Objective To investigate the safety and efficacy of combined confluence microdissection or balloon dilatation followed by laparoscopic transcystic common bile duct exploration (LTCBDE) in day surgery laparoscopic cholecystectomy. Methods The clinical data of 203 patients with day surgery laparoscopic cholecystectomy combined with LTCBDE from June 2021 to June 2024 in Beijing Friendship Hospital, Capital Medical University were retrospectively analyzed. They were divided into an observation group (59 cases, including 42 cases of confluent microdissection and 17 cases of balloon dilatation) and a conventional group (144 cases) according to the surgical technique used. Baseline characteristics, intraoperative exploration results, operation time, postoperative recovery and complications were compared between the two groups. Results The history of preoperative cholangitis or pancreatitis (P<0.001) was more common in the observation group. And total bilirubin level was significantly higher in the observation group than in the conventional group (P=0.035). The observation group had a longer operative time (P=0.014) and higher hospitalization costs (P=0.001), but there was no difference in intraoperative bleeding and postoperative discharge time. There were no serious postoperative complications in either group. Conclusions Under the premise of strict patient screening, day surgery LTCBDE combined with confluence microdissection or balloon dilatation can effectively solve the problem of difficult choledochoscopic access, with high safety and thoroughness of exploration. Both techniques provide a feasible minimally observation solution for day surgery biliary exploration.

Objective:To investigate the role of pyroptosis in T-2 toxin induced articular cartilage injury.Methods:A total of 145 SPF grade male Wistar rats were randomly divided into blank control group ( n = 45), solvent control group ( n = 45), and T-2 toxin group ( n = 55) based on body weight (50 - 70 g). The T-2 toxin group and the solvent control group were given 100 ng·g -1·d -1 T-2 toxin and an equal amount of anhydrous ethanol by gavage, respectively; the blank control group was fed routinely. Fifteen rats from each group were euthanized at 6, 12, and 24 weeks of intervention, and bilateral knee joints of the rats were collected. Pathological changes in rat knee articular cartilage were observed using hematoxylin and eosin staining. TdT-mediated dUTP nick-end labeling (TUNEL) staining was used to detect chondrocyte injury. Western blot was used to detect the protein expression of gasdermin D (GSDMD), cleaved N-terminal of gasdermin D (GSDMD-N), NOD like receptor thermal protein domain associated protein 3 (NLRP3), cysteinyl aspartate specific proteinase 1 (Caspase-1), interleukin 1β (IL-1β), interleukin 18 (IL-18), and apoptosis-associated spike-like protein containing CARD (ASC). Results:At 6, 12, and 24 weeks of intervention, the T-2 toxin group rats showed varying degrees of damage to the knee articular cartilage tissue, including a decrease in the number of chondrocytes and death. At 24 weeks of intervention, the TUNEL staining positivity rates of chondrocytes in the blank control group, solvent control group, and T-2 toxin group were (1.28 ± 0.45)%, (0.73 ± 0.27)%, and (4.01 ± 2.37)%, respectively, with statistically significant differences between the groups ( F = 6.11, P = 0.036); and the T-2 toxin group was higher than the blank control group ( P < 0.05). At 24 weeks of intervention, there were statistically significant differences in the expression levels of NLRP3, Caspase-1, GSDMD, GSDMD-N, and IL-1β proteins among the blank control group, solvent control group, and T-2 toxin group ( F = 3.81, 11.81, 6.74, 3.71, 155.49, P = 0.044, 0.003, 0.023, 0.036, 0.001); and the T-2 toxin group was higher than the blank control group ( P < 0.05). At different intervention cycles, there was no statistically significant difference in the expression levels of ASC and IL-18 proteins among the groups ( F = 0.78, 0.93, 3.73, 2.26, 0.88, 0.11, P > 0.05). Conclusion:The NLRP3/Caspase-1/GSDMD pathway mediated pyroptosis is involved in T-2 toxin induced articular cartilage injury in rats.

