Purpose: Due to the preservation of the entire stomach after endoscopic resection, the occurrence of metachronous gastric cancer (MGC) remains a possibility. In this study, we investigated the incidence and risk factors for MGC in patients with early gastric cancer who underwent endoscopic submucosal dissection (ESD) and successfully eradicatedHelicobacter pylori. Materials and Methods: A retrospective analysis was conducted of 1,191 patients who underwent ESD and successfully eradicated H. pylori at the Affiliated Drum Tower Hospital of Nanjing University. Endoscopic surveillance was performed at 3, 6, and 12 months post-resection, and annually thereafter. MGC was defined as the development of a new cancer at a site other than the primary gastric cancer site, at least 1 year after the initial endoscopic resection. Results: A total of 77 patients were diagnosed with MGC during a median follow-up of 41.5 months. Kaplan-Meier analysis showed a 5-year cumulative incidence of MGC of 9.4% after successful H. pylori eradication. Multivariate analysis of the training set using Cox proportional hazards models identified male sex, severe atrophic gastritis, multiple gastric cancers before H. pylori eradication, and smoking history as independent risk factors for MGC.The nomogram exhibited favorable discrimination, with area under the curves of 0.767 and 0.822 in the training set and 0.724 and 0.745 in the testing set at 3 and 5 years, respectively. Conclusions Patients with gastric cancer who undergo endoscopic resection, even after successful H. pylori eradication, should undergo annual and continuous endoscopic surveillance for MGC.

Objective:To explore the clinical characteristics and treatment methods of patients with small bowel obstruction secondary to mesenteric ischemia (MI).Methods:The clinical data of 24 patients with small intestinal obstruction secondary to MI from December 2021 to December 2024 in the Fourth Affiliated Hospital of Nanjing Medical University were retrospectively analyzed, including the clinical characteristics and surgical treatment.Results:Among the 24 patients with small intestinal obstruction secondary to MI, 19 were male and 5 were female, with ages ranging from 21 to 65 years old, and the disease course was 0.5 (1.0, 5.5) months. There were 8 cases of deep vein thrombosis, 6 cases of hypertension, 6 cases of atrial fibrillation, 5 cases of short bowel syndrome, 4 cases of abdominal trauma and 23 cases with a history of abdominal surgery. There were 4 cases of acute onset, presenting with full abdominal pain, elevated D-dimer and hematogenous intestinal obstruction. There were 20 cases of chronic onset, presenting with recurrent abdominal pain, weight loss and mechanical intestinal obstruction. The pathogenic factors were superior mesenteric vein thrombosis in 7 cases, superior mesenteric arteriosclerosis in 6 cases, mesenteric injury repair in 4 cases, superior mesenteric artery embolism in 3 cases, superior mesenteric aneurysm in 2 cases, superior mesenteric artery dissection in 1 case, and ileocolic aneurysm in 1 case. Three patients underwent surgical operations after the failure of interventional surgeries, and 20 patients were directly treated with surgery. The small intestinal obstruction was completely relieved in all cases. Another case was treated conservatively, but the small intestinal obstruction was not completely relieved.Conclusions:Small bowel obstruction secondary to MI is often atypical. CT angiography should be performed to identify the cause of obstruction due to deep vein thrombosis, atrial fibrillation, abdominal trauma or abdominal surgery. Surgery is the preferred treatment.

AIM To analyze the dynamic change patterns of aflatoxin B1,aflatoxin B2,aflatoxin G1,aflatoxin G2,T-2 toxin and deoxynivalenol contents during the fermentation of Massa Medicata Fermentata.METHODS The analysis was performed on a 40 ℃ thermostatic Waters ACQUITY UPLC HSS T3 column(100 mm×2.1 mm,1.8 μm),with the mobile phase comprising of 0.01％formic acid-[acetonitrile-methanol(1∶1)]flowing at 0.3 mL/min,and electron spray ionization source was adopted in positive ion scanning with multiple reaction monitoring mode.RESULTS Six mycotoxins showed good linear relationships within their own ranges(R2＞0.998 0),whose average recoveries were 76.1％-119.3％with the RSDs of 0.49％-9.27％,and except for deoxynivalenol,their contents demonstrated the trends of growing out of nothing and gradually increasing.CONCLUSION The risk of mycotoxin infection exists in the fermentation of Massa Medicata Fermentata.This simple,efficient,rapid and sensitive method can provide a reference for whole-process monitoring the fermentation process for Massa Medicata Fermentata.

