ObjectiveTo explore the molecular mechanisms by which serum containing Gegen Qinlian Tang （GQT） inhibits glycolysis and enhances chemotherapy sensitivity in 5-fluorouracil （5-FU）-resistant colorectal cancer （CRC） cells based on the cyclin-dependent kinase 16 （CDK16）/MYC proto-oncogene （MYC） pathway. MethodsHCT-116/5-FU cells were treated with different concentrations （5%， 10%， 20%， 30%） of GQT-containing serum. Cell viability and 5-FU sensitivity were assessed using the cell counting kit-8 （CCK-8） assay， and the experimental concentrations of 5-FU and GQT for subsequent experiments were determined. Cell proliferation and apoptosis under individual 5-FU， GQT， and combined 5-FU + GQT treatments were evaluated using 5-ethynyl-2′-deoxyuridine （EDU） staining and annexin V-FITC/PI double staining， respectively. Glucose consumption， adenosine triphosphate （ATP） production， and lactate levels were measured by colorimetric assays. Expression levels of glycolysis-related proteins， CDK16， MYC， and phosphorylated MYC were detected by Western blot. Co-immunoprecipitation （CoIP） was used to examine the protein interaction between CDK16 and MYC， and cycloheximide （CHX） treatment was applied to assess the effect of CDK16 overexpression on MYC protein stability. ResultsCCK-8 assays showed that 2.5 mg·L^-1 5-FU significantly inhibited HCT-116 cell viability in a dose-dependent manner. In HCT-116/5-FU cells， significant inhibition was observed only at 5 mg·L^-1 5-FU （P<0.05）， which was used for model establishment. Compared with 5-FU alone， addition of 5% GQT-containing serum significantly suppressed HCT-116/5-FU cell viability （P<0.05）， with stronger inhibition at higher serum concentrations. Thus， 5% GQT-containing serum was used in subsequent experiments. Compared with the control group， 5-FU， GQT， and 5-FU + GQT treatments all significantly reduced cell proliferation （P<0.05） and increased apoptosis （P<0.01）. The 5-FU + GQT combination showed superior inhibition of proliferation compared with 5-FU or GQT alone （P<0.01）， accompanied by more pronounced reductions in glucose consumption， ATP production， and lactate generation （P<0.01）. Additionally， compared with control， 5-FU， and GQT groups， the 5-FU + GQT group exhibited stronger suppression of MYC and its phosphorylated forms （P<0.01） and greater inhibition of glycolytic enzymes， including hexokinase 2 （HK2）， 3-phosphoinositide-dependent protein kinase 1 （PDK1）， lactate dehydrogenase A （LDHA）， and pyruvate kinase M2 （PKM2） （P<0.01）. CDK16， MYC， and MYC phosphorylation expression levels were significantly downregulated in the 5-FU + GQT group compared with the 5-FU group （all P<0.01）. MYC protein stability decreased in a time-dependent manner in the 5-FU + GQT group （P<0.05）， which was rescued by CDK16 overexpression （P<0.05）. ConclusionGQT significantly enhances the sensitivity of HCT-116/5-FU cells to 5-FU， potentially by inhibiting CDK16 and thereby reducing MYC-mediated glycolysis.

