Objective·To compare the safety and short-term outcomes of robot-assisted versus laparoscopic-assisted proximal gastrectomy combined with double-flap esophagogastrostomy in the treatment of early upper gastric cancer.Methods·A retrospective cohort study was conducted to analyze the clinical and pathological data of 31 early gastric cancer patients who underwent proximal gastrectomy combined with double-flap esophagogastrostomy for gastrointestinal reconstruction at the Department of Gastrointestinal Surgery,Renji Hospital,Shanghai Jiao Tong University School of Medicine,from September 2023 to March 2024.Based on the surgical approach,patients were divided into the robot-assisted surgery group(robotic group,20 cases)and the laparoscope-assisted surgery group(laparoscopic group,11 cases).General clinical data,intraoperative conditions,and postoperative recovery between the two groups were compared.At the 6-month postoperative follow-up,upper gastrointestinal radiography and esophagogastroscopy were performed to assess anastomotic stricture and gastroesophageal reflux disease.Additionally,the gastric cancer-specific module of the European Organization for Research and Treatment of Cancer(EORTC),Quality of Life Questionnaire-Stomach 22(QLQ-STO22),was used to evaluate the patients' quality of life.Results·The general data of the two groups,including gender,age,preoperative comorbidities,American Society of Anesthesiologists(ASA)classification,Siewert classification,and pathological staging of tumors,showed no statistically significant differences(all P>0.05).All patients successfully underwent the procedure without conversion to open surgery.The time for gastroesophageal anastomosis was significantly shorter in the robotic group compared to the laparoscopic group[(31.09±8.23)min vs(43.73±8.83)min,P<0.001],while there were no statistically significant differences in other intraoperative and postoperative parameters,including operative time,intraoperative blood loss,number of lymph nodes removed,duration of gastric tube placement,time to start a liquid diet,length of postoperative hospital stay,and incidence of postoperative complications(all P>0.05).At the 6-month postoperative follow-up,30 patients completed the follow-up,with one patient lost to follow-up in the robotic group.Upper gastrointestinal radiography and esophagogastroscopy results showed that only one patient in the laparoscopic group developed an anastomotic stricture,while one patient in the robotic group developed grade A and one developed grade B gastroesophageal reflux disease(GERD).In addition,one patient in the laparoscopic group also developed grade B GERD.The incidences of GERD and anastomotic stricture showed no statistically significant differences between the two groups(both P>0.05).EORTC QLQ-STO22 results indicated that the robotic group had significantly lower scores in the dimensions of dysphagia,gastroesophageal reflux,and dietary restrictions,as well as in the total score,compared to the laparoscopic group(all P<0.05).Conclusion·Robot-assisted proximal gastrectomy combined with double-flap esophagogastrostomy is safe and feasible.It shortens anastomosis time and offers potential advantages in postoperative functional recovery and quality of life improvement.

