ObjectiveTo observe the clinical efficacy of Sanren Runchang formula in treating constipation-predominant irritable bowel syndrome （IBS-C） by regulating the brain-gut axis and the effects of the formula on serum levels of 5-hydroxytryptamine （5-HT）， vasoactive intestinal peptide （VIP）， and substance P （SP）. MethodsA randomized controlled design was adopted， and 72 IBS-C patients meeting Rome Ⅳ criteria were randomized into observation and control groups （36 cases）.The observation group received Sanren Runchang formula granules twice daily， and the control group received lactulose oral solution daily for 4 weeks. IBS Symptom Severity Scale （IBS-SSS）， IBS Quality of Life Scale （IBS-QOL）， and Bristol Stool Form Scale （BSFS） were used to assess clinical symptoms， and bowel movement frequency was recorded. The Self-Rating Anxiety Scale （SAS） and Self-Rating Depression Scale （SDS） were employed to evaluate psychological status. ELISA was employed to measure the serum levels of 5-HT， VIP， and SP. ResultsThe total response rate in the observation group was 91.67% （33/36）， which was higher than that （77.78%， 28/36） in the control group （χ²=4.50， P<0.05）. After treatment， both groups showed increased defecation frequency and BSFS scores， decreased IBS-SSS total score， abdominal pain and bloating scores， IBS-QOL health anxiety， anxiety， food avoidance， and behavioral disorders scores， SAS and SDS scores， serum 5-HT and VIP levels， and increased SP levels （P<0.05， P<0.01）. Moreover， the observation group showed more significant changes in the indicators above than the control group （P<0.05， P<0.01）. The SP level showed no significant difference between the two groups. During the 4-week follow-up， the recurrence rate was 5.88% in the observation group and 31.25% in the control group. No adverse events occurred in observation group， and 2 cases of mild diarrhea occurred in the control group. ConclusionSanren Runchang formula demonstrated definitive efficacy in alleviating gastrointestinal symptoms and improving the psychological status and quality of life in IBS-C patients， with a low recurrence rate. The formula can regulate serum levels of neurotransmitters such as 5-HT and VIP， suggesting its potential regulatory effect on the brain-gut axis through modulating neurotransmitters and neuropeptides. However， its complete mechanism of action requires further investigation through detection of additional brain-gut axis-related biomarkers.

Cancer remains a complex and challenging medical problem, driving extensive research efforts. Despite significant progress in understanding its genetic and molecular aspects, the quest for effective treatments continues. Nanomedicines have shown great potential for revolutionizing cancer treatment by offering targeted and controlled drug delivery, reducing side effects, and improving patient outcomes. Accordingly, nanomedicines have been the focus of extensive research and development for clinical translation. As of September 2024, a search on the ClinicalTrials.gov website using the term "nanoparticles" revealed numerous ongoing and planned clinical trials. Motivated by recent advances in the field, this review explores the current frontier of cancer nanomedicine. Nanomedicines have supported chemotherapy, phototherapy and sonodynamic therapy, nucleic acid therapy, and immunotherapy. However, translating nanomedicines into practice has been challenged by complex interactions between nanoparticles and biological systems, variable permeability and retention of nanoparticles in tumors, safety concerns, difficulty achieving targeted delivery, and issues with scaling up manufacturing. Perspectives on addressing these challenges are offered. Future opportunities for cancer nanomedicines, including modifying the tumor microenvironment, integrating artificial intelligence and big data, and targeting new medical areas, are also discussed. This review underscores the potential of cancer nanomedicines to revolutionize treatment from a clinical standpoint.