ObjectiveTo explore the molecular mechanisms by which serum containing Gegen Qinlian Tang （GQT） inhibits glycolysis and enhances chemotherapy sensitivity in 5-fluorouracil （5-FU）-resistant colorectal cancer （CRC） cells based on the cyclin-dependent kinase 16 （CDK16）/MYC proto-oncogene （MYC） pathway. MethodsHCT-116/5-FU cells were treated with different concentrations （5%， 10%， 20%， 30%） of GQT-containing serum. Cell viability and 5-FU sensitivity were assessed using the cell counting kit-8 （CCK-8） assay， and the experimental concentrations of 5-FU and GQT for subsequent experiments were determined. Cell proliferation and apoptosis under individual 5-FU， GQT， and combined 5-FU + GQT treatments were evaluated using 5-ethynyl-2′-deoxyuridine （EDU） staining and annexin V-FITC/PI double staining， respectively. Glucose consumption， adenosine triphosphate （ATP） production， and lactate levels were measured by colorimetric assays. Expression levels of glycolysis-related proteins， CDK16， MYC， and phosphorylated MYC were detected by Western blot. Co-immunoprecipitation （CoIP） was used to examine the protein interaction between CDK16 and MYC， and cycloheximide （CHX） treatment was applied to assess the effect of CDK16 overexpression on MYC protein stability. ResultsCCK-8 assays showed that 2.5 mg·L^-1 5-FU significantly inhibited HCT-116 cell viability in a dose-dependent manner. In HCT-116/5-FU cells， significant inhibition was observed only at 5 mg·L^-1 5-FU （P<0.05）， which was used for model establishment. Compared with 5-FU alone， addition of 5% GQT-containing serum significantly suppressed HCT-116/5-FU cell viability （P<0.05）， with stronger inhibition at higher serum concentrations. Thus， 5% GQT-containing serum was used in subsequent experiments. Compared with the control group， 5-FU， GQT， and 5-FU + GQT treatments all significantly reduced cell proliferation （P<0.05） and increased apoptosis （P<0.01）. The 5-FU + GQT combination showed superior inhibition of proliferation compared with 5-FU or GQT alone （P<0.01）， accompanied by more pronounced reductions in glucose consumption， ATP production， and lactate generation （P<0.01）. Additionally， compared with control， 5-FU， and GQT groups， the 5-FU + GQT group exhibited stronger suppression of MYC and its phosphorylated forms （P<0.01） and greater inhibition of glycolytic enzymes， including hexokinase 2 （HK2）， 3-phosphoinositide-dependent protein kinase 1 （PDK1）， lactate dehydrogenase A （LDHA）， and pyruvate kinase M2 （PKM2） （P<0.01）. CDK16， MYC， and MYC phosphorylation expression levels were significantly downregulated in the 5-FU + GQT group compared with the 5-FU group （all P<0.01）. MYC protein stability decreased in a time-dependent manner in the 5-FU + GQT group （P<0.05）， which was rescued by CDK16 overexpression （P<0.05）. ConclusionGQT significantly enhances the sensitivity of HCT-116/5-FU cells to 5-FU， potentially by inhibiting CDK16 and thereby reducing MYC-mediated glycolysis.

Obesity has become a global public health challenge,and metabolic and bariatric surgery(MBS)remains one of the most effective treatments for severe obesity.However,substantial variability in patient characteristics,surgical complexity,and postoperative adherence leads to heterogeneous outcomes.The rapid evolution of artificial intelligence(AI)offers new opportunities to address these limitations.By integrating multidimensional clinical,imaging,and longitudinal follow-up data,machine learning and large language models support key aspects of MBS,including candidate selection,surgical decision-making,perioperative risk prediction,skill assessment,and long-term outcome management.Recent studies have demonstrated notable progress in decision support,complication forecasting,robotic surgery optimization,patient counselling,and postoperative weight-trajectory prediction.Nevertheless,challenges remain regarding model generalizability,ethical and regulatory oversight,data privacy,and transparency in AI-assisted decision-making.This review summarizes current advances,limitations,and future directions of AI applications in MBS,providing a reference for clinicians seeking to understand and apply these emerging technologies.

With the rising obesity rates and increased demand for weight-loss methods in China, there is a need for safer and more effective solutions to improve metabolic disorders associated with obesity and enhance patients' quality of life. Current bariatric surgery, while being the most effective method, faces limitations such as insufficient weight loss, weight regain, and complications. However, advancements in bariatric surgery techniques, the development of less invasive endoscopic bariatric procedures, the emergence of new anti-obesity drugs with single and multiple targets, and the application of artificial intelligence in metabolic and bariatric surgery are addressing these issues and revealing the rapid progress of obesity metabolism research and its clinical applications. This paper reviews relevant research published in 2024, explores emerging hotspots and potential research directions, and provides references for further exploring advancements in bariatric surgery techniques, combination anti-obesity drug therapies, and AI-assisted applications.