Objective·To compare the safety and short-term outcomes of robot-assisted versus laparoscopic-assisted proximal gastrectomy combined with double-flap esophagogastrostomy in the treatment of early upper gastric cancer.Methods·A retrospective cohort study was conducted to analyze the clinical and pathological data of 31 early gastric cancer patients who underwent proximal gastrectomy combined with double-flap esophagogastrostomy for gastrointestinal reconstruction at the Department of Gastrointestinal Surgery,Renji Hospital,Shanghai Jiao Tong University School of Medicine,from September 2023 to March 2024.Based on the surgical approach,patients were divided into the robot-assisted surgery group(robotic group,20 cases)and the laparoscope-assisted surgery group(laparoscopic group,11 cases).General clinical data,intraoperative conditions,and postoperative recovery between the two groups were compared.At the 6-month postoperative follow-up,upper gastrointestinal radiography and esophagogastroscopy were performed to assess anastomotic stricture and gastroesophageal reflux disease.Additionally,the gastric cancer-specific module of the European Organization for Research and Treatment of Cancer(EORTC),Quality of Life Questionnaire-Stomach 22(QLQ-STO22),was used to evaluate the patients' quality of life.Results·The general data of the two groups,including gender,age,preoperative comorbidities,American Society of Anesthesiologists(ASA)classification,Siewert classification,and pathological staging of tumors,showed no statistically significant differences(all P>0.05).All patients successfully underwent the procedure without conversion to open surgery.The time for gastroesophageal anastomosis was significantly shorter in the robotic group compared to the laparoscopic group[(31.09±8.23)min vs(43.73±8.83)min,P<0.001],while there were no statistically significant differences in other intraoperative and postoperative parameters,including operative time,intraoperative blood loss,number of lymph nodes removed,duration of gastric tube placement,time to start a liquid diet,length of postoperative hospital stay,and incidence of postoperative complications(all P>0.05).At the 6-month postoperative follow-up,30 patients completed the follow-up,with one patient lost to follow-up in the robotic group.Upper gastrointestinal radiography and esophagogastroscopy results showed that only one patient in the laparoscopic group developed an anastomotic stricture,while one patient in the robotic group developed grade A and one developed grade B gastroesophageal reflux disease(GERD).In addition,one patient in the laparoscopic group also developed grade B GERD.The incidences of GERD and anastomotic stricture showed no statistically significant differences between the two groups(both P>0.05).EORTC QLQ-STO22 results indicated that the robotic group had significantly lower scores in the dimensions of dysphagia,gastroesophageal reflux,and dietary restrictions,as well as in the total score,compared to the laparoscopic group(all P<0.05).Conclusion·Robot-assisted proximal gastrectomy combined with double-flap esophagogastrostomy is safe and feasible.It shortens anastomosis time and offers potential advantages in postoperative functional recovery and quality of life improvement.

OBJECTIVE To investigate the intervention effect of kushenol F （KSC-F） on ulcerative colitis （UC） mice. METHODS Totally 30 male C57BL/6J mice were randomly divided into the normal group， model group， positive drug group （sulfasalazine， 703 mg/kg）， KSC-F 50 mg/kg group （KSC-F50 group）， and KSC-F 100 mg/kg group （KSC-F100 group）， with 6 mice in each group. Except for the normal group， the mice in the remaining groups were given 3% dextran sulfate sodium solution continuously for 7 days to induce UC model. Concurrently， administration groups received corresponding drug solution intragastrically， once a day， for 10 consecutive days. During the experiment， the changes in body weight and bowel movements of the mice were observed. Disease activity index scoring was performed after the last administration. The histopathological morphology of colonic tissue was examined. The levels of inflammatory factors in the serum and colon tissue were measured. Additionally， the mRNA expression of inflammatory factors， and the protein expressions of inflammation-related proteins [interleukin-1β （IL-1β）， forkhead box O1（FOXO1）， phosphoinositide 3-kinase（PI3K）， phosphorylated PI3K（p-PI3K）， p38 mitogen-activated protein kinase（p38 MAPK）， phosphorylated p38 MAPK（p-p38 MPAK） and phosphorylated protein kinase B（p- Akt）] were determined in colonic tissue. RESULTS KSC-F could alleviate weight loss and colonic tissue damage in UC mice. KSC- F reduced the levels of IL-1β， IL-6， IL-8 and tumor necrosis factor-α （TNF-α） in serum， as well as IL-1β， IL-6， IL-17 and TNF- α in colonic tissue to varying degrees and increased the levels of IL-10 in both serum and colonic tissue （P＜0.05 or P＜0.01）. Moreover， KSC-F decreased the expression levels of IL-1β， IL-17 and TNF-α mRNA， as well as p-PI3K， p-p38 MAPK， and p- Akt proteins in colonic tissue to varying degrees， and increased the expression levels of IL-10 mRNA and FOXO1 protein in colonic tissue （P＜0.05 or P＜0.01）. CONCLUSIONS KSC-F effectively alleviates UC symptoms in mice by inhibiting PI3K， Akt and p38 MAPK activation， mitigating the release of pro-inflammatory factors such as IL-1β， IL-6， TNF- α，promoting the anti-inflammatory factor IL-10 secretion， and reducing inflammation-induced colonic tissue damage.

