ObjectiveTo explore the effect and mechanism of Taishan Panshi powder （TSPSP） on inhibiting oxidative stress injury in human chorionic trophoblast cells （HTR-8/SVneo）， and to uelucidate the underlying mechanism of TSPSP in the treatment of spontaneous abortion （SA）. MethodsGene differential analysis of SA was performed using the Gene Expression Omnibus （GEO） database and correlated with oxidative stress. Network pharmacology was employed to screen the active components of TSPSP， and a "Chinese medicine-component-target-disease" network was constructed to predict the mechanism of action of TSPSP. For in vitro validation experiments， HTR-8/SVneo cells were divided into blank group， model group， TSPSP-containing serum 2.5%， 5%， 10% groups， and nuclear factor E₂-related factor 2 （Nrf2） inhibitor group （ML385， 30 μmol·L^-1）. Except for the blank group， other groups were stimulated with 150 μmol·L^-1 H₂O₂ for 3 h to establish a cell oxidative stress injury model. After successful modeling， the blank group and model group were given 10% blank serum， each TSPSP-containing serum group was treated with the corresponding concentration of drug-containing serum， and the Nrf2 inhibitor group was additionally given 30 μmol·L^-1 ML385 on the basis of 10% TSPSP-containing serum. All groups of cells were continuously cultured under the above conditions for 24 h， and then samples were collected for subsequent detection. Cell viability in each group was detected by CCK-8 assay. Cell migration rate was detected by scratch test. The contents of malondialdehyde （MDA）， Fe²⁺， and Glutathione （GSH） were detected by enzyme-linked immunosorbent assay （ELISA）. Intracellular reactive oxygen species （ROS） level was detected by a fluorescent probe （DCF-DA）. The protein and mRNA expression levels of Kelch-like ECH-associated protein 1 （KEAP1）， Nrf2， and forkhead box protein O3 （FoxO3） in cells were detected by immunofluorescence （IF） and real-time quantitative polymerase chain reaction （Real-time PCR）. The protein expression levels of KEAP1， Nrf2， FoxO3， Glutathione peroxidase 4 （GPX4）， and superoxide dismutase （SOD） in cells were detected by Western blot. ResultsThe GSE76862 and GSE22490 datasets were obtained from the GEO database. Differential gene analyses showed that the KEAP1， Nrf2， and FoxO3 genes were all associated with the disease. After matching with the oxidative stress pathway， nine significantly differential pathways were identified （P<0.05）， among which three contained the target genes Nrf2 and FoxO3. A total of 246 active ingredient targets of TSPSP and 2 804 SA-related targets were obtained through network pharmacology， and 154 potential action targets were obtained after taking the intersection. Topological analysis showed that targets such as KEAP1 and Nrf2 exhibited high degree values. GO and KEGG enrichment analyses indicated that the intersection targets were mainly involved in oxidative stress response， FOXO and MAPK signaling pathways， etc. In in vitro experiments， compared with the blank group， the cell viability in the model group was significantly decreased （P<0.01）. Compared with the model group， the cell viability in each TSPSP-containing serum group was significantly increased （P<0.01）. Compared with the 10% TSPSP-containing serum group， the cell viability in the ML385 group decreased to approximately 70% （P<0.01）. Compared with the blank group， the model group showed significantly increased contents of MDA， Fe²⁺， and ROS， decreased GSH expression （P<0.01）， significantly reduced cell migration rate （P<0.01）， and increased protein and mRNA expression levels of KEAP1 and FoxO3 （P<0.01）， while decreased protein and mRNA expression levels of Nrf2， GPX4， and SOD （P<0.01）. Compared with the model group， each TSPSP-containing serum group showed significantly decreased contents of MDA， Fe²⁺， and ROS， increased GSH expression （P<0.01）， significantly increased migration rate （P<0.01）， significantly decreased protein and mRNA expression levels of KEAP1 and FoxO3 （P<0.05， P<0.01）， and significantly increased protein and mRNA expression levels of Nrf2， GPX4， and SOD （P<0.05， P<0.01）. Compared with the 10% TSPSP-containing serum group， the ML385 group showed reversed trends in all indicators （P<0.05， P<0.01）. ConclusionTSPSP can inhibit H₂O₂-induced oxidative stress injury of trophoblast cells， and its mechanism of action may be related to the drug activating the KEAP1/Nrf2/FoxO3 signaling pathway.