BACKGROUND:Previous studies have indicated that cathepsin K can intervene with the occurrence and development of osteoporosis by regulating bone mineral density in middle-aged and older adults. However,whether there is a causal relationship between the cathepsin family and bone mineral density in other populations remains unknown. OBJECTIVE:To investigate the causal relationship between cathepsin and bone mineral density.METHODS:Genetic loci associated with eight cathepins were extracted from the IEU Open GWAS database as instrumental variables,and bone mineral density values in five age groups acted as an outcome. The causal relationship between cathepin and bone mineral density was assessed by two-way Mendelian randomization analysis. Heterogeneity of the genetic instrumental variables was assessed using Cochran's Q test,pleiotropy was assessed using the MR-Egger intercept test,and the sensitivity of single nucleotide polymorphisms used as instrumental variables to the causal effect of exposure and outcome was assessed using the leave-one-out method. RESULTS AND CONCLUSION:The results of the inverse variance weighting method with positive Mendelian randomization showed that cathepin H was negatively associated with bone mineral density in people aged 45-60 years[odds ratio (95％ confidence interval)=0.965(0.94-0.99),P=0.04];cathepin Z was negatively associated with bone mineral density in people aged 30-45 year[odds ratio (95％ confidence interval)=1.06 (1.00-1.11),P=0.03]. The results of sensitivity analysis showed a stable causal relationship,and MR-Egger intercept analysis did not detect potential horizontal pleiotropy. The inverse Mendelian randomization results showed that bone mineral density had no significant inverse effect on cathepin. The above results confirm that cathepin can affect bone mineral density in some age groups,which may increase the risk of osteoporosis and should be given more attention.

YTHDF2 is a key m6A RNA modification"reader"that plays a crucial role in cell biological processes and tumor development.This review deeply explores the biological role of YTHDF2 and the advances in its application in tumors.The YTHDF2 structures are divided into mRNA procsomes and YTH domains,which recognize and bind m6A modified RNA molecules.It plays a biological role by promoting mRNA degradation,regu-lating cell signaling pathways and metabolism,and can regulate macrophage function and maintain an immunosup-pressive state in the tumor microenvironment.YTHDF2 has the potential to serve as diagnostic markers,therapeu-tic targets and prognostic evaluation biomarkers in different tumors,but currently relevant studies are insufficient in sample size,molecular mechanism and clinical application.In the future,research can be conducted on compre-hensive clinical research,in-depth analysis of molecular mechanisms,and research and development of optimized treatment strategies.

BACKGROUND:Previous studies have indicated that cathepsin K can intervene with the occurrence and development of osteoporosis by regulating bone mineral density in middle-aged and older adults. However,whether there is a causal relationship between the cathepsin family and bone mineral density in other populations remains unknown. OBJECTIVE:To investigate the causal relationship between cathepsin and bone mineral density.METHODS:Genetic loci associated with eight cathepins were extracted from the IEU Open GWAS database as instrumental variables,and bone mineral density values in five age groups acted as an outcome. The causal relationship between cathepin and bone mineral density was assessed by two-way Mendelian randomization analysis. Heterogeneity of the genetic instrumental variables was assessed using Cochran's Q test,pleiotropy was assessed using the MR-Egger intercept test,and the sensitivity of single nucleotide polymorphisms used as instrumental variables to the causal effect of exposure and outcome was assessed using the leave-one-out method. RESULTS AND CONCLUSION:The results of the inverse variance weighting method with positive Mendelian randomization showed that cathepin H was negatively associated with bone mineral density in people aged 45-60 years[odds ratio (95％ confidence interval)=0.965(0.94-0.99),P=0.04];cathepin Z was negatively associated with bone mineral density in people aged 30-45 year[odds ratio (95％ confidence interval)=1.06 (1.00-1.11),P=0.03]. The results of sensitivity analysis showed a stable causal relationship,and MR-Egger intercept analysis did not detect potential horizontal pleiotropy. The inverse Mendelian randomization results showed that bone mineral density had no significant inverse effect on cathepin. The above results confirm that cathepin can affect bone mineral density in some age groups,which may increase the risk of osteoporosis and should be given more attention.

YTHDF2 is a key m6A RNA modification"reader"that plays a crucial role in cell biological processes and tumor development.This review deeply explores the biological role of YTHDF2 and the advances in its application in tumors.The YTHDF2 structures are divided into mRNA procsomes and YTH domains,which recognize and bind m6A modified RNA molecules.It plays a biological role by promoting mRNA degradation,regu-lating cell signaling pathways and metabolism,and can regulate macrophage function and maintain an immunosup-pressive state in the tumor microenvironment.YTHDF2 has the potential to serve as diagnostic markers,therapeu-tic targets and prognostic evaluation biomarkers in different tumors,but currently relevant studies are insufficient in sample size,molecular mechanism and clinical application.In the future,research can be conducted on compre-hensive clinical research,in-depth analysis of molecular mechanisms,and research and development of optimized treatment strategies.

