Objective To systematically evaluate the efficacy and safety of proximal gastrectomy (PG) versus total gastrectomy (TG) for the treatment of Siewert type Ⅱ/Ⅲ adenocarcinoma of the esophagogastric junction (AEG). Methods PubMed, The Cochrane Library, Web of Science, EMbase, CNKI, Wanfang, and VIP databases were searched for literature comparing the efficacy and safety of PG and TG for the treatment of Siewert type Ⅱ/Ⅲ AEG. The search period was from database inception to March 2023. Meta-analysis was performed using Review Manager 5.4 software. Results A total of 23 articles were included, including 16 retrospective cohort studies, 5 prospective cohort studies, and 2 randomized controlled trials. The total sample size was 2 826 patients, with 1 389 patients undergoing PG and 1 437 patients undergoing TG. Meta-analysis results showed that compared with TG, PG had less intraoperative blood loss [MD=−19.85, 95%CI (−37.20, −2.51), P=0.02] and shorter postoperative hospital stay [MD=−1.23, 95%CI (−2.38, −0.08), P=0.04]. TG had a greater number of lymph nodes dissected [MD=−6.20, 95%CI (−7.68, −4.71), P<0.001] and a lower incidence of reflux esophagitis [MD=3.02, 95%CI (1.24, 7.34), P=0.01]. There were no statistically significant differences between the two surgical approaches in terms of operative time, postoperative survival rate (1-year, 3-year, 5-year), and postoperative overall complications (P>0.05). Conclusion PG has advantages in terms of intraoperative blood loss and postoperative hospital stay, while TG has advantages in terms of the number of lymph nodes dissected and the incidence of reflux esophagitis. There is no significant difference in long-term survival between the two surgical approaches.

Objective To systematically evaluate the short-term efficacy and safety of McKeown and Sweet methods in the treatment of esophageal cancer. Methods PubMed, EMbase, The Cochrane Library, Web of Science, Wanfang, VIP, CNKI and Chinese Biomedical Literature database were searched for literature on the short-term efficacy and safety of McKeown and Sweet methods in the treatment of esophageal cancer published from the establishment to May 2023. Newcastle-Ottawa Scale was used to evaluate the quality of researches, and meta-analysis was performed using RevMan5.4. Results A total of 9 articles were included, involving 3687 patients including 1019 in the McKeown group and 2668 in the Sweet group. NOS score was 8-9 points. There were no statistical differences in the age, sex or American Joint Committee on Cancer stage between the two groups (P>0.05). Patients in the McKeown group had longer operative time and hospital stay, more intraoperative blood loss, and higher Eastern Cooperative Oncology Group scores than those in the Sweet group (P<0.05). However, the McKeown operation could remove more lymph nodes (P=0.001). In terms of safety, the incidences of pulmonary complications [OR=2.20, 95%CI (1.40, 3.46), P=0.001] and postoperative anastomotic leakage [OR=2.06, 95%CI (1.45, 2.92), P=0.001] were higher in the McKeown group than those in the Sweet group. In addition, there were no statistical differences between the two groups in the Karnofsky score, cardiac complications, vocal cord injury or paralysis, chylous leakage, or gastric emptying (P>0.05). Conclusion Compared with McKeown, Sweet method has advantages in operation time, intraoperative blood loss and hospital stay, and has lower incidence of postoperative pulmonary complications and anastomotic leakage. However, McKeown has more lymph node dissection.

Dual-source computed tomography(CT)has a series of functions such as rapid scanning,cardiac imaging,multi-site imaging and spectral imaging,and it has the advantages of high image quality and low radiation dose.The timely maintenance and repair can ensure the stable operation of equipment,and guarantee smooth progress of clinical examinations,and provide reliable basis for the diagnosis and treatment to patients.This paper sorted out and analyzed the mechanical structure about the SOMATOM Force CT equipment from three parts:operation and control,data acquisition,and processing and transmission.It also analyzed the correlation between the mechanical structure and functions around the key components such as X-ray tubes,detectors,collimators,slip rings and high-voltage generators,and clarified the role of each component in CT imaging.In general,this paper summarized the troubleshooting ideas and the key points of maintenance and repair for the mechanical faults of the SOMATOM Force CT scanning bed,cooling device and slip ring,which can accumulate the practical experience in improving the guarantee ability of engineers.

