Objective:To explore the application value of part-cut jejunal transection in digestive tract reconstruction of totally laparoscopic total gastrectomy.Methods:The propensity score matching and retrospective cohort study was conducted. The clinicopathological data of 112 patients with gastric cancer who underwent totally laparoscopic total gastrectomy in The Second Affiliated Hospital of Anhui Medical University from June 2018 to September 2022 were collected. There were 81 males and 31 females, aged (70±8)years. Among the 112 patients, 60 patients undergoing diges-tive tract reconstruction by Roux-en-Y anastomosis with part-cut jejunum were set as the part-cut group, and 52 patients undergoing digestive tract reconstruction by traditional Roux-en-Y anasto-mosis were set as the traditional group. Observation indicators: (1) propensity score matching status and comparison of clinical data of patients between the two groups after matching; (2) intraopera-tive and postoperative conditions; (3) follow-up. Comparison of measurement data with normal dis-tribution between groups was conducted using the independent sample t test. Comparison of count data between groups was conducted using the chi-square test or Fisher exact probability. Com-parison of ordinal data was conducted using the nonparametic rank sum test. Propensity score matching was performed using the 1∶1 nearest neighbor matching method, with the caliper value of 0.02. Results:(1) Propensity score matching status and comparison of clinical data of patients between the two groups after matching. Of the 112 patients, 90 patients were successfully matched, with 45 cases in each of the part-cut group and the traditional group. After propensity score matching, the elimination of body mass index, clinical TNM staging confounding bias ensured comparability. (2) Intraoperative and postoperative conditions. After propensity score matching, the total operation time and digestive tract reconstruction time of patients in the part-cut group were (217.0±15.1)minutes and (34.7±1.8)minutes, versus (252.6±21.9)minutes and (52.6±7.4)minutes in the traditional group, respectively, showing significant differences in the above indicators between the two groups ( t=?8.97, ?15.66, P<0.05). (3) Follow-up. After propensity score matching, 90 patients were followed up postoperatively for (47±15)months. During the follow-up, no patient in either group received secondary surgery, and there was no death. There were 3 cases and 10 cases of Roux stasis syndrome in the part-cut group and the traditional group, respectively, showing a significant difference between the two groups ( χ2=4.41, P<0.05). Conclusion:Compared with traditional Roux-en-Y anastomosis, the Roux-en-Y anastomosis with part-cut jejunum in totally laparoscopic total gastrectomy can signifi-cantly shorten the time for digestive tract reconstruction and reduce the incidence of postoperative Roux stasis syndrome.

Objective To investigate the effects of dihydroquercetin(DHQ)on retinal ferroptosis and visual function in rats with optic nerve injury(ONI),and to elucidate the underlying mechanisms.Methods Thirty-six 8-12-week-old adult male SD rats were randomly divided into three groups:SHAM group(sham surgery without optic nerve damage,fol-lowed by saline injection at the same time points),ONI group(ONI model established by surgery,followed by saline injec-tion),DHQ+ONI group(ONI model established by surgery,followed by intraperitoneal injection of 50 mg·kg-1DHQ on days 1,3,5,and 7 post-surgery).The ONI model was constructed by optic nerve clamping.After 7 days:Brn3a immuno-fluorescence was used to observe morphological and quantitative changes in retinal ganglion cells(RGCs).Immunohisto-chemistry and Western blot were performed to analyze protein expression of nuclear factor-erythroid 2-related factor 2(Nrf2),phosphorylated protein kinase B(p-AKT),and glutathione peroxidase 4(Gpx4),Flash visual evoked potential(F-VEP)was applied to assess visual function changes.Results Immunofluorescence quantification of Brn3a-positive cells:SHAM group:(61.49±3.84)cells·mm-1,ONI group:(25.24±1.81)cells·mm-1,DHQ+ONI group:(46.50±3.51)cells·mm-1.Compared with SHAM group,ONI group showed decreased Brn3a-positive cells(P＜0.001).Compared with ONI group,DHQ+ONI group showed increased Brn3a-positive cells(P＜0.01).Immunohistochemistry and Western blot:Compared with SHAM group,ONI group showed decreased protein expression of Nrf2,p-AKT,and Gpx4(all P＜0.001).Compared with ONI group,DHQ+ONI group showed increased expression of these proteins(all P＜0.01).F-VEP meas-urements:SHAM group:P1 wave amplitude(49.87±0.81)μV,ONI group:(5.87±0.25)μV,DHQ+ONI group:(36.43±0.21)μV.Compared with SHAM group,ONI group showed reduced P1 amplitude(P＜0.001).Compared with ONI group,DHQ+ONI group showed increased P1 amplitude(P＜0.001).Conclusion DHQ may protect and repair RGCs in ONI rats by inhibiting the ferroptosis-related Nrf2/p-AKT/Gpx4 signaling pathway,thereby ameliorating vision impairment caused by ONI.