ObjectiveTo explore the effect and mechanism of Taishan Panshi powder （TSPSP） on inhibiting oxidative stress injury in human chorionic trophoblast cells （HTR-8/SVneo）， and to uelucidate the underlying mechanism of TSPSP in the treatment of spontaneous abortion （SA）. MethodsGene differential analysis of SA was performed using the Gene Expression Omnibus （GEO） database and correlated with oxidative stress. Network pharmacology was employed to screen the active components of TSPSP， and a "Chinese medicine-component-target-disease" network was constructed to predict the mechanism of action of TSPSP. For in vitro validation experiments， HTR-8/SVneo cells were divided into blank group， model group， TSPSP-containing serum 2.5%， 5%， 10% groups， and nuclear factor E₂-related factor 2 （Nrf2） inhibitor group （ML385， 30 μmol·L^-1）. Except for the blank group， other groups were stimulated with 150 μmol·L^-1 H₂O₂ for 3 h to establish a cell oxidative stress injury model. After successful modeling， the blank group and model group were given 10% blank serum， each TSPSP-containing serum group was treated with the corresponding concentration of drug-containing serum， and the Nrf2 inhibitor group was additionally given 30 μmol·L^-1 ML385 on the basis of 10% TSPSP-containing serum. All groups of cells were continuously cultured under the above conditions for 24 h， and then samples were collected for subsequent detection. Cell viability in each group was detected by CCK-8 assay. Cell migration rate was detected by scratch test. The contents of malondialdehyde （MDA）， Fe²⁺， and Glutathione （GSH） were detected by enzyme-linked immunosorbent assay （ELISA）. Intracellular reactive oxygen species （ROS） level was detected by a fluorescent probe （DCF-DA）. The protein and mRNA expression levels of Kelch-like ECH-associated protein 1 （KEAP1）， Nrf2， and forkhead box protein O3 （FoxO3） in cells were detected by immunofluorescence （IF） and real-time quantitative polymerase chain reaction （Real-time PCR）. The protein expression levels of KEAP1， Nrf2， FoxO3， Glutathione peroxidase 4 （GPX4）， and superoxide dismutase （SOD） in cells were detected by Western blot. ResultsThe GSE76862 and GSE22490 datasets were obtained from the GEO database. Differential gene analyses showed that the KEAP1， Nrf2， and FoxO3 genes were all associated with the disease. After matching with the oxidative stress pathway， nine significantly differential pathways were identified （P<0.05）， among which three contained the target genes Nrf2 and FoxO3. A total of 246 active ingredient targets of TSPSP and 2 804 SA-related targets were obtained through network pharmacology， and 154 potential action targets were obtained after taking the intersection. Topological analysis showed that targets such as KEAP1 and Nrf2 exhibited high degree values. GO and KEGG enrichment analyses indicated that the intersection targets were mainly involved in oxidative stress response， FOXO and MAPK signaling pathways， etc. In in vitro experiments， compared with the blank group， the cell viability in the model group was significantly decreased （P<0.01）. Compared with the model group， the cell viability in each TSPSP-containing serum group was significantly increased （P<0.01）. Compared with the 10% TSPSP-containing serum group， the cell viability in the ML385 group decreased to approximately 70% （P<0.01）. Compared with the blank group， the model group showed significantly increased contents of MDA， Fe²⁺， and ROS， decreased GSH expression （P<0.01）， significantly reduced cell migration rate （P<0.01）， and increased protein and mRNA expression levels of KEAP1 and FoxO3 （P<0.01）， while decreased protein and mRNA expression levels of Nrf2， GPX4， and SOD （P<0.01）. Compared with the model group， each TSPSP-containing serum group showed significantly decreased contents of MDA， Fe²⁺， and ROS， increased GSH expression （P<0.01）， significantly increased migration rate （P<0.01）， significantly decreased protein and mRNA expression levels of KEAP1 and FoxO3 （P<0.05， P<0.01）， and significantly increased protein and mRNA expression levels of Nrf2， GPX4， and SOD （P<0.05， P<0.01）. Compared with the 10% TSPSP-containing serum group， the ML385 group showed reversed trends in all indicators （P<0.05， P<0.01）. ConclusionTSPSP can inhibit H₂O₂-induced oxidative stress injury of trophoblast cells， and its mechanism of action may be related to the drug activating the KEAP1/Nrf2/FoxO3 signaling pathway.