Objective : To analyze the correlation between different laboratory biomarkers and disease activity in ankylosing spondylitis and to compare their specificity and sensitivity in assessing disease activity. Methods : Spearman correlation or Pearson correlation was used to analyze the correlation between disease activity and laboratory biomarkers. Receiver operating characteristic(ROC) was used to compare the sensitivity and specificity of each laboratory biomarker in evaluating disease activity. Results : Hypersensitive C-reactive protein, fibrinogen, D-dimer, erythrocyte sediment rate, C-reactive protein, immuno-inflammatory index(platelet count×neutrophil count/lymphocyte count), fibrinogen/albumin ratio, albumin and pro-albumin were correlated with disease activity. The ratio of fibrinogen to albumin, fibrinogen, erythrocyte sedimentation rate, immuno-inflammatory index, C-reactive protein and hypersensitive C-reactive protein had good values in determining the disease activity. Conclusion Different laboratory biomarkers are correlated with the disease activity of ankylosing spondylitis, and some of them have better discriminating values for the disease activity.

Objective To investigate the expression of dermatopontin(DPT)in abdominal aortic aneurysm(AAA)and to explore the mechanism in promoting AAA progression.Methods Differential gene expression(DEG)and GO-KEGG pathway enrichment were used to assess DPT expression level and related pathways in AAA.AAA tissue samples were collected from patients undergoing open surgical repair at Beijing Hospital(experimental group,n=3),while control aortic tissues were collected from kidney transplant donors(n=3).Immun-ohistochemistry and immuno-fluorescence staining were performed to validate DPT protein expression differences in AAA tissues.Masson staining microscopy was used to evaluate fibrosis level.Human aortic smooth muscle cells(HASMCs)were divided into control(Ctrl)and lipopolysaccharide(LPS)-treated groups(n=3).RT-qPCR,ELISA,and immu-nocytochemistry(ICC)were used to measure DPT expression level.HASMCs were further divided into control(Ctrl)and recombinant human DPT-treated groups with 3 cases in each.RT-qPCR was performed to detect the ex-pression of interleukin-1α(IL-1α),interleukin-1β(IL-1β),collagen type Ⅰ alpha 1 chain(COL1A1),matrix metalloproteinase-2(MMP2),and matrix metalloproteinase-9(MMP9).Cell adhesion assays were conducted to ex-amine the role of integrin α3 and integrin β1 in HASMC adhesion.Results DPT was highly expressed in human AAA tissues(P＜0.01).LPS induced DPT expression and secretion in HASMCs(P＜0.05).DPT promoted IL-1α(P＜0.001)and IL-1β(P＜0.01)expression through a positive feedback mechanism while suppressed COL1A1(P＜0.001)production.DPT enhanced HASMC adhesion via the integrin α3β1 receptor(P＜0.001).Conclusions DPT promotes AAA progression by activating IL-1α/IL-1β inflammatory cytokines and inhibits COL1A1-mediated extra cellular matrix(ECM)remodeling.Integrin α3β1 is potentially involved in the regulation process.

Objective To investigate the risk factors for bronchopulmonary dysplasia(BPD)in infants with hyaline membrane disease(HMD)and establish a predictive model.Methods A retrospective analysis was conducted on 551 hospitalized HMD infants at Kunming First People's Hospital from January 2018 to December 2022.Patients were randomly divided into a training set(n=413)and a validation set(138)at a 3∶1 ratio.The training set was further divided into a simple HMD group(n=339)and an HMD with BPD group(n=74).Univariate and multivariate Logistic regression prediction models were used to analyze the risk factors associated with HMD complicated by BPD,with subsequent validation in the validation set.Results Univariate analysis showed statistically significant differences between the two groups in birth conditions,perinatal conditions,maternal conditions,laboratory indicators,and treatment conditions(P<0.05).Multivariate analysis indicated that birth weight and oxygen exposure time were independent risk factors for HMD complicated by BPD(P<0.05).The ROC curve assessment showed an area under the curve(AUC)of 0.954,indicating a certain predictive value for the model.In the validation set,the AUC was 0.917,with a sensitivity of 92.00%and a specificity of 89.38%.Conclusion Neonatal birth weight and duration of oxygen therapy were identified as significant risk factors for bronchopulmonary dysplasia(BPD)complicating hyaline membrane disease(HMD).The risk prediction model for HMD with BPD has good predictive performance.

The National Institute for Health and Care Excellence(NICE)first updated its 2013 Health Technology Evaluations Guidelines in 2022,followed by further minor adjustments in 2023.This round of updates primarily focuses on five key areas:mea-suring the value of health technologies,understanding and improving the evidence base,structured decision-making,addressing challenging diseases and technologies,and ensuring consistency in methods across evaluation and review projects.It outlines the up-date process and major changes,providing an analysis of these key points with the aim of offering valuable insights and methodologi-cal references for health technology assessment in China.