Objective To study the influence of stent and balloon shape on hemodynamics in tapered vessels with multiple stenosis.Methods The hemodynamic model was established after the implantation of vascular stent in tapered vessel with multiple stenosis.The numerical simulation method was used to study the effect of the combination of different shaped stents and balloons on postoperative hemodynamics.Results When the cylindrical stent was expanded using the cylindrical balloon and tapered balloon respectively,compared with cylindrical balloon expansion,the proportion of low-speed blood flow area generated by tapered balloon expansion was reduced by 0.58％,and the proportion of low time-averaged wall shear stress(TAWSS)area was reduced by 3.22％.The use of tapered balloon for expansion could produce less low-speed blood flow and low TAWSS area.When tapered balloon was used to expand the cylindrical stent and tapered stent respectively,compared with expanding tapered stent,the proportion of low-speed blood flow area generated by expanding cylindrical stent decreased by 1.35％,and the proportion of low TAWSS area decreased by 9.73％.Conclusions The hemodynamic environment of tapered vessel with multiple stenosis was influenced by the shape of stent and balloon.The use of tapered balloon to expand the cylindrical stent in tapered vessels with multiple stenosis can achieve favorable hemodynamic environment and reduce the risk of ISR occurence.This study can provide a scientific basis for the rational formulation of clinical intervention scheme.

Objective:To explore the application value of part-cut jejunal transection in digestive tract reconstruction of totally laparoscopic total gastrectomy.Methods:The propensity score matching and retrospective cohort study was conducted. The clinicopathological data of 112 patients with gastric cancer who underwent totally laparoscopic total gastrectomy in The Second Affiliated Hospital of Anhui Medical University from June 2018 to September 2022 were collected. There were 81 males and 31 females, aged (70±8)years. Among the 112 patients, 60 patients undergoing diges-tive tract reconstruction by Roux-en-Y anastomosis with part-cut jejunum were set as the part-cut group, and 52 patients undergoing digestive tract reconstruction by traditional Roux-en-Y anasto-mosis were set as the traditional group. Observation indicators: (1) propensity score matching status and comparison of clinical data of patients between the two groups after matching; (2) intraopera-tive and postoperative conditions; (3) follow-up. Comparison of measurement data with normal dis-tribution between groups was conducted using the independent sample t test. Comparison of count data between groups was conducted using the chi-square test or Fisher exact probability. Com-parison of ordinal data was conducted using the nonparametic rank sum test. Propensity score matching was performed using the 1∶1 nearest neighbor matching method, with the caliper value of 0.02. Results:(1) Propensity score matching status and comparison of clinical data of patients between the two groups after matching. Of the 112 patients, 90 patients were successfully matched, with 45 cases in each of the part-cut group and the traditional group. After propensity score matching, the elimination of body mass index, clinical TNM staging confounding bias ensured comparability. (2) Intraoperative and postoperative conditions. After propensity score matching, the total operation time and digestive tract reconstruction time of patients in the part-cut group were (217.0±15.1)minutes and (34.7±1.8)minutes, versus (252.6±21.9)minutes and (52.6±7.4)minutes in the traditional group, respectively, showing significant differences in the above indicators between the two groups ( t=?8.97, ?15.66, P<0.05). (3) Follow-up. After propensity score matching, 90 patients were followed up postoperatively for (47±15)months. During the follow-up, no patient in either group received secondary surgery, and there was no death. There were 3 cases and 10 cases of Roux stasis syndrome in the part-cut group and the traditional group, respectively, showing a significant difference between the two groups ( χ2=4.41, P<0.05). Conclusion:Compared with traditional Roux-en-Y anastomosis, the Roux-en-Y anastomosis with part-cut jejunum in totally laparoscopic total gastrectomy can signifi-cantly shorten the time for digestive tract reconstruction and reduce the incidence of postoperative Roux stasis syndrome.