Chemotherapy-induced peripheral neurotoxicity (CIPN) is a severe dose-limiting adverse event of chemotherapy. Presently, the mechanism underlying the induction of CIPN remains unclear, and no effective treatment is available. In this study, through metabolomics analyses, we found that nab-paclitaxel therapy markedly increased serum serotonin [5-hydroxtryptamine (5-HT)] levels in both cancer patients and mice compared to the respective controls. Furthermore, nab-paclitaxel-treated enterochromaffin (EC) cells showed increased 5-HT synthesis, and serotonin-treated Schwann cells showed damage, as indicated by the activation of CREB3L3/MMP3/FAS signaling. Venlafaxine, an inhibitor of serotonin and norepinephrine reuptake, was found to protect against nerve injury by suppressing the activation of CREB3L3/MMP3/FAS signaling in Schwann cells. Remarkably, venlafaxine was found to significantly alleviate nab-paclitaxel-induced CIPN in patients without affecting the clinical efficacy of chemotherapy. In summary, our study reveals that EC cell-derived 5-HT plays a critical role in nab-paclitaxel-related neurotoxic lesions, and venlafaxine co-administration represents a novel approach to treating chronic cumulative neurotoxicity commonly reported in nab-paclitaxel-based chemotherapy.
Paclitaxel/toxicity* ; Animals ; Albumins/adverse effects* ; Serotonin/metabolism* ; Mice ; Humans ; Male ; Female ; Venlafaxine Hydrochloride/therapeutic use* ; Neurotoxicity Syndromes/metabolism* ; Middle Aged ; Schwann Cells/metabolism* ; Peripheral Nervous System Diseases/drug therapy* ; Antineoplastic Agents

BACKGROUND:Percutaneous kyphoplasty assisted by C-arm under local anesthesia requires continuous adjustment of the puncture direction under multiple C-arm fluoroscopy.The establishment time of the working channel is longer,and the intraoperative pain stimulation of patients is larger.With the help of the robot,the puncture can be successfully performed at one time,which can significantly improve the experience of patients and reduce the risk of bone cement leakage.OBJECTIVE:To compare the patient experience and other outcomes of percutaneous kyphoplasty using robot-assisted and conventional C-arm fluoroscopy under local anesthesia.METHODS:A total of 241 patients with single-stage osteoporotic vertebral compression fracture were selected from Sichuan Academy of Medical Sciences·Sichuan Provincial People's Hospital(Affiliated Hospital,University of Electronic Science and Technology of China).132 patients underwent robot-assisted percutaneous kyphoplasty under local anesthesia(robot-assisted group).109 cases of conventional C-arm assisted percutaneous kyphoplasty under local anesthesia(conventional fluoroscopy group).Patients'intraoperative experience evaluation,bone cement injection amount,operation time,working channel establishment time,hospitalization cost and complications were recorded.Puncture deviation and bone cement leakage were evaluated by imaging on the first day after surgery.RESULTS AND CONCLUSION:(1)The intraoperative experience of 59 patients in the robot-assisted group was rated as"very good",43 as"good",16 as"average",10 as"poor",and 4 as"very poor,"while that of 30 patients in the conventional fluoroscopy group was rated as"very good",44 cases were"good",21"average",9"poor",and 5"very poor."There was a significant difference between the two groups in intraoperative experience evaluation(Z=-2.546,P=0.011).Intraoperative pain visual analog scale score was lower in the robot-assisted group than that in the conventional fluoroscopy group(t=-9.513,P=0.000).Totally 84 patients in the robot-assisted group and 47 patients in the conventional fluoroscopy group were willing to undergo percutaneous kyphoplasty again when necessary,and there was a significant difference between the two groups(Z=-2.730,P=0.006).(2)The operation time and hospitalization cost of the robot-assisted group were more than those of the conventional fluoroscopy group(t=2.860,P=0.003;t=36.522,P=0.000).The working channel establishment time of robot-assisted group was shorter than that of conventional fluoroscopy group(t=-27.066,P=0.000).The puncture deviation of robot-assisted group was better than that of conventional fluoroscopy group(Z=-3.656,P=0.000).The cement leakage of robot-assisted group was lower than that of conventional fluoroscopy group(χ2=7.284,P=0.007).(3)It is concluded that under local anesthesia,patients with robot-assisted percutaneous kyphoplasty have good surgical experience,with advantages of accurate puncture,short time to establish working channel,and low leakage rate of bone cement.