Objective:To investigate the effects of microRNA (miR) -125b on the proliferation and phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway of hepatocellular carcinoma (HCC) cell by targeting Polo like kinases (PLK4).Methods:The tumor tissues and adjacent tissues of 65 patients with HCC were collected from March 2022 to March 2023 in Tianjin Medical University Cancer Hospital, including 33 males and 32 females, aged (60.1±5.6) years. The expressions of miR-125a and miR-125b in liver cancer, adjacent tissues and liver cancer cells were detected by fluorescence quantitative polymerase chain reaction. Low expression liver cancer cell was selected to transfect negative control (NC) sequences of miR, miR-125a and miR-125b. Subsequently, miR-NC and NC plasmid, miR-125b sequence and NC plasmid, and miR-125b sequence and PLK4 plasmid were co-transfected. Cell proliferation was detected by cell counting assay, the expression of PLK4, phosphorylated PI3K (p-PI3K) and phosphorylated Akt (p-Akt) was detected by Western blot, and miR-125b-targeting PLK4 were detected by bioinformatics analysis and dual luciferase reporter gene.Results:The relative expressions of miR-125a and miR-125b in HCC patients were (0.62±0.08) and (0.58±0.07), respectively, lower than those in adjacent tissues (1.00±0.12) and (1.00±0.13), and the differences were statistically significant ( t=21.24, 22.93, P=0.005, P<0.001). HepG2 cells with low expression of miR-125a and miR-125b and miR-125b targeting PI3K/Akt were selected for transfection. Bioinformatic analysis and dual luciferase reporter gene assay confirmed that miR-125b binds to PLK4. Overexpression of miR-125b could inhibit the proliferation of HepG2 cells and the expression of p-PI3K and p-Akt, while overexpression of PLK4 could partially reverse the proliferation inhibition caused by miR-125b and the expression of p-PI3K and p-Akt, (0.91±0.07) vs(0.41±0.04), (0.97±0.08) vs (0.32±0.03)( t=13.87, 17.01, both P<0.001). Conclusion:The inhibitory effect of miR-125b on HepG2 cell proliferation and PI3K/Akt signaling pathway is partly mediated by targeted inhibition of PLK4.

Objective This study uses whole-genome methylation capture sequencing technology to screen differential sites and regions of gene methylation in mouse liver and colon under simulated weightlessness conditions to reveal the specific impact of weightlessness on gene methylation.Methods Six 8-week-old male C57BL/6J mice were randomized into the tail suspension group and the control group,with 3 in each.The 3 mice in the tail suspension group recieved tail suspension for simulated weightlessness for 42 days.After the experiment,DNA was extracted from liver and colon tissue and analyzed using genome-wide methylation capture sequencing technology.Results DNA analysis of liver tissue showed that a total of 7 517 differentially methylated sites and 997 differentially methylated regions were found,involving 4 892 genes.DNA analysis of colon tissue revealed 70 340 differentially methylated sites and 12 004 differentially methylated regions,affecting 12 877 genes.GO and KEGG path analysis revealed that these differentially methylated genes were mainly involved in protein binding,cell adhesion,cell activation,and various metabolic pathways.Conclusion This study successfully identified differential methylation sites and regions in mouse liver and colon under simulated weightlessness conditions through high-throughput sequencing technology.These findings help to further understand the impact of long-term space residence on biological gene methylation.It provides new research ideas for the prevention and early treatment of space flight-related diseases.

With the increasing maturity and progress of China's space technology,astronauts can stay longer in the space station and complete more complex space experiments and tasks.In the Microgravity(MG)environment of space,the digestive system of astronauts is inevitably affected,especially the liver and colon,and there are many physiological and pathological changes.MG can affect liver metabolic function,cell proliferation and differentiation,oxidative stress response and inflammatory factor levels.MG can disrupt the intestinal barrier of the colon,intestinal flora and microecology,intestinal immunity,and the gut-liver axis.However,the existing studies on the effects of MG on liver and colon are not completely clear,and there is a lack of reliable diagnostic indicators for the pathological changes of both.Therefore,in order to explore the damage mechanism of MG on liver and colon and ensure the digestive system health of astronauts,this paper reviews the research progress on the effects of MG on liver and colon.