Objective To investigate the effects of dihydroquercetin(DHQ)on retinal ferroptosis and visual function in rats with optic nerve injury(ONI),and to elucidate the underlying mechanisms.Methods Thirty-six 8-12-week-old adult male SD rats were randomly divided into three groups:SHAM group(sham surgery without optic nerve damage,fol-lowed by saline injection at the same time points),ONI group(ONI model established by surgery,followed by saline injec-tion),DHQ+ONI group(ONI model established by surgery,followed by intraperitoneal injection of 50 mg·kg-1DHQ on days 1,3,5,and 7 post-surgery).The ONI model was constructed by optic nerve clamping.After 7 days:Brn3a immuno-fluorescence was used to observe morphological and quantitative changes in retinal ganglion cells(RGCs).Immunohisto-chemistry and Western blot were performed to analyze protein expression of nuclear factor-erythroid 2-related factor 2(Nrf2),phosphorylated protein kinase B(p-AKT),and glutathione peroxidase 4(Gpx4),Flash visual evoked potential(F-VEP)was applied to assess visual function changes.Results Immunofluorescence quantification of Brn3a-positive cells:SHAM group:(61.49±3.84)cells·mm-1,ONI group:(25.24±1.81)cells·mm-1,DHQ+ONI group:(46.50±3.51)cells·mm-1.Compared with SHAM group,ONI group showed decreased Brn3a-positive cells(P＜0.001).Compared with ONI group,DHQ+ONI group showed increased Brn3a-positive cells(P＜0.01).Immunohistochemistry and Western blot:Compared with SHAM group,ONI group showed decreased protein expression of Nrf2,p-AKT,and Gpx4(all P＜0.001).Compared with ONI group,DHQ+ONI group showed increased expression of these proteins(all P＜0.01).F-VEP meas-urements:SHAM group:P1 wave amplitude(49.87±0.81)μV,ONI group:(5.87±0.25)μV,DHQ+ONI group:(36.43±0.21)μV.Compared with SHAM group,ONI group showed reduced P1 amplitude(P＜0.001).Compared with ONI group,DHQ+ONI group showed increased P1 amplitude(P＜0.001).Conclusion DHQ may protect and repair RGCs in ONI rats by inhibiting the ferroptosis-related Nrf2/p-AKT/Gpx4 signaling pathway,thereby ameliorating vision impairment caused by ONI.

Objective To investigate internal arsenic exposure levels and influencing factors in infants and young children from low-arsenic regions.Methods A total of 390 urine samples from 130 children aged 0-7 years in Wuhan(central China)and Shenzhen(southern China)were analyzed using high performance liquid chromatography-inductively coupled plasma mass spec-trometry.A linear mixed model was applied to assess factors influencing arsenic exposure levels,and risk evaluation was conduc-ted based on biomonitoring equivalents.Results The average urinary total arsenic level in children was 15.6 μg/L.The concen-trations of these species increased with age,except for arsenate(AsⅤ).Children in Shenzhen had higher level of arsenobetaine(AsB)than in Wuhan(P＜0.05).The urinary levels of monomethyl arsenic acid(MMA)and dimethyl arsenic acid(DMA)were significantly higher in winter than in autumn(P＜0.05).Total urinary arsenic levels in 72％of the children exceeded the bio-monitoring equivalent.Conclusion Arsenic exposure among children shows an increasing trend with age,and there are regional and seasonal differences.More than half of the children may suffer potential health risks of As exposure,highlighting the urgent need for improved monitoring and preventive measures.