OBJECTIVE To explore the action mechanism of kushenol F （KSCF） in treating ulcerative colitis （UC） in mice. METHODS The potential targets of KSCF intervening in UC were predicted with network pharmacology and molecular docking. C57BL/6J mice were randomly divided by body weight into model group， positive control group （sulfasalazine， 703 mg/kg）， KSCF group （100 mg/kg）， and normal group， with 6 mice per group. The UC model of mice was induced by dextran sulfate sodium solution. During the modeling period， the mice were given relevant medicine intragastrically， once a day， for 7 consecutive days. After the last administration， the disease activity index （DAI） of the mice was scored； the length of the mice’s colon was measured； pathological changes in the colon tissue of mice were observed； the levels of lipopolysaccharide （LPS） in serum， myeloperoxidase （MPO）， nitric oxide （NO） and superoxide dismutase （SOD） in the colon were detected in mice； the expression levels of occludin and ZO-1 in colon tissue of mice were detected； the proportions of CD3+T， CD4+T， and CD8+T lymphocytes in the spleen and the ratio of CD4+/CD8+ were detected； changes in colonic microbiota were analyzed by 16S rDNA sequencing. RESULTS Results of network pharmacology indicated that KSCF may treat UC by regulating signaling pathways such as phosphatidylinositol-3 kinase/protein kinase B （PI3K/AKT） and nuclear factor kappa B （NF- κB）. Molecular docking results showed that KSCF bound most stably with NF-κB p65 protein. Animal experiment results demonstrated that， compared with the model group， the pathological characteristics of colon tissue in mice were improved in KSCF group. DAI scores， serum levels of LPS， the levels of MPO，NF-κB p65 phosphorylation and NLRP3 protein expression in the colon， and the proportion of CD8+T lymphocytes in the spleen were reduced significantly （P＜0.05）. Body weight， SOD levels， expression levels of occludin and ZO-1 in the colon， proportions of CD3+T and CD4+T lymphocytes， and the CD4+/CD8+ ratio in the spleen were significantly increased （P＜0.05）； the abundance of Firmicutes， Actinobacteria， Akkermansia， and Lactobacillus genera were increased， while Proteobacteria decreased； the microbial community structure tended towards that of the normal group. CONCLUSIONS KSCF alleviates UC by restoring intestinal microbial imbalance， enhancing immune response， and inhibiting colonic inflammatory responses， thereby improving intestinal barrier integrity.

Objective To observe CT findings of mycoplasma pneumoniae pneumonia(MPP)in children.Methods A total of 85 MPP children confirmed by mycoplasma pneumoniae nucleic acid test were retrospectively collected.Chest CT manifestations of MPP were analyzed,and artificial intelligence pneumonia CT image-assisted diagnostic analysis software was used to quantify lesion volume(LV),percentage of lesion LV in total lung volume(LV％)and CT value,and the correlations of quantitative CT parameters with clinical laboratory indicators were explored.Results The main CT manifestations of MPP in children included thickened bronchial wall(78/85,91.76％),tree bud sign(70/85,82.35％),large mass compaction(39/85,45.88％),bronchial occlusion(29/85,34.12％),air bronchial sign(25/85,29.41％),acinar nodules(23/85,27.06％),consolidation along the bronchus(21/85,24.71％),cotton ball sign(19/85,22.35％),tree fog sign(15/85,17.65％)and atelectasis(14/85,16.47％).The median LV of MPP was 50.73(26.38,85.90)cm3,the median LV％was 3.10％(1.60％,5.70％)and the median CT value was-422.61(-479.46,-343.76)HU.MPP LV was positively correlated with serum sialic acid,C reactive protein(CRP),D-dimer,fibrin degradation products(FDP)and fibrinogen(Fib)(rs=0.232-0.400),while LV％was positively correlated with serum sialic acid,D-dimer and FDP(rs=0.349-0.439).There was a positive correlation between CT value and CRP(rs=0.288).Conclusion CT findings of MPP in children had certain characteristics.Combining with laboratory examinations was conducive to clinical diagnosis,monitoring condition and evaluating therapeutic efficacy of MPP in children.