Objective:To investigate the role of pyroptosis in T-2 toxin induced articular cartilage injury.Methods:A total of 145 SPF grade male Wistar rats were randomly divided into blank control group ( n = 45), solvent control group ( n = 45), and T-2 toxin group ( n = 55) based on body weight (50 - 70 g). The T-2 toxin group and the solvent control group were given 100 ng·g -1·d -1 T-2 toxin and an equal amount of anhydrous ethanol by gavage, respectively; the blank control group was fed routinely. Fifteen rats from each group were euthanized at 6, 12, and 24 weeks of intervention, and bilateral knee joints of the rats were collected. Pathological changes in rat knee articular cartilage were observed using hematoxylin and eosin staining. TdT-mediated dUTP nick-end labeling (TUNEL) staining was used to detect chondrocyte injury. Western blot was used to detect the protein expression of gasdermin D (GSDMD), cleaved N-terminal of gasdermin D (GSDMD-N), NOD like receptor thermal protein domain associated protein 3 (NLRP3), cysteinyl aspartate specific proteinase 1 (Caspase-1), interleukin 1β (IL-1β), interleukin 18 (IL-18), and apoptosis-associated spike-like protein containing CARD (ASC). Results:At 6, 12, and 24 weeks of intervention, the T-2 toxin group rats showed varying degrees of damage to the knee articular cartilage tissue, including a decrease in the number of chondrocytes and death. At 24 weeks of intervention, the TUNEL staining positivity rates of chondrocytes in the blank control group, solvent control group, and T-2 toxin group were (1.28 ± 0.45)%, (0.73 ± 0.27)%, and (4.01 ± 2.37)%, respectively, with statistically significant differences between the groups ( F = 6.11, P = 0.036); and the T-2 toxin group was higher than the blank control group ( P < 0.05). At 24 weeks of intervention, there were statistically significant differences in the expression levels of NLRP3, Caspase-1, GSDMD, GSDMD-N, and IL-1β proteins among the blank control group, solvent control group, and T-2 toxin group ( F = 3.81, 11.81, 6.74, 3.71, 155.49, P = 0.044, 0.003, 0.023, 0.036, 0.001); and the T-2 toxin group was higher than the blank control group ( P < 0.05). At different intervention cycles, there was no statistically significant difference in the expression levels of ASC and IL-18 proteins among the groups ( F = 0.78, 0.93, 3.73, 2.26, 0.88, 0.11, P > 0.05). Conclusion:The NLRP3/Caspase-1/GSDMD pathway mediated pyroptosis is involved in T-2 toxin induced articular cartilage injury in rats.

Acromioclavicular joint dislocation is a common clinical condition in shoulder injuries, causing shoulder pain, swelling, and tenderness, and leading to limitations in abduction, elevation, forward flexion, and extension of the upper limb, which severely affects the patient′s daily life. Rockwood type ⅢB to type Ⅵ acromioclavicular joint dislocations, involving coracoclavicular ligament rupture, often require surgical treatment. Coracoclavicular fixation or ligament reconstruction, by reconstructing the coracoclavicular ligament, restores the vertical stability of the acromioclavicular joint and is more in line with the anatomical structure of the joint, which has been widely accepted by clinical physicians and patients. However, in recent years, there have been reports questioning its adequacy in horizontal stability. This article aims to review the treatment of acromioclavicular joint dislocations with coracoclavicular fixation and coracoclavicular ligament reconstruction and to discuss the future prospects of this approach.

Objective:To evaluate the efficacy and safety profile of tenofovir amibufenamide (TMF) at 48 weeks in patients with hepatitis B virus-related compensated and decompensated stage cirrhosis.Methods:Patients with treatment-na?ve or treatment-experienced hepatitis B virus-related cirrhosis with nucleos(t)ide analogues (NA) who met the inclusion and exclusion criteria from 2022 to 2024 were retrospectively collected and divided into the tenofovir amibufenamide group (TMF, n=25) and the tenofovir alafenamide fumarate group (TAF, n=14). The conditional changes in hepatitis B virus DNA (HBV DNA), hepatitis B surface antigen (HBsAg), liver function indexes, serum creatinine (Cr), estimated glomerular filtration rate (eGFR), serum phosphorus, blood lipid profiles, and other variables were compared between and within the groups at baseline and 48 weeks. The t-test or Kruskal-Wallis H test was used to compare the measurement data among the groups. The χ2 test was used for the enumeration data. Results:There were no statistically significant differences in baseline, age, gender, proportion of compensated/decompensated stage cirrhosis, proportion of NA-naive/treatment experienced, liver function indexes, serum Cr, and eGFR between the two groups ( P>0.05). There was no statistically significant difference in the proportion of patients with HBV DNA<30 IU/ml ( P=1.00) between the two groups, regardless of whether they were NA-naive ( P=0.52) or treatment experienced ( P=1.00) at 48 weeks. There was no statistically significant difference in HBsAg levels between the TMF and TAF groups ( P=0.18) at 48 weeks. There was no statistically significant difference in the decline of HBsAg within each group ( P>0.05). The levels of alanine aminotransferase ( P<0.001) and aspartate aminotransferase ( P=0.045) were significantly lower at 48 weeks than those at baseline, while the albumin level was higher than that at baseline ( P=0.004) among the TMF group. There were no statistically significant differences in the rest of the liver function indicators among the TMF and the TAF groups between baseline and 48 weeks ( P>0.05). There were no statistically significant differences in Cr ( P=0.34) and eGFR levels ( P=0.60) at 48 weeks between the TMF and TAF groups.There were no statistically significant differences in Cr ( P=0.89) and eGFR levels ( P=0.57) at 48 weeks in patients aged<40 years ( n=8) compared with baseline in the TMF group. There were no statistically significant differences ( P=0.09, P=0.13) in patients with similar aged≥40 years ( n=17). The reduction in Cr level ( P<0.001) and the increase in eGFR ( P<0.001) at 48 weeks were statistically significant in patients aged<40 years ( n=3) among the TAF group. There were no statistically significant differences in Cr ( P=0.30) and eGFR ( P=0.13) at 48 weeks in patients aged≥40 years compared with baseline. There were no statistically significant differences in serum phosphorus, triglycerides, total cholesterol, high-density lipoprotein, low-density lipoprotein, and blood glucose levels at baseline and 48 weeks in the TMF and TAF groups ( P>0.05). Conclusion:TMF has a relatively better efficacy and safety profile than TAF at 48 weeks in patients with hepatitis B virus-related cirrhosis.