Objective To discuss the mechanism of the streaking artifact of Star-volumetric interpolated body examination(Star-VIBE)sequence and the influence of phase coding on it.Methods Twenty-six volunteers underwent many times Star-VIBE sequences scanning with different phase coding(320,640,960,1 280,1 600).The severity of streaking artifact of images in different phase cod-ing groups was evaluated qualitatively.The signal-to-noise ratio(SNR)of muscle,thyroid and contrast-enhanced artery,contrast-to-noise ratio(CNR)between soft tissues,and CNR between muscle and contrast-enhanced artery of the images in different phase coding groups were evaluated quantitatively.Results In qualitative evaluation,with the number of phase coding increased,the streaking artifact decreased(H=83.022,P＜0.005).In quantitative evaluation,SNRmuscle,SNRthyroid,SNRcontrast-enhanced artery and CNRcontrast-enhanced gradually increased with the increase of phase coding number(SNRmuscle:F=6.913,P＜0.005;SNRthyroid:F=3.930,P=0.005;SNRcontrast-enhanced artery:F=6.980,P＜0.005;CNRcontrast-enhanced:F=6.482,P＜0.005),while CNRsoft tissue showed no statistical difference(F=1.114,P=0.339).Conclusion There is streaking artifact on the image of the Star-VIBE sequence,which can be reduced by increas-ing the number of phase coding appropriately.The most suitable phase coding is 960.

Objective To discuss the mechanism of the streaking artifact of Star-volumetric interpolated body examination(Star-VIBE)sequence and the influence of phase coding on it.Methods Twenty-six volunteers underwent many times Star-VIBE sequences scanning with different phase coding(320,640,960,1 280,1 600).The severity of streaking artifact of images in different phase cod-ing groups was evaluated qualitatively.The signal-to-noise ratio(SNR)of muscle,thyroid and contrast-enhanced artery,contrast-to-noise ratio(CNR)between soft tissues,and CNR between muscle and contrast-enhanced artery of the images in different phase coding groups were evaluated quantitatively.Results In qualitative evaluation,with the number of phase coding increased,the streaking artifact decreased(H=83.022,P＜0.005).In quantitative evaluation,SNRmuscle,SNRthyroid,SNRcontrast-enhanced artery and CNRcontrast-enhanced gradually increased with the increase of phase coding number(SNRmuscle:F=6.913,P＜0.005;SNRthyroid:F=3.930,P=0.005;SNRcontrast-enhanced artery:F=6.980,P＜0.005;CNRcontrast-enhanced:F=6.482,P＜0.005),while CNRsoft tissue showed no statistical difference(F=1.114,P=0.339).Conclusion There is streaking artifact on the image of the Star-VIBE sequence,which can be reduced by increas-ing the number of phase coding appropriately.The most suitable phase coding is 960.