Objective:To explore the clinical efficacy of coiling dragon needling plus chin tuck against resistance(CTAR)training for post-stroke deglutition disorders and its impact on surface electromyography.Methods:A total of 100 patients with post-stroke deglutition disorders were randomly divided into two groups,with 50 cases in each group.Both groups received the same CTAR training,and the observation group was treated with additional coiling dragon needling.Both groups were treated for 2 weeks.The clinical efficacy,swallowing function,average value of the maximum amplitude of surface electromyography,quality of life,and the difference in adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,the standardized swallowing assessment(SSA),aspiration score,and deglutition disorders score of the videofluoroscopic swallowing study(VFSS)in both groups were significantly lower than those before treatment(P<0.05).The average value of the maximum amplitude of surface electromyography in the relaxed state,dry swallowing state,and the state of swallowing water,and the swallowing quality of life questionnaire(SWAL-QOL)score were all significantly higher than those before treatment in the two groups(P<0.05).After treatment,the SSA score,VFSS aspiration score,and VFSS deglutition disorders score in the observation group were lower than those in the control group(P<0.05),and the average value of the maximum amplitude of surface electromyography in the relaxed state,dry swallowing state,and the state of swallowing water,and the SWAL-QOL score in the observation group were higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Compared to CTAR treatment alone,coiling dragon needling plus CTAR treatment can enhance the clinical efficacy in treating patients with post-stroke deglutition disorders,enhancing the contraction ability of swallowing muscles and improving their swallowing function and quality of life.

Obesity has become a global public health challenge,and metabolic and bariatric surgery(MBS)remains one of the most effective treatments for severe obesity.However,substantial variability in patient characteristics,surgical complexity,and postoperative adherence leads to heterogeneous outcomes.The rapid evolution of artificial intelligence(AI)offers new opportunities to address these limitations.By integrating multidimensional clinical,imaging,and longitudinal follow-up data,machine learning and large language models support key aspects of MBS,including candidate selection,surgical decision-making,perioperative risk prediction,skill assessment,and long-term outcome management.Recent studies have demonstrated notable progress in decision support,complication forecasting,robotic surgery optimization,patient counselling,and postoperative weight-trajectory prediction.Nevertheless,challenges remain regarding model generalizability,ethical and regulatory oversight,data privacy,and transparency in AI-assisted decision-making.This review summarizes current advances,limitations,and future directions of AI applications in MBS,providing a reference for clinicians seeking to understand and apply these emerging technologies.

Objective:To explore the clinical efficacy of coiling dragon needling plus chin tuck against resistance(CTAR)training for post-stroke deglutition disorders and its impact on surface electromyography.Methods:A total of 100 patients with post-stroke deglutition disorders were randomly divided into two groups,with 50 cases in each group.Both groups received the same CTAR training,and the observation group was treated with additional coiling dragon needling.Both groups were treated for 2 weeks.The clinical efficacy,swallowing function,average value of the maximum amplitude of surface electromyography,quality of life,and the difference in adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,the standardized swallowing assessment(SSA),aspiration score,and deglutition disorders score of the videofluoroscopic swallowing study(VFSS)in both groups were significantly lower than those before treatment(P<0.05).The average value of the maximum amplitude of surface electromyography in the relaxed state,dry swallowing state,and the state of swallowing water,and the swallowing quality of life questionnaire(SWAL-QOL)score were all significantly higher than those before treatment in the two groups(P<0.05).After treatment,the SSA score,VFSS aspiration score,and VFSS deglutition disorders score in the observation group were lower than those in the control group(P<0.05),and the average value of the maximum amplitude of surface electromyography in the relaxed state,dry swallowing state,and the state of swallowing water,and the SWAL-QOL score in the observation group were higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Compared to CTAR treatment alone,coiling dragon needling plus CTAR treatment can enhance the clinical efficacy in treating patients with post-stroke deglutition disorders,enhancing the contraction ability of swallowing muscles and improving their swallowing function and quality of life.

With the rising obesity rates and increased demand for weight-loss methods in China, there is a need for safer and more effective solutions to improve metabolic disorders associated with obesity and enhance patients' quality of life. Current bariatric surgery, while being the most effective method, faces limitations such as insufficient weight loss, weight regain, and complications. However, advancements in bariatric surgery techniques, the development of less invasive endoscopic bariatric procedures, the emergence of new anti-obesity drugs with single and multiple targets, and the application of artificial intelligence in metabolic and bariatric surgery are addressing these issues and revealing the rapid progress of obesity metabolism research and its clinical applications. This paper reviews relevant research published in 2024, explores emerging hotspots and potential research directions, and provides references for further exploring advancements in bariatric surgery techniques, combination anti-obesity drug therapies, and AI-assisted applications.