Objective:To analyze the differences in clinical and endoscopic ultrasonography (EUS) findings between diffuse and focal IgG4-related autoimmune pancreatitis (IgG4-AIP).Methods:Data of patients diagnosed as having IgG4-AIP who underwent EUS at Chinese PLA General Hospital from September 2011 to April 2022 were retrospectively collected. General clinical data, EUS features, and postoperative pathology were analyzed for characteristic differences.Results:A total of 40 patients were included in the study, 60.03±10.87 years old, a higher proportion of males (85.0%, 34/40). All patients underwent EUS, and 28 underwent EUS-guided fine-needle aspiration. Among the 40 patients, 29 (72.5%) had diffuse type and 11 (27.5%) had focal type. Abdominal pain [65.5% (19/29) VS 18.2% (2/11), χ2=5.393, P=0.020] and thickening of the bile duct wall [51.7% (15/29) VS 9.1% (1/11), χ2=4.394, P=0.036] were more common in the diffuse type, while main pancreatic duct dilation [45.5% (5/11) VS 10.3% (3/29), χ2=4.146, P=0.042] was more common in the focal type, with the lesion most commonly located in the pancreatic head (90.9%, 10/11). There was no significant difference in the presence of chronic pancreatitis parenchymal changes between the two groups [34.5% (10/29) VS 27.3% (3/11), χ2=0.003, P=0.955]. Conclusion:There are certain differences in abdominal pain and biliary and pancreatic duct lesions between diffuse and focal AIP. The high expression of chronic pancreatitis characteristics is not observed in either group, which provides clues for the classification of AIP in clinical practice.

Objective:To explore the therapeutic effect of peroral endoscopic myotomy (POEM) for primary achalasia (AC) in patients aged over 60 years.Methods:Data of 146 patients aged ≥60 years (the elderly group) and 146 patients aged 18-59 years (the adult group) who received POEM from November 2010 to September 2019 at the Digestive Endoscopy Center of PLA General Hospital were retrospectively analyzed. Baseline data, surgery data, surgery-related complications and surgery-related efficacy were compared.Results:There was no significant difference in gender, Ling classification, HRM classification or previous treatment between the two groups ( P>0.05). All 292 patients successfully underwent POEM surgery. The clinical success (Eckardt score ≤3) rates in the elderly group and the adult group were 96.33% (105/109) and 96.77% (90/93), respectively with no significant difference between the two groups ( χ2=0.030， P>0.05). There was no significant difference in the length of myotomy between the two groups (7.09±2.49 cm VS 7.12±2.24 cm， t=0.472， P>0.05). Complications occurred in 26 cases (17.81%) in the elderly group and 21 cases (14.38%) in the adult group with no significant difference between the two groups ( χ2=0.634， P>0.05). There was no significant difference in the postoperative hospital stay (12.61±9.69 days VS 11.00±4.43 days, t=1.825, P>0.05) or the incidence of gastroesophageal reflux [43.33% (13/30) VS 51.52% (17/33), χ2=0.422, P>0.05] between the elderly group and the adult group. Conclusion:The efficacy of POEM for AC patients over 60 years old is equivalent to that of adult patients, and the incidence of complications is similar. POEM is safe and effective for AC patients over 60 years old.

OBJECTIVE To prepare Angelica•Cinnamomum（Angelica sinensis-Cinnamomum cassia ）self•microemulsion drug delivery system （AC•SMEDDS），and to optimize its formulation and characterize its preparation . METHODS Using Angelica• Cinnamomum mixed volatile oil as oil phase and model drug ，on the basis of selecting emulsifier and co -emulsifier and the optimization of their mass ratio range ，the formulation was optimized with central composite design •response surface methodology using the ratio of oil phase （Angelica•Cinnamomum mixed volatile oil ），mass ratio of emulsifier and co -emulsifier as factors ，the comprehensive score of volatile oil content ，particle size and emulsifying time as index . Morphology，particle size ，drug loading ， entrapped efficiency and stability of optimized AC•SMEDDS were characterized . RESULTS The optimum formulation of AC•SMEDDS contained the ratio of oil phase was 30%，and the mass ratio of emulsifier （EL•40）and co -emulsifier（ethanol）was 9∶1. Results of validation tests showed that the average particle size of AC•SMEDDS was （148.33±1.53）nm，and emulsifying time was （18.44±0.11）s. The comprehensive score was 0.68，relative deviation of which from the predicted value （0.70）was 2.86%. AC•SMEDDS prepared by optimal formulation was faint yellow ，uniform and transparent liquid ，and spherical particals with translucent edge were observed under transmission electron microscope . Calculated by ligustilide and cinnamaldehyde ，the drug loading was （7.58±0.03） and （4.17±0.01） mg/g，and entrapped efficiency was （93.25±0.01）% and （88.89±0.02）% ， respectively. No stratification or precipitation occurred after centrifugation at the speed of 10 000 r/min or placing within 7 （No.2019-0520） days at 4 and 25 ℃ . The contents of ligustilide and cinnamaldehyde were stable . Its particle size had no significant change after 50，100 and 200 times dilution by purified water . CONCLUTIONS AC•SMEDDS is prepared successfully and its formulation is optimized . The stability of the preparation is good .