Aim To investigate the effect of Shenqi Dihuang decoction(SQDH)on henoch-schonlein pur-pura nephritis(HSPN)rats by regulating AMPK/Sirt1/Nrf2 mediated ferroptosis and the possible mech-anism.Methods Thirty SD rats were randomly divid-ed into a control group(Control),HSPN group,SQDH low-dose group(SQDH-L,5.4 g·kg-1),SQDH high-dose group(SQDH-H,21.6 g·kg-1),and SQDH high-dose+AMPK inhibitor group(SQDH-H+CC,20 mg·kg-1),with six rats in each group.Except for the control group,all other groups of rats were injected intraperitoneally with ovalbumin and complete Freund's adjuvant to establish HSPN rat models.After the successful construction of the model,each group of rats was orally administered with the cor-responding dosage or physiological saline once a day for five weeks.HE staining was used to observe the his-topathological changes in renal tissues;immunohisto-chemistry(IHC)was employed to detect the deposition of IgA and IgG in renal tissues;serum biochemical pa-rameters of renal function and urinary protein levels were measured;commercial assay kits were utilized to determine oxidative stress markers and Fe2+levels in renal tissues;Western blot analysis was performed to assess ferroptosis-related proteins and the protein ex-pression of the AMPK/Sirt1/Nrf2 signaling pathway in renal tissues.Results Compared with the control group,the HSPN group showed significant pathological damage in kidney tissue,with significantly increased scores,increased deposition of IgA and IgG in kidney tissue,decreased serum total protein(TP)and albu-min(ALB),and average increases in serum creatinine(Cre),urea nitrogen(BUN),and urinary protein levels(P＜0.05).The levels of MDA,ROS,Fe2+,and ACSL4 protein expression in the kidney tissue sig-nificantly increased,while SOD activity,SLC7A11,GPX4,p-AMPK/AMPK,Sirt1,and Nrf2 protein ex-pression significantly decreased(P＜0.05).Com-pared with the HSPN group,the pathological damage to renal tissue was reduced,IgA and IgG deposition in renal tissue decreased,TP and ALB decreased,Cre,BUN,and urinary protein levels were all reduced(P＜0.05),and the levels of MDA,ROS,Fe2+,and ACSL4 protein expression in renal tissue were signifi-cantly reduced in each dose group of SQDH rats.SOD activity,SLC7A11,GPX4,p-AMPK/AMPK,Sirt1,and Nrf2 protein expression significantly increased(P＜0.05).Compared with the SQDH-H group,the AMPK inhibitor CC could inhibit the AMPK/Sirt1/Nrf2 signaling pathway induced ferroptosis and reverse the protective effect of SQDH on renal injury in HSPN rats.Conclusions SQDH can improve renal injury in HSPN rats,and its mechanism may be related to the activation of AMPK/Sirt1/Nrf2 signaling pathway to in-hibit ferroptosis.

Objective To study the effects of porous prothesis with radial gradient and homogenized structures on stress transmission in the tibia by using finite element method.Methods Based on the reverse engineering technology,the tibial model was constructed,and the bionic trabecular bone structure prosthesis with gradient change of pore edge diameter and the homogeneous bionic trabecular bone structure prosthesis were designed.The Vicon dynamic capture platform was used to obtain the human gait and the axial force of the tibia-femoral joint during flexion,which was imported into ANSYS Workbench as a boundary condition for mechanical performance analysis.Results In the case of proximal defect,the von Mises stress of the bone for prosthesis with radial gradient structure was increased by 3.68 MPa,and that in the case of distal defect was increased by 7.34 MPa.Compared with the homogenized prosthesis,the von Mises stress of the proximal and distal defects was decreased by 171 MPa and 190.4 MPa,respectively.Conclusions The stress of the radial gradient structure prosthesis diffuses from the outside to the middle high porosity area along the prosthesis,which can effectively transfer the tibial plateau load,reduce stress concentration of the prosthesis,improve bone stress and prolong service life of the prosthesis.This study provides a theoretical reference for clinical prosthesis replacement.