Breast cancer is the leading cause of cancer-related mortality among women worldwide and has drawn extensive research attention.Owing to its molecular heterogeneity,drug resistance,and low therapeutic response,single-modality treatments often fail to achieve satisfactory efficacy or broad applicability.Combination therapy,designed based on the pathophysiological characteristics,related signaling pathways,and biomarkers of breast cancer,has emerged as a promising approach for improving therapeutic outcomes.With the advancement of research on combination strategies,the understanding of their molecular mechanisms—particularly key signaling pathways and biomarkers—has become increasingly important.However,comprehensive reviews addressing these molecular mechanisms and synergistic strategies remain scarce.This article summarizes recent advances in combination therapy for breast cancer,providing a comprehensive review of recent combination therapies for breast cancer and their underlying molecular mechanisms,and focusing on key signaling pathways involved in combination therapy and synergistic strategies,thereby providing theoretical insights and reference for researchers,graduate students,and clinicians engaged in the development of novel combination therapeutic strategies for breast cancer and related malignancies.

Objective To investigate internal arsenic exposure levels and influencing factors in infants and young children from low-arsenic regions.Methods A total of 390 urine samples from 130 children aged 0-7 years in Wuhan(central China)and Shenzhen(southern China)were analyzed using high performance liquid chromatography-inductively coupled plasma mass spec-trometry.A linear mixed model was applied to assess factors influencing arsenic exposure levels,and risk evaluation was conduc-ted based on biomonitoring equivalents.Results The average urinary total arsenic level in children was 15.6 μg/L.The concen-trations of these species increased with age,except for arsenate(AsⅤ).Children in Shenzhen had higher level of arsenobetaine(AsB)than in Wuhan(P＜0.05).The urinary levels of monomethyl arsenic acid(MMA)and dimethyl arsenic acid(DMA)were significantly higher in winter than in autumn(P＜0.05).Total urinary arsenic levels in 72％of the children exceeded the bio-monitoring equivalent.Conclusion Arsenic exposure among children shows an increasing trend with age,and there are regional and seasonal differences.More than half of the children may suffer potential health risks of As exposure,highlighting the urgent need for improved monitoring and preventive measures.

Breast cancer is the leading cause of cancer-related mortality among women worldwide and has drawn extensive research attention.Owing to its molecular heterogeneity,drug resistance,and low therapeutic response,single-modality treatments often fail to achieve satisfactory efficacy or broad applicability.Combination therapy,designed based on the pathophysiological characteristics,related signaling pathways,and biomarkers of breast cancer,has emerged as a promising approach for improving therapeutic outcomes.With the advancement of research on combination strategies,the understanding of their molecular mechanisms—particularly key signaling pathways and biomarkers—has become increasingly important.However,comprehensive reviews addressing these molecular mechanisms and synergistic strategies remain scarce.This article summarizes recent advances in combination therapy for breast cancer,providing a comprehensive review of recent combination therapies for breast cancer and their underlying molecular mechanisms,and focusing on key signaling pathways involved in combination therapy and synergistic strategies,thereby providing theoretical insights and reference for researchers,graduate students,and clinicians engaged in the development of novel combination therapeutic strategies for breast cancer and related malignancies.

This research study focuses on addressing the limitations of current neuropathic pain (NP) treatments by developing a novel dual-target modulator, E0199, targeting both Na_V1.7, Na_V1.8, and Na_V1.9 and K_V7 channels, a crucial regulator in controlling NP symptoms. The objective of the study was to synthesize a compound capable of modulating these channels to alleviate NP. Through an experimental design involving both in vitro and in vivo methods, E0199 was tested for its efficacy on ion channels and its therapeutic potential in a chronic constriction injury (CCI) mouse model. The results demonstrated that E0199 significantly inhibited Na_V1.7, Na_V1.8, and Na_V1.9 channels with a particularly low half maximal inhibitory concentration (IC₅₀) for Na_V1.9 by promoting sodium channel inactivation, and also effectively increased K_V7.2/7.3, K_V7.2, and K_V7.5 channels, excluding K_V7.1 by promoting potassium channel activation. This dual action significantly reduced the excitability of dorsal root ganglion neurons and alleviated pain hypersensitivity in mice at low doses, indicating a potent analgesic effect without affecting heart and skeletal muscle ion channels critically. The safety of E0199 was supported by neurobehavioral evaluations. Conclusively, E0199 represents a ground-breaking approach in NP treatment, showcasing the potential of dual-target small-molecule compounds in providing a more effective and safe therapeutic option for NP. This study introduces a promising direction for the future development of NP therapeutics.