Objective:To evaluate the efficacy and safety of the second session of endoscopic ultrasound-guided lauromacrogol ablation (EUS-LA) for pancreatic cystic neoplasms (PCNs).Methods:A total of 74 patients with suspected of PCNs who underwent EUS-LA in the First Medical Center of Chinese PLA General Hospital from April 2015 to December 2020 were enrolled in the study. Fifteen of them underwent the second ablation. The efficiency of EUS-LA was determined based on the change of lesion volume during the imaging follow-up, categorized into complete resolution (CR), partial resolution (PR) and stable disease (SD). The safety was determined by the complication incidence.Results:Among the 15 patients undergoing the second EUS-LA, there were 9 males and 6 females with age of 51.5±17.6 years. Thirteen patients completed imaging follow-up after the second EUS-LA, CR was achieved in 8 patients, PR in 2 patients and 3 in SD. The CR rate increased from 0 after the first ablation to 8/13 after the second ablation ( P=0.002). The median cyst diameter decreased from 22.0 mm before the second ablation to 15.0 mm after the second ablation ( Z=-2.666, P=0.008) and the median cyst volume reduced from 2 419.7 mm 3 to 1 099.5 mm 3 ( Z=-2.134, P=0.033). The complication incidence of the second ablation was 2/15, similar to that of the first ablation. Conclusion:The second ablation is effective and safe without increasing the complication incidence in patients without achieving CR after the first EUS-LA.

Objective:To determine the safety and long-term efficacy of endoscopic ultrasonography-guided lauromacrogol ablation (EUS-LA) for treatment of pancreatic cystic neoplasms (PCNs) with a larger population.Methods:From April 2015 to April 2019, 255 patients suspected of PCNs were enrolled in the First Medical Center of Chinese PLA General Hospital in the study, and 57 patients underwent EUS-LA. The effectiveness of EUS-LA was determined based on imaging volume changes. The occurrence of complications was observed and recorded.Results:Among the 57 patients who underwent EUS-LA, 38 were female and 19 were male, with the mean age of 52.0±14.6 years. The cysts were located in the head/uncinate of the pancreas in 33 patients and in the body/tail of the pancreas in 24 patients. A total of 50 patients were followed up by imaging examinations. After treated by EUS-LA, the cyst median volume sharply reduced from 11 434.1 mm 3 to 639.4 mm 3 ( Z=-5.556, P<0.01), and the median diameter decreased from 32.0 mm to 12.0 mm ( Z=-6.161, P<0.01). Postoperative imaging showed a complete resolution in 24 patients (48.0%), partial resolution in 14 patients (28.0%), and persistent cyst in 12 patients (24.0%). The total number of ablation was 69, and there were 12 patients undergoing a second ablation. The adverse events rate was 4.3% (3/69). Among the 34 patients followed up for 12 months or more, complete resolution was observed in 18 patients (52.9%), partial resolution in 9 (26.5%), and persistent cyst in 7 (20.6%). Conclusion:EUS-LA is effective and safe for the treatment of PCNs. Its effectiveness is stable after more than 12 months′ follow-up.