Objective To observe CT findings of mycoplasma pneumoniae pneumonia(MPP)in children.Methods A total of 85 MPP children confirmed by mycoplasma pneumoniae nucleic acid test were retrospectively collected.Chest CT manifestations of MPP were analyzed,and artificial intelligence pneumonia CT image-assisted diagnostic analysis software was used to quantify lesion volume(LV),percentage of lesion LV in total lung volume(LV％)and CT value,and the correlations of quantitative CT parameters with clinical laboratory indicators were explored.Results The main CT manifestations of MPP in children included thickened bronchial wall(78/85,91.76％),tree bud sign(70/85,82.35％),large mass compaction(39/85,45.88％),bronchial occlusion(29/85,34.12％),air bronchial sign(25/85,29.41％),acinar nodules(23/85,27.06％),consolidation along the bronchus(21/85,24.71％),cotton ball sign(19/85,22.35％),tree fog sign(15/85,17.65％)and atelectasis(14/85,16.47％).The median LV of MPP was 50.73(26.38,85.90)cm3,the median LV％was 3.10％(1.60％,5.70％)and the median CT value was-422.61(-479.46,-343.76)HU.MPP LV was positively correlated with serum sialic acid,C reactive protein(CRP),D-dimer,fibrin degradation products(FDP)and fibrinogen(Fib)(rs=0.232-0.400),while LV％was positively correlated with serum sialic acid,D-dimer and FDP(rs=0.349-0.439).There was a positive correlation between CT value and CRP(rs=0.288).Conclusion CT findings of MPP in children had certain characteristics.Combining with laboratory examinations was conducive to clinical diagnosis,monitoring condition and evaluating therapeutic efficacy of MPP in children.

Genetically engineered intestinal microbes could be powerful tools to detect and treat intestine inflammation due to their non-invasive character, low costs, and convenience. Intestinal inflammation is usually detected along with an increasing concentration of thiosulfate and tetrathionate molecules in the intestines. ThsSR and TtrSR are two-component biosensors to detect the presence of thiosulfate and tetrathionate molecules, respectively. In real-life intestinal inflammation detection, sophisticated instruments are needed if using fluorescent proteins as reporters. However, chromoproteins and other colored small molecules, which can be seen by the unaided eye, could extend the use of ThsSR and TtrSR biosensors to detect intestine inflammation. The feasibility of ThsSR and TtrSR systems was tested by monitoring the fluorescence intensity of sfGFP in response to the concentration of thiosulfate and tetrathionate, followed by the incorporation of the two systems into Escherichia coli Top10 and E. coli Nissle 1917. The potential for the real-life application of the two systems was further corroborated by substituting sfGFP with a series of chromoproteins and a protoviolaceinic acid synthesis cassette as reporter genes. The results indicated that signal expression of the new systems had a positive correlation with the concentration of tetrathionate and thiosulfate molecules. Thus, the modified ThsSR and TtrSR system may potentially be applied in the human body for the detection of intestinal inflammation.
Escherichia coli ; Humans ; Inflammatory Bowel Diseases ; Intestines ; Thiosulfates