Vitamin D plays multiple crucial roles in human health, especially in bone meta-bolism and immune modulation. Obese patients generally confront the risk of vitamin D deficiency. Furthermore, bariatric surgery may further intensify the vitamin D deficient condition. The authors, in combination with relevant literature, conduct analysis and induction on the relationship between obesity and vitamin D, the influence of vitamin D deficiency on the immune system, the impacts of different bariatric surgery approaches on the vitamin D status, as well as the supplementation strategies of vitamin D, aiming to offer practical guidance and reference for the management of vitamin D after bariatric surgery.

Objective:To investigate the clinical efficacy of single-port and mini-three-port laparoscopic sleeve gastrectomy (MTP-SG) for obesity.Methods:The propensity score matching and retrospective cohort study was conducted. The clinical data of 364 obesity patients in the Chinese Obesity and Metabolic Surgery Database who were admitted to The First Affiliated Hospital of Jinan University from July 2016 to December 2023 were collected. There were 79 males and 285 females, aged (31±9)years. Of 364 patients, 67 cases undergoing single-port laparoscopic sleeve gastrectomy (SP-SG) were divided into the SP group, and 297 cases undergoing MTP-SG were divided into the MTP group. Propensity score matching was done by the 1∶1 nearest neighbor matching method. The clamp value was set as 0.1. Measurement data with normal distribution were expressed as Mean± SD, and t test was used for comparison between groups. Measurement data with skewed distribution were expressed as M( Q1, Q1), and the rank sum test was used for comparison between groups. Count data were expressed as absolute numbers, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Results:(1) Propensity score matching and comparison of general data of patients between the two groups after matching. Of 364 patients, 126 cases were successfully matched, including 63 cases in the SP group and 63 cases in the MTP group. After propensity score matching, the confounding bias of gender, body mass, body mass index (BMI), waist circumference, waist hip ratio were eliminated between the two groups. (2) Intraoperative and post-operative conditions. Both groups of patients successfully completed laparoscopic sleeve gastrectomy. After propensity score matching, the operation time, volume of intraoperative blood loss, number of postoperative painkillers used, number of postoperative antiemetics used, duration of postoperative hospital stay, duration of total hospital stay, surgical cost, and total hospitalization cost of the 63 pati-ents in SP group were 101(90,120)minutes, 10(10,10)mL, 1.0(1.0,2.5)times, 3.0(1.0,5.0)times, 4(3,5)days, 7(5,8)days, 4.1(3.5,4.3) ten thousand yuan, and (6.4±0.8) ten thousand yuan, respectively. The above indicators of the 27 patients in MTP group were 100(90,120)minutes, 10(10,15)mL, 2.0(1.0,4.0)times, 4.0(3.0,5.0)times, 3(3,4)days, 5(5,6)days, 3.2(2.8,4.2) ten thousand yuan, and (5.8±0.8) ten thousand yuan, respectively. There were significant differences in number of postoperative antiemetics used, duration of postoperative hospital stay, duration of total hospital stay and total hospitalization cost between the two groups ( Z=-2.39, -3.93, -3.03, t=4.04, P<0.05), and there was no significant difference in operation time, volume of intraoperative blood loss, number of post-operative painkillers used and surgical cost between the two groups ( Z=-0.49, -1.00, -1.23, -1.47, P>0.05). (3) Follow-up. One hundred and ninety five of the 364 patients conducted postoperative 1 month follow-up, including 25 patients in the SP group and 170 patients in the MTP group, and no patient experienced complications such as gastric leakage, infection, or incisional hernia. Both groups of patients had good surgical incisions. After propensity score matching, the change in BMI (ΔBMI), percentage of total weight loss (%TWL), and percentage of excess weight loss (%EWL) of 24 patients in the SP group were (3.7±1.4)kg/m 2, 11.0%±3.0%, 52.6%±30.0%, respectively. The above indicators of 40 patients in the MTP group were (4.1±1.3)kg/m 2, 11.1%±2.8%, 41.8%±19.1%, respectively. Patients who conducted the postoperative 12 month follow-up were 21 and 131 in the SP group and the MTP group, respectively. After propensity score matching, the ΔBMI, %TWL and %EWL of 15 patients in the SP group were (8.7±4.1)kg/m 2, 26.2%±9.8%, 130.0%±45.1%, respectively. The above indicators of 36 patients in the MTP group were (9.8±4.0)kg/m 2, 27.2%± 8.7%, 107.1%±40.7%, respectively. Conclusion:Both SP-SG and MTP-SG can be used to treat obesity patients and achieve satisfactory short-term results.