chinese scientists, represent a novel and remarkable property of nanomaterials. They not only exhibit catalytic activity comparable to natural enzymes, but also boast exceptional stability, tunable reactivity, and the ability to catalyze reactions under mild conditions. The identification of nanozymes has unveiled the biocatalytic potential of inorganic nanomaterials. In parallel, inorganic minerals have long been regarded as pivotal catalysts in the origin of life, driving the synthesis of early biomolecules. These minerals not only facilitate redox reactions that convert simple inorganic compounds into organic molecules but also enable chiral selection, the synthesis of biomacromolecules, and radioprotective functions via their surface structures. Recent advances suggest that inorganic nanomaterials can delicately catalyze the formation of biomolecules, aid in macromolecular assembly, and provide radiation shielding. Furthermore, nanominerals are found in abundance across Earth and extraterrestrial environments. This paper seeks to explore the potential of nanozymes as catalytic agents in the processes that gave rise to life, integrating the catalytic roles of inorganic minerals with the unique attributes of nanozymes, which will provide a new perspective for research of origin of life.

The statement of"qi transformation leading to the removal of pathogenic dampness"was recorded in Wen Bing Tiao Bian(Analysis on Epidemic Febrile Diseases)written by the Qing Dynasty physician WU Ju-Tong.Dampness in the triple energizer is caused by the dysfunction of qi transformation,and the treatment of dampness must be based on the activation of qi movement and focused on the promotion of qi movement and the restoration of the qi transformation in the triple energizer.For the treatment of dampness attack in the upper energizer,therapies of dispersing lung to smooth qi and resolving dampness to relieve the obstruction are recommended.For the treatment of dampness obstruction in the middle energizer,therapy of activating spleen qi by strengthening spleen and moving qi is stressed for helping the removal of dampness and for the eradication of the source of dampness.For the treatment of dampness stagnation in the lower energizer,therapy of draining dampness with sweet-light medicines and activating yang can be used according to the illness status.The three methods of treating dampness,namely dispersing the upper energizer,activating the middle energizer and draining the lower energizer,all embody the mechanism of"qi transformation leading to the removal of pathogenic dampness",and the therapies of dispersing lung with light medicines,inducing perspiration by opening striated layer,eliminating dampness with aromatics and draining dampness with sweet-light medicines should be used in accordance with the syndromes.The elucidation of the academic thoughts of"qi transformation leading to the removal of pathogenic dampness"can provide theoretical reference for the fundamental research of dampness syndrome and clinical application of therapies for resolving dampness in Chinese medicine.

Based on the background of a multidisciplinary treatment team and the increasing high-quality life aspirations of patients,the preservation of anal function for patients with low rectal cancer has undergone changes in recent years.With the optimization of neoadjuvant therapy,refinement of surgical techniques,and the deepening of the concept of anal preservation after surgery,the concept of anal preservation for low rectal cancer has gradually shifted from traditional simple surgery to comprehensive treatment,and anal preservation surgery tends to be more accurate preservation.The goal of comprehensive treatment is to preserve good anal function and reduce surgical damage.However,comprehensive treatment for anal preservation in low rectal cancer is still in its infancy,and there is no consensus on the strategy planning for anal preservation.Therefore,summarizing various preoperative,intraoperative,and postoperative treatment strategies for low rectal cancer is of great significance for the selection of anal preservation schemes for patients with low rectal cancer.This article focus on exploring the optimization of neoadjuvant therapy models,"watch and wait"plans,the development of anal preservation techniques,and postoperative and preservation strategies,aiming to review the current status of anal preservation strategy planning for low rectal cancer.

Objective:To detect the expression level of tRF-31-PER8YP9LON4VD in the serum of breast cancer patients and to explore its effect on the function of breast cancer cells.Methods:The serums of 57 breast cancer patients, 39 breast benign tumor patients and 40 normal physical examination patients in the Affiliated Cancer Hospital of Nanjing Medical University from April to August in 2022 were collected. Real-time quantitative polymerase chain reaction(RT-qPCR) to detect the expression level of tRF-31-PER8YP9LON4VD in breast cancer cell lines and serum of breast cancer patients. Cell invasion assay, migration assay and CCK-8 proliferation assay were used to analyze the effect of tRF-31-PER8YP9LON4VD on breast cancer cell function. The receiver operating characteristic curve (ROC) curve was used to analyze the diagnostic efficacy of tRF-31-PER8YP9LON4VD in serum in breast cancer. The chi-square test was used to analyze the correlation between tRF-31-PER8YP9LON4VD and clinical features.Results:The expression levels of tRF-31-PER8YP9LON4VD in breast cancer cell lines MDA-MB-231 (0.50±0.22 vs 1.00±0.01), T-47D (0.33±0.02 vs 1.00±0.01) and MCF-7 (0.50±0.02 vs 1.00±0.01) were significantly lower than those in normal mammary epithelial cell lines (1.00±0.01), and the difference was statistically significant (all P<0.05). The expression level of tRF-31-PER8YP9LON4VD in the serum of breast cancer patients (1.35±1.25) was lower than that in the serum of patients with normal physical examination (6.42±3.13) and patients with benign breast tumors (9.57±2.11), and the difference was statistically significant (both P<0.001). Compared with the control group, the invasiveness of overexpressing tRF-31-PER8YP9LON4VD T-47D (86.67±12.22 vs 532.00±22.68, P<0.001) and MDA-MB-231 (535.33±99.12 vs 1 055.67±24.00, P=0.002) was weaker, and that of T-47D (442.67±81.79 vs 1 210.67±115.02, P=0.002) and MDA-MB-231 (278.67±108.40 vs 571.33±95.37, P=0.015) had weaker migration ability, and T-47D and MDA-MB-231 had weaker proliferative ability (all P<0.05). The area under the curve of serum tRF-31-PER8YP9LON4VD for the diagnostic efficacy of breast cancer was 0.743 (95% CI 0.644-0.842), and the sensitivity and specificity were 89.50% and 53.10%, respectively. Conclusion:tRF-31-PER8YP9LON4VD is low expressed in the serum of breast cancer patients, and it may inhibit the proliferation, migration and invasion of breast cancer cells.