Objective:To explore the effect of horizontal Baduanjin guided by interactive standard reaching theory(ISRT)on cardiac function and quality of life in patients with chronic heart failure(CHF).Methods:This random-ized controlled study enrolled 114 patients diagnosed with CHF in Bozhou People's Hospital between September 2024 and February 2025.Patients were randomly divided into control group(n=57,routine nursing care)and interven-tion group(n=57,horizontal Baduanjin under the guidance of interactive standard theory).Both groups were con-tinuously treated for 3 months.Cardiac function indexes,N-terminal pro-brain natriuretic peptide(NT-proB-NP),self-care ability,quality of life and incidence of major adverse cardiovascular events(MACE)were com-pared between the two groups.Results:Compared to patients in the control group,those in the intervention had significant higher left ventricular ejection fraction(LVEF)[(56.34±0.86)％vs.(46.69±0.91)％],6min walking distance(6MWD)[(477.16±6.62)m vs.(451.39±4.17)m]and the proportion of New York Heart Association(NYHA)class Ⅱ(70.18％vs.35.09％),and significant lower NT-proBNP[(237.76±6.41)pg/ml vs.(377.46±6.85)pg/ml],scores of the European heart failure self-care behavior scale 9(EHFSCB-9)[(12.61±1.81)points vs.(25.51±1.71)points],the physical domain[(3.96±0.91)points vs.(11.05±0.79)points],emotional domain[(4.00±0.85)points vs.(11.95±0.81)points]and other domain[(4.05±0.83)points vs.(13.47±1.15)points]of MLHFQ(P＜0.001 all).Compared to those in the control group,patients in intervention group had significant lower incidence of MACE(7.02％vs.22.81％,P=0.035).Conclusion:Under the guidance of the interactive standard theory,the horizontal Baduanjin exercise may enhance the cardiac function,improve self-care ability and quality of life in patients with chronic heart failure.

Objective To study the effects of porous prothesis with radial gradient and homogenized structures on stress transmission in the tibia by using finite element method.Methods Based on the reverse engineering technology,the tibial model was constructed,and the bionic trabecular bone structure prosthesis with gradient change of pore edge diameter and the homogeneous bionic trabecular bone structure prosthesis were designed.The Vicon dynamic capture platform was used to obtain the human gait and the axial force of the tibia-femoral joint during flexion,which was imported into ANSYS Workbench as a boundary condition for mechanical performance analysis.Results In the case of proximal defect,the von Mises stress of the bone for prosthesis with radial gradient structure was increased by 3.68 MPa,and that in the case of distal defect was increased by 7.34 MPa.Compared with the homogenized prosthesis,the von Mises stress of the proximal and distal defects was decreased by 171 MPa and 190.4 MPa,respectively.Conclusions The stress of the radial gradient structure prosthesis diffuses from the outside to the middle high porosity area along the prosthesis,which can effectively transfer the tibial plateau load,reduce stress concentration of the prosthesis,improve bone stress and prolong service life of the prosthesis.This study provides a theoretical reference for clinical prosthesis replacement.

Objective:To explore the effect of horizontal Baduanjin guided by interactive standard reaching theory(ISRT)on cardiac function and quality of life in patients with chronic heart failure(CHF).Methods:This random-ized controlled study enrolled 114 patients diagnosed with CHF in Bozhou People's Hospital between September 2024 and February 2025.Patients were randomly divided into control group(n=57,routine nursing care)and interven-tion group(n=57,horizontal Baduanjin under the guidance of interactive standard theory).Both groups were con-tinuously treated for 3 months.Cardiac function indexes,N-terminal pro-brain natriuretic peptide(NT-proB-NP),self-care ability,quality of life and incidence of major adverse cardiovascular events(MACE)were com-pared between the two groups.Results:Compared to patients in the control group,those in the intervention had significant higher left ventricular ejection fraction(LVEF)[(56.34±0.86)％vs.(46.69±0.91)％],6min walking distance(6MWD)[(477.16±6.62)m vs.(451.39±4.17)m]and the proportion of New York Heart Association(NYHA)class Ⅱ(70.18％vs.35.09％),and significant lower NT-proBNP[(237.76±6.41)pg/ml vs.(377.46±6.85)pg/ml],scores of the European heart failure self-care behavior scale 9(EHFSCB-9)[(12.61±1.81)points vs.(25.51±1.71)points],the physical domain[(3.96±0.91)points vs.(11.05±0.79)points],emotional domain[(4.00±0.85)points vs.(11.95±0.81)points]and other domain[(4.05±0.83)points vs.(13.47±1.15)points]of MLHFQ(P＜0.001 all).Compared to those in the control group,patients in intervention group had significant lower incidence of MACE(7.02％vs.22.81％,P=0.035).Conclusion:Under the guidance of the interactive standard theory,the horizontal Baduanjin exercise may enhance the cardiac function,improve self-care ability and quality of life in patients with chronic heart failure.