Glaesserella parasuis is the causative agent of Gl?sser's disease in pigs.However,the pathogenic mechanisms underlying its virulence is not yet fully understood.The RuvB protein,a member of the AAA+superfamily,is implicated in various cellular processes,yet its specific role in the virulence of Glaesserella parasuis has not been fully characterized.In this study,we con-structed a RuvB gene deletion mutant,designated ΔRuvB,using the serotype 13 Glaesserella pa-rasuis strain ZJ1208 and a suicide plasmid-mediated natural transformation approach.To elucidate the functional role of the RuvB gene,we comprehensively evaluated the biological characteristics of the ΔRuvB strain through a series of assays,including growth kinetics,colony morphology,bac-terial staining,transmission electron microscopy(TEM),osmotic stress tolerance,high-tempera-ture tolerance,heat shock resistance,UV resistance,capsular polysaccharide quantification,serum bactericidal assays,and murine virulence experiments.Our findings revealed that the growth rate of ΔRuvB showed no significant difference compared to the parental strain.TEM revealed a notable increase in bacterial cell length;however,the number of outer membrane vesicles(OMVs)on the surface of ΔRuvB did not significantly increase.Notably,the ΔRuvB strain displayed a significant reduction in capsular polysaccharide production and serum resistance,as well as diminished toler-ance to UV radiation and high temperatures.Significant alterations were observed in its resistance to osmotic stress or oxidative stress.In the mouse toxicity challenge experiment,in com-parison with the parental strain ZJ1208,the mortality rate dropped by 20 percentage points,suggesting that the virulence of ΔRuvB has been weakened to some extent.Collectively,these results underscore the critical role of the RuvB gene in enhancing the environmental adaptability of Glaesserella parasuis.

The aim of this paper was to investigate the serotypes,virulence factors and drug resist-ance of clinical isolates of Pasteurella rnultocida of porcine origin in recent years.Morphological screening and polymerase chain reaction(PCR)were used to isolate and identify 119 isolates from nasal swabs and lung tissue samples sent from swine farms in Zhejiang Province from 2010 to 2024.The isolates of Pasteurella multocida were subjected to capsular polysaccharide serotyping,lipopolysaccharide serotyping,virulence factor detection and drug resistance analysis by PCR and Kirby-Bauer disc agar diffusion method(K-B).The results showed that there were 64 strains(53.7％)of A-type,54 strains(45.3％)of D-type and 1 strain(0.9％)of F-type among the capsu-lar polysaccharide serotypes,and 10 strains(8.4％)of L1-type,20 strains(16.8％)of L3-type,86 strains(72.2％)of L6-type,and 3 strains(2.6％)of undetermined type among the lipopolysaccha-ride serotypes.The amplification results of 10 virulence genes showed that the detection rate of virulence genes hgbA,higbB and fimA was over 86.0％,the detection rate of toxA was 8.4％,while the virulence gene tbpA was not detected.There were also differences in the distribution vir-ulence genes in different capsular polysaccharide serotypes.Virulence factor pfhA was detected in type A and F but not in type D.The detection rate of adhesin gene tadD in serotype A(92.2％)was significantly higher than that of type D(9.3％),and,on the contrary,the detection rate of ad-hesin gene hsf-l in serotype D(90.7％)was significantly higher than that of type A(20.3％).Drug resistance analysis revealed that Pasteurella multocida showed high susceptibility to antimi-crobial drugs such as amoxicillin,ampicillin,cephalosporins,doxycycline,fosfenicol and ciprofloxa-cin,and showed strong resistance to antimicrobial drugs such as lincomycin,cotrimoxazole,genta-micin and amikacin,and there were 54 multi-drug resistant strains(78.3％).In summary,capsular polysaccharide serotypes were dominated by type A and D,lipopolysaccharide serotypes were dom-inated by L6,the distribution of some virulence genes varied greatly among different serotypes,and the proportion of multi-resistant strains was high,which provide reference for the prevention and control of this disease.

The National Institute for Health and Care Excellence(NICE)first updated its 2013 Health Technology Evaluations Guidelines in 2022,followed by further minor adjustments in 2023.This round of updates primarily focuses on five key areas:mea-suring the value of health technologies,understanding and improving the evidence base,structured decision-making,addressing challenging diseases and technologies,and ensuring consistency in methods across evaluation and review projects.It outlines the up-date process and major changes,providing an analysis of these key points with the aim of offering valuable insights and methodologi-cal references for health technology assessment in China.