Objective To observe the expression of neural axon guidance molecules Slit3 and Robo receptors in mouse aortic smooth muscle cell(MASMC) and investigate the effect of exogenous Slit3 protein on migration and proliferation of MASMC.Methods The primary cultured MASMC were identified by immunofluorescent assay.The expression of Slit3/Robo signal pathway was detected by RT-PCR and immunocytochemical staining.MASMC were divided into 6 groups:the negative control group (DMEM medium containing bovine serum albumin 86 μg/L),Slit3 0μg/L group (DMEM medium without Slit3),Slit3 24 μg/L group (DMEM medium containing Slit3 24 μg/L),Slit3 40 μg/L group (DMEM medium containing Slit3 40 μg/L),Slit3 80 μg/L group (DMEM medium containing Slit3 80 μg/L) and the positive control group (DMEM medium containing platelet derived growth factor 10 μg/L).The effects of exogenous Slit3 on MASMC proliferation and migration were detected by CCK-8 and scratched cells and transwell chambers respectively.Results (1) The mRNA and protein expressions of Slit2,Slit3,Robo1 and Robo4 were detected in MASMC.mRNA level of Slit2 was lower than Slit3 (P ＜ 0.05) and there were no significant difference between mRNA level of Robo1 and Robo4.(2) The mitogenic responses of MASMC were significantly enhanced in Slit3 24 μg/L group,Slit3 40 μg/L group and Slit3 80 μg/L group compared with negative control group (1.13 ± 0.04,1.19 ± 0.02,1.18 ± 0.08 and 0.64 ± 0.10 respectively,all P ＜0.05).The mitogenic activity of MASMC was the strongest in Slit3 40 μg/L group (compared with positive control group 1.27 ± 0.05,P ＞ 0.05).(3) The autonomous migration activity of MASMC were significantly increased in Slit3 24 μg/L group,Slit3 40 μg/L group,Slit3 80 μg/L group compared with negative control group (cell scratch width were (0.40 ± 0.03) cm,(0.32 ± 0.03) cm,(0.30 ± 0.02) cm and (0.49 ±0.01) cm respectively,all P ＜ 0.05).The autonomous migration activity of MASMC was the strongest in Slit3 80 μg/L group (compared with positive control group (0.22 ± 0.01)cm,P＞ 0.05).The transmembrane migration activity of MASMC were significantly increased in Slit3 24 μg/L group,Slit3 40 μg/L group,Slit3 80 μg/L group compared with negative control group (the number of cell migration were 46.67 ± 2.23,65.33 ± 3.43,81.67 ± 4.22 and 39.33 ± 2.03 respectively,all P ＜ 0.05).The transmembrane migration activity of MASMC was the strongest in Slit3 80 μg/L group (compared with positive control group 84.00 ± 2.02,P ＞ 0.05).Conclusion Slit2,Slit3,Robo1 and Robo4 were expressed in MASMC,and exogenous Slit3 could promote proliferation and migration of MASMC in vitro.

Objective To observe the effects of Slit2 protein on the proliferation and migration of VSMCs .Methods The VSMCs was cultured in our laboratory .The experiment was divided into two parts ,part one:VSMCs were divided into normal con‐trol group and experimental groups(culture with 50 ,75 ,100 ,125 and 150 ng/mL Slit2 respectively);part two :VSMCs were divided into normal control group ,positive control group(culture with TNF‐α10 ng/mL) and experimental groups(culture with TNF‐α10 ng/mL+Slit2 50 ng/mL ,TNF‐α10 ng/mL+Slit2 75ng/mL ,TNF‐α10 ng/mL+ Slit2 100 ng/mL ,TNF‐α10 ng/mL+ Slit2 125 ng/mL and TNF‐α10 ng/mL+Slit2 150 ng/mL respectively) .To detect proliferation and migration of VSMCs by CCK‐8 and tran‐swell experiment .Results The difference of OD value and numbers of VSMCs has no statistical significance in the presence of Slit 2 (P=0 .516 ,P=0 .52) .The numbers of VSMCs has statistical significance between control and positive control groups (P=0 .00) . The numbers of VSMCs in experimental groups were fewer than positive control group (P<0 .05) ,whereas the difference of OD value still has no statistical significance between experimental and positive groups (P= 0 .173) .Conclusion Recombinant Slit2 could inhibits migration in VSMCs induced by TNF‐α,whereas it has no effect on proliferation of VSMCs .

Objective To observe the effect of atorvastatin on intraabdominal fat and microalbuminuria (MAU) in patients with metabolic syndrome (MS). Methods Forty-four MS patients were divided into the atorvastatin group and the control group. Blood pressure and blood glucose were controlled in both groups, in addition, atorvastatin was administered to the patients in the atorvastatin group. Blood pressure, blood glucose, body weight, abdominal wall fat, intraabdominal fat and MAU were compared before and after 12 weeks’ treatment. Results Obvious decrease of the intraabdominal fat and MAU was found in the atorvastatin group compared with those before the treatment Intraabdominal fat: non-ACE1/ARB (41.76?3.61) mm vs (33.23?2.47) mm, P