Objective:To evaluate the efficacy and safety profile of tenofovir amibufenamide (TMF) at 48 weeks in patients with hepatitis B virus-related compensated and decompensated stage cirrhosis.Methods:Patients with treatment-na?ve or treatment-experienced hepatitis B virus-related cirrhosis with nucleos(t)ide analogues (NA) who met the inclusion and exclusion criteria from 2022 to 2024 were retrospectively collected and divided into the tenofovir amibufenamide group (TMF, n=25) and the tenofovir alafenamide fumarate group (TAF, n=14). The conditional changes in hepatitis B virus DNA (HBV DNA), hepatitis B surface antigen (HBsAg), liver function indexes, serum creatinine (Cr), estimated glomerular filtration rate (eGFR), serum phosphorus, blood lipid profiles, and other variables were compared between and within the groups at baseline and 48 weeks. The t-test or Kruskal-Wallis H test was used to compare the measurement data among the groups. The χ2 test was used for the enumeration data. Results:There were no statistically significant differences in baseline, age, gender, proportion of compensated/decompensated stage cirrhosis, proportion of NA-naive/treatment experienced, liver function indexes, serum Cr, and eGFR between the two groups ( P>0.05). There was no statistically significant difference in the proportion of patients with HBV DNA<30 IU/ml ( P=1.00) between the two groups, regardless of whether they were NA-naive ( P=0.52) or treatment experienced ( P=1.00) at 48 weeks. There was no statistically significant difference in HBsAg levels between the TMF and TAF groups ( P=0.18) at 48 weeks. There was no statistically significant difference in the decline of HBsAg within each group ( P>0.05). The levels of alanine aminotransferase ( P<0.001) and aspartate aminotransferase ( P=0.045) were significantly lower at 48 weeks than those at baseline, while the albumin level was higher than that at baseline ( P=0.004) among the TMF group. There were no statistically significant differences in the rest of the liver function indicators among the TMF and the TAF groups between baseline and 48 weeks ( P>0.05). There were no statistically significant differences in Cr ( P=0.34) and eGFR levels ( P=0.60) at 48 weeks between the TMF and TAF groups.There were no statistically significant differences in Cr ( P=0.89) and eGFR levels ( P=0.57) at 48 weeks in patients aged<40 years ( n=8) compared with baseline in the TMF group. There were no statistically significant differences ( P=0.09, P=0.13) in patients with similar aged≥40 years ( n=17). The reduction in Cr level ( P<0.001) and the increase in eGFR ( P<0.001) at 48 weeks were statistically significant in patients aged<40 years ( n=3) among the TAF group. There were no statistically significant differences in Cr ( P=0.30) and eGFR ( P=0.13) at 48 weeks in patients aged≥40 years compared with baseline. There were no statistically significant differences in serum phosphorus, triglycerides, total cholesterol, high-density lipoprotein, low-density lipoprotein, and blood glucose levels at baseline and 48 weeks in the TMF and TAF groups ( P>0.05). Conclusion:TMF has a relatively better efficacy and safety profile than TAF at 48 weeks in patients with hepatitis B virus-related cirrhosis.