Objective:To investigate the influence of inner cell mass and trophectoderm cytoplasmic strings during blastocyst expan-sion on embryonic development and pregnancy outcome.Methods:A retrospective cohort analysis was performed for the clinical data of patients who received pre-implantation genetic testing for aneuploidy(PGT-A)and underwent single blastocyst transplantation in our hospital from June 2019 to December 2021.A total of 530 patients were enrolled,and genetic testing was performed for 2132 blasto-cysts.According to the presence or absence of cytoplasmic strings during blastocyst expansion,the blastocysts were divided into cyto-plasmic strings(+)group with 534 blastocysts and cytoplasmic strings(-)group with 1598 blastocysts,and quality and PGT-A results were compared between the two groups.After the transfer of euploid blastocysts,pregnancy outcome was compared between the 115 blastocysts with cytoplasmic strings and the 415 blastocysts without cytoplasmic strings.Results:The rates of cytoplasmic strings(+)in the high-,average-,and low-quality blastocyst groups were 30.19%,24.62%,and 12.63%,respectively.The correlation analysis showed a correlation coefficient of-0.115(P<0.001)between embryo quality and the rate of cytoplasmic strings(+).There was no sig-nificant difference in euploidy rate between the two groups(45.3%vs.44.6%).There were no significant differences between the euploid blastocysts with cytoplasmic strings and those without cytoplasmic strings in implantation rate(72.17%vs.66.02%,P=0.213),miscarriage rate(14.46%vs.12.77%,P=0.691),and live birth rate(61.74%vs.57.59%,P=0.424).Conclusion:The presence of cyto-plasmic strings is associated with the morphological quality of blas-tocysts,while it has no impact on embryo ploidy or clinical outcome after euploid embryo transfer.Further research is needed to confirm the impact of cytoplasmic strings on embryonic development.

Background and Aims:Precise localization of lesions and optimization of the surgical approach are crucial in laparoscopic left hepatectomy.Traditional surgical techniques have certain limitations,whereas indocyanine green(ICG)fluorescence navigation can accurately delineate the boundaries of liver lesions.The Laennec's capsule approach aids in clearly exposing intrahepatic structures.This study was conducted to evaluate the clinical effectiveness of combining ICG fluorescence navigation with the Laennec's capsule approach in laparoscopic left hepatectomy.Methods:The clinical data of 44 liver cancer patients who underwent surgery at the Hepatobiliary Surgery Department of Xuanhan People's Hospital from January 2023 to November 2024 were retrospectively collected.Among them,22 patients underwent laparoscopic left hepatectomy with Pringle's maneuver for total hepatic inflow occlusion(control group),while the other 22 patients received laparoscopic left hepatectomy using ICG fluorescence navigation combined with the Laennec's capsule approach(observation group).The two groups were compared in terms of intraoperative surgical time,average blood loss,intraoperative transfusion rate,liver function on postoperative days(POD)1,3,and 7[total bilirubin(TBIL),aspartate aminotransferase(AST),alanine aminotransferase(ALT)],average length of hospital stay,gastrointestinal function recovery time,POD 1-6 drainage volume,incidence of postoperative complications,and short-term efficacy.Results:The observation group had significantly shorter average surgical time than the control group[(218.19±39.18)min vs.(245.23±44.36)min,P＜0.05]and less average blood loss[(320.44±78.62)mL vs.(456.37±88.16)mL,P＜0.05].The intraoperative transfusion rate between the two groups was not significantly different(13.64％vs.9.09％,P＞0.05).The observation group had significantly less postoperative drainage POD 1-6 than the control group[(431.19±152.18)mL vs.(528.23±184.36)mL,P＜0.05].The average hospital stay and gastrointestinal function recovery time were shorter in the observation group[(9.21±2.92)d vs.(12.72±3.24)d;(2.24±0.42)d vs.(3.35±0.53)d,both P＜0.05].Postoperative liver function tests(TBIL,AST,ALT)on days 1,3,and 7 were significantly lower in the observation group compared to the control group(all P＜0.05).The difference in the overall response rate between the two groups was not statistically significant(72.73％vs.77.27％,P＞0.05).No severe postoperative complications occurred in either group.Conclusion:The combination of ICG fluorescence navigation with the Laennec's capsule approach demonstrates favorable clinical outcomes in laparoscopic left hepatectomy and is worthy of clinical promotion.

On the occasion of the 110th Anniversary of the establishment of the Chinese Medical Association, the third conference of the Fourth Editorial Board of Chinese Journal of Digestive Surgery, and the Second Elite Group of Chinese Journal of Digestive Surgery, was successfully held in Kunming on July 4, 2025. This conference systematically summarizes the development experience of the journal over the past 20 years from three aspects: the role of ecological construction of thought in the discipline construction of digestive surgery, the display of the latest academic achievements in the field of digestive surgery, the development difficulties, and breakthrough paths of the discipline, and strategically plans the path of discipline construction in the new era.

Objective:To evaluate the short-term and long-term outcomes of patients with locally advanced low rectal cancer who achieved clinical complete response (cCR) or near-clinical complete response (near-cCR) after neoadjuvant chemoradiotherapy (nCRT) and then underwent local excision.Methods:This was a descriptive case series study. Clinical data of patients with low rectal cancer who received neoadjuvant therapy, achieved cCR or near-cCR, underwent local excision, and had complete postoperative follow-up data were retrospectively analyzed. The study period was from May, 2015 to October, 2024, and the patients were treated at Fujian Medical University Union Hospital. Indications for local excision in this study were as follows: pathologically confirmed rectal adenocarcinoma, with the lower edge of the tumor ≤ 6 cm from the anal verge; maximum diameter of the lesion ≤ 2 cm after nCRT; no regional lymph node metastasis detected by transrectal endoscopic ultrasound (ERUS), pelvic magnetic resonance imaging (MRI), or positron emission tomography-computed tomography (PET-CT) after nCRT; MRI showing fibrosis of the primary lesion with a small amount of high signal on diffusion-weighted imaging (DWI), consistent with ymrT0-1 stage; serum carcinoembryonic antigen level within the normal range (< 5 μg/L) after nCRT; complicated with severe underlying diseases such as cardiovascular and cerebrovascular diseases and assessed as unable to tolerate radical surgery through comprehensive evaluation; and signed informed consent for local excision. The contraindications were: colonoscopic pathology indicating poorly differentiated adenocarcinoma or signet ring cell carcinoma; suspected lateral lymph node metastasis before neoadjuvant therapy; patients with residual lesions exceeding 3 cm in range after treatment. A total of 153 patients were included in this study, including 84 males and 69 females. The median age was 62 years, and the median distance from the tumor to the anal verge after neoadjuvant therapy was 4.0 cm. The short-term efficacy indicators of this study included postoperative complications of local excision and postoperative pathological results, and the long-term efficacy indicators included oncological prognosis (3-year cumulative local recurrence rate, 3-year cumulative distant metastasis rate, 3-year progression-free survival, and 3-year overall survival) and anal function at 1 year after surgery evaluated using the Low Anterior Resection Syndrome (LARS) scale where the total score is 42 points such that 0-20 points indicate no LARS, 21-29 points indicate mild LARS, and 30-42 points indicate severe LARS.Results:Postoperative pathology showed 122 cases (79.7%) of ypT0 stage, 10 cases (6.5%) of ypT1 stage, 18 cases (11.8%) of ypT2 stage, and 3 cases (2.0%) of ypT3 stage. The incidence of surgery-related complications was 42.5% (65/153), and the main complications included perianal pain (39.9%, 61/153), intestinal wall incision dehiscence (21.6%, 33/153), and intestinal wall incision infection (18.3%, 28/153). The proportion of patients who received hypofractionated radiotherapy before surgery and developed intestinal wall incision dehiscence was 65.2% (15/23), which was higher than that in the conventional long-course (13.6%, 16/118) and short-course radiotherapy groups (16.7%,2/12) (χ 2=30.55, P<0.001); of the 20 patients who received additional immunotherapy before surgery, 13 developed intestinal wall incision dehiscence was 65.0%, which was higher than that in the group without additional immunotherapy [15.0%(20/133),χ 2=25.66, P<0.001]. The median follow-up time of the entire group was 35.4 months. During the follow-up period, there were 9 cases of postoperative local recurrence, with a 3-year cumulative local recurrence rate of 7.9% and 5 cases of distant metastasis, with a 3-year cumulative distant metastasis rate of 5.0%. The 3-year progression-free survival rate was 89.0%, and the 3-year overall survival rate was 95.9%. At 1 year after surgery, 10 cases (10.5%, 10/95) had severe anal dysfunction, and the median LARS score of the entire group was 5.0 (range: 0-41.0) points. Conclusions:For patients with locally advanced low rectal cancer who achieve cCR or near-cCR after neoadjuvant therapy, local excision results in favorable oncological prognosis and anal function preservation effects; however, the incidence of complications is relatively high.

On the occasion of the 110th Anniversary of the establishment of the Chinese Medical Association, the third conference of the Fourth Editorial Board of Chinese Journal of Digestive Surgery, and the Second Elite Group of Chinese Journal of Digestive Surgery, was successfully held in Kunming on July 4, 2025. This conference systematically summarizes the development experience of the journal over the past 20 years from three aspects: the role of ecological construction of thought in the discipline construction of digestive surgery, the display of the latest academic achievements in the field of digestive surgery, the development difficulties, and breakthrough paths of the discipline, and strategically plans the path of discipline construction in the new era.

BACKGROUND:Percutaneous kyphoplasty assisted by C-arm under local anesthesia requires continuous adjustment of the puncture direction under multiple C-arm fluoroscopy.The establishment time of the working channel is longer,and the intraoperative pain stimulation of patients is larger.With the help of the robot,the puncture can be successfully performed at one time,which can significantly improve the experience of patients and reduce the risk of bone cement leakage.OBJECTIVE:To compare the patient experience and other outcomes of percutaneous kyphoplasty using robot-assisted and conventional C-arm fluoroscopy under local anesthesia.METHODS:A total of 241 patients with single-stage osteoporotic vertebral compression fracture were selected from Sichuan Academy of Medical Sciences·Sichuan Provincial People's Hospital(Affiliated Hospital,University of Electronic Science and Technology of China).132 patients underwent robot-assisted percutaneous kyphoplasty under local anesthesia(robot-assisted group).109 cases of conventional C-arm assisted percutaneous kyphoplasty under local anesthesia(conventional fluoroscopy group).Patients'intraoperative experience evaluation,bone cement injection amount,operation time,working channel establishment time,hospitalization cost and complications were recorded.Puncture deviation and bone cement leakage were evaluated by imaging on the first day after surgery.RESULTS AND CONCLUSION:(1)The intraoperative experience of 59 patients in the robot-assisted group was rated as"very good",43 as"good",16 as"average",10 as"poor",and 4 as"very poor,"while that of 30 patients in the conventional fluoroscopy group was rated as"very good",44 cases were"good",21"average",9"poor",and 5"very poor."There was a significant difference between the two groups in intraoperative experience evaluation(Z=-2.546,P=0.011).Intraoperative pain visual analog scale score was lower in the robot-assisted group than that in the conventional fluoroscopy group(t=-9.513,P=0.000).Totally 84 patients in the robot-assisted group and 47 patients in the conventional fluoroscopy group were willing to undergo percutaneous kyphoplasty again when necessary,and there was a significant difference between the two groups(Z=-2.730,P=0.006).(2)The operation time and hospitalization cost of the robot-assisted group were more than those of the conventional fluoroscopy group(t=2.860,P=0.003;t=36.522,P=0.000).The working channel establishment time of robot-assisted group was shorter than that of conventional fluoroscopy group(t=-27.066,P=0.000).The puncture deviation of robot-assisted group was better than that of conventional fluoroscopy group(Z=-3.656,P=0.000).The cement leakage of robot-assisted group was lower than that of conventional fluoroscopy group(χ2=7.284,P=0.007).(3)It is concluded that under local anesthesia,patients with robot-assisted percutaneous kyphoplasty have good surgical experience,with advantages of accurate puncture,short time to establish working channel,and low leakage rate of bone cement.