Irritable bowel syndrome with diarrhea （IBS-D）， as a prototypical disorder involving the microbiota-gut-brain axis， remains poorly understood in terms of its pathogenesis， posing ongoing challenges for clinical diagnosis. Omics technologies， leveraging their high-throughput detection and systematic analysis advantages， has emerged as a critical tool for deciphering the complex mechanisms underlying traditional Chinese medicine （TCM） treatment of IBS-D. This systematic review summarizes the research progress of transcriptomics， proteomics， metabolomics， microbiomics， and multi-omics integration techniques in TCM interventions for IBS-D. In single-omics studies， transcriptomics using techniques like RNA-seq， reveals the regulatory mechanisms of TCM on IBS-related signaling pathways. Proteomics， leveraging quantitative technologies such as 2D-difference gel electrophoresis and tandem mass tag， identifies differentially expressed proteins and elucidates the action targets of TCM in treating IBS-D. Metabolomics， employing methods like UPLC-Q-TOF-MS and LC-MS/MS， discovers metabolic pathways regulated by TCM to improve metabolic disturbances in IBS-D. Microbiomics， based on 16S rRNA sequencing， confirms that TCM can reshape the gut microbiota structure and restore the intestinal microecological balance， thereby improving IBS-D. Multi-omics integration further overcomes the limitations of single-omics approaches by synthesizing information from transcriptomics， proteomics， metabolomics， and microbiomics， enabling a more comprehensive and systematic elucidation of the complex mechanisms underlying TCM treatment for IBS-D. In the future， research related to IBS-D should be advanced from three aspects： stratified clinical research based on TCM syndrome types， multi-omics integration verification mechanisms， and emerging omics to explore new mechanisms， providing more innovative ideas for the precise diagnosis and treatment of this disease.

OBJECTIVE: To report the clinical experience of using Ilizarov wrist joint distraction technique in the treatment of a case of rheumatoid arthritis of the wrist. METHODS: In January 2019, a 49-year-old female patient with rheumatoid arthritis of the left wrist, complicated by ulnar impaction syndrome, was admitted for treatment. Preoperatively, the active range of motion of the left wrist was as follows: extension 0°-flexion 0°, pronation 65°-supination 35°, and grip strength of 4.0 kg. The visual analogue scale (VAS) score was 9, and the Cooney wrist function score was 15, indicating poor function. As conservative treatment failed to achieve symptom relief, Ilizarov wrist joint distraction surgery was performed. Postoperatively, joint distraction was applied at 2 mm increments on postoperative days 2 and 7, in 4 separate sessions. RESULTS: Postoperative X-ray film examination at 7 days revealed a distraction of 3.6 mm in the affected wrist joint compared to the contralateral side. The external fixator was removed 2.5 months postoperatively. At 22 months postoperatively, X-ray film and MRI examinations revealed that the joint space of the left wrist had returned to near-normal, with significant reduction in joint effusion and synovial proliferation. The active range of motion of the left wrist improved to extension 15°- flexion 30°, pronation 90°-supination 90°, with a grip strength of 18.0 kg. The wrist pain VAS score decreased to 0, and the Cooney wrist function score improved to 90, indicating excellent function. At 50 months postoperatively, follow-up X-ray film, MRI, and functional assessments showed the results similar to those at 22 months. CONCLUSION Ilizarov wrist joint distraction may be a viable treatment option for rheumatoid arthritis of the wrist.
Humans ; Female ; Middle Aged ; Wrist Joint/physiopathology* ; Arthritis, Rheumatoid/physiopathology* ; Range of Motion, Articular ; Ilizarov Technique ; Treatment Outcome ; Osteogenesis, Distraction/methods*

In recent years, with continuous advancements in molecular biology and gene testing technologies, the diagnosis and treatment of colorectal cancer have been rapidly transitioning toward precision medicine. The application of molecular classification, target detection, and liquid biopsy technologies has driven ongoing updates to clinical guidelines. Multidisciplinary team colla-boration, innovations in precision surgical techniques, and the widespread adoption of neoadjuvant combination therapies have collectively promoted more individualized and scientific management of colorectal cancer. Looking ahead,the authors believe that as multi-omics biomarkers, organoid models, and artificial intelligence are increasingly integrated into clinical practice, precision diagnosis and treatment of colorectal cancer will deepen further, offering patients more efficient and personalized therapeutic options.

Objective:To analyze the clinical characteristics of locally advanced rectal cancer patients with pathological complete response (pCR) after neoadjuvant chemoradiotherapy combined with immunotherapy.Methods:The retrospective cohort study was conducted. The clinicopatholo-gical data of 46 patients with locally advanced rectal cancer who were admitted to 6 medical centers, including Beijing Friendship Hospital of Capital Medical University et al, from June 2021 to November 2022 were collected. There were 29 males and 17 females, aged (61±4)years. Patients received neoadjuvant chemoradiotherapy combined with immune checkpoint inhibitor therapy, and under-went radical total mesorectal excision during 6-12 weeks after radiotherapy. Observation indicators: (1) comparison of clinical characteristics between pCR and non-pCR patients;(2) postoperative complications and adverse reactions of pCR and non-pCR patients. Comparison of measurement data with normal distribution between groups was conducted using the t test. Comparison of measurement data with skewed distribution between groups was conducted using the Mann-Whitney U test. Comparison of count data between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data between groups was conducted using the Mann-Whitney U test. Results:(1) Comparison of clinical characteristics between pCR and non-pCR patients. Before neoadjuvant therapy, there were 14 cases aged ≥50 years and 6 cases aged <50 years in pCR patients, versus 25 cases and 1 case in non-pCR patients, showing a significant difference between the two groups ( P<0.05). After neoadjuvant therapy, cases in clinical stage T0, T1, T2, T3, T4 were 11, 1, 5, 3, 0 for pCR patients versus 7, 4, 2, 11, 2 for non-pCR patients, cases of tumor regression grade 1, 2, 3, 4 were 11, 8, 1, 0 for pCR patients versus 7, 14, 4, 1 for non-pCR patients, cases in low-risk, medium-risk, high-risk of neoadjuvant rectal scoring and grading were 20, 0, 0 for pCR patients versus 4, 18, 4 for non-pCR patients, respectively, showing significant differences in above indicators between the two groups ( Z=-2.256, -2.104, -5.458, P<0.05). (2) Postoperative complications and adverse reactions of pCR and non-pCR patients. Postoperative complications occurred in 2 cases of pCR patients and 5 cases of non-pCR patients, postoperative adverse reactions occurred in 11 cases of pCR patients and 10 cases of non-pCR patients, showing no significant difference between the two groups ( P>0.05). Conclusion:Compared with locally advanced rectal cancer patients aged ≥50 years, those aged <50 years have significant benefits from neoadjuvant chemoradiotherapy combined with immunotherapy. Clinical T staging and magnetic resonance imaging-detected tumor regression grade after neoadjuvant therapy have predictive value for patients with pCR .

Objective To provide precise,effective,and intuitive nutritional and dietary recommendations for different population groups,a multi-modal nutritional knowledge graph was constructed,which includes entities such as food,nutrition,population,and diseases.Methods Data sets in the field of nutrition were obtained using web crawling and other technical means.The OneRel model was referenced to complete the joint extraction of Chinese entity relationships and construct a text library.The RoBERTa-ResNet model were used to learn the features of text and image data separately,to align images with text,and to construct a multi-modal knowledge graph.Results The F1 value of the joint entity relationship extraction model was 0.703.The constructed multi-modal knowledge graph contains 3312 textual entities,11 259 relationships,and 1000 image entities.Conclusion The algorithms used in this study to construct the multi-modal nutritional knowledge graph achieve good results.This knowledge graph not only systematically integrates multi-modal knowledge in the field of nutrition and enables good visual query capabilities,but also serves as the underlying support for downstream tasks such as intelligent question answering and nutritional recommendation systems.

Objective To explore the value of dynamic contrast-enhanced(DCE)-MRI quantitative parameters based on differential sub-sampling with Cartesian ordering(DISCO)technology for differentiating high-and low-grade breast cancer.Methods A total of 80 patients with single breast cancer confirmed by biopsy pathology were retrospectively enrolled,including 40 cases of low-grade(L group)and 40 cases of high-grade breast cancer(H group).Then quantitative parameters obtained from DISCO-DCE-MRI before treatment were compared between groups,including extravascular extracellular volume fraction(Ve),rate constant(Kep),contrast enhancement ratio(CER),maximum slope(MaxSlope)and volume transfer constant(Ktrans),and their correlations with histological grade were analyzed.Receiver operating characteristic(ROC)curves of DISCO-DCE-MRI quantitative parameters being significantly different between groups were plotted,and the area under the curves(AUC)were calculated to evaluate their efficacy for differentiating high-and low-grade breast cancer.Results Ve(0.91[0.59,0.99]),CER(2.76±0.54)and MaxSlope(0.02[0.01,0.03])in L group were all higher than those in H group(0.52[0.34,0.73],[2.31±0.74],0.01[0.01,0.02],all P＜0.05),and no significant difference of Kep nor Ktrans was found between groups(both P＞0.05).Ve,CER and MaxSlope of breast cancer were all negatively correlated with histological grade(rs=-0.43,-0.39,-0.35,all P＜0.05),while Kep andKtranshad no significant correlation with histological grade(both P＞0.05).The AUC of Ve,CER and MaxSlope for differentiating high-and low-grade breast cancer was 0.749,0.725 and 0.700,respectively.Conclusion Among DISCO-DCE-MRI quantitative parameters,Ve,CER and MaxSlope could be used for differentiating high-and low-grade breast cancer.

Objective:To investigate the effects of two anastomosis methods on perioperative and pathological outcomes during totally laparoscopic right hemicolectomy (TLRH).Methods:In a national multicenter snapshot study, 1,854 patients who underwent laparoscopic right hemicolectomy were enrolled from 52 tertiary hospitals across China. The post-hoc analysis based on this study compared the data of 303 patients who underwent TLRH. Patients were divided into the antiperistaltic group (33 cases) and the isoperistaltic group (270 cases) according to type of anastomosis. Due to the significant difference in sample size between the two groups, propensity score matching (PSM) was performed to eliminate the influence of baseline characteristic discrepancies. The matching was based on the following known confounding factors: age, gender, body mass index (BMI), history of abdominal surgery, and history of diabetes, with a caliper value of 0.2. Perioperative and pathological outcomes were compared between the two groups.Results:After PSM, 33 patients were included in the antiperistaltic group and 65 patients in the isoperistaltic group. There were no statistically significant differences in baseline data between the two groups (all P>0.05). No significant differences were observed between the two groups in terms of operation time, blood loss, time to first defecation, time to first oral intake, or the incidence and grading of complications either (all P>0.05). However, length of postoperative hospital stay in the isoperistaltic group was significantly shorter than that in the antiperistaltic group, however (7.0 [6.0, 9.0] days vs. 8.0 [7.0, 10.5] days, P=0.049). In terms of pathological outcomes, there were also no statistically significant differences between the two groups in the number of harvested lymph nodes or the number of positive lymph nodes (all P>0.05). Conclusions:The two digestive tract reconstruction modalities, antiperistaltic and isoperistaltic anastomosis, have comparable perioperative safety and efficacy in TLRH. The isoperistaltic group had better outcomes in terms of postoperative hospital stay.

Objective:To investigate the effects of two anastomosis methods on perioperative and pathological outcomes during totally laparoscopic right hemicolectomy (TLRH).Methods:In a national multicenter snapshot study, 1,854 patients who underwent laparoscopic right hemicolectomy were enrolled from 52 tertiary hospitals across China. The post-hoc analysis based on this study compared the data of 303 patients who underwent TLRH. Patients were divided into the antiperistaltic group (33 cases) and the isoperistaltic group (270 cases) according to type of anastomosis. Due to the significant difference in sample size between the two groups, propensity score matching (PSM) was performed to eliminate the influence of baseline characteristic discrepancies. The matching was based on the following known confounding factors: age, gender, body mass index (BMI), history of abdominal surgery, and history of diabetes, with a caliper value of 0.2. Perioperative and pathological outcomes were compared between the two groups.Results:After PSM, 33 patients were included in the antiperistaltic group and 65 patients in the isoperistaltic group. There were no statistically significant differences in baseline data between the two groups (all P>0.05). No significant differences were observed between the two groups in terms of operation time, blood loss, time to first defecation, time to first oral intake, or the incidence and grading of complications either (all P>0.05). However, length of postoperative hospital stay in the isoperistaltic group was significantly shorter than that in the antiperistaltic group, however (7.0 [6.0, 9.0] days vs. 8.0 [7.0, 10.5] days, P=0.049). In terms of pathological outcomes, there were also no statistically significant differences between the two groups in the number of harvested lymph nodes or the number of positive lymph nodes (all P>0.05). Conclusions:The two digestive tract reconstruction modalities, antiperistaltic and isoperistaltic anastomosis, have comparable perioperative safety and efficacy in TLRH. The isoperistaltic group had better outcomes in terms of postoperative hospital stay.

Laparoscopic right hemicolectomy is the standard surgical procedure for treating right-sided colon cancer,yet its complex anatomical layers and technically demanding operations pose significant challenges to surgeons'expertise.Currently,surgical skill assessment in clinical practice still predominantly relies on subjective expert evaluation,an approach inherently limited by low efficiency and inconsistent standards.With the rapid advancement of artificial intelligence(AI)technologies(particularly breakthroughs in computer vision and deep learning algorithms),a revolutionary technical foundation has been established for developing objective and precise automated surgical evaluation systems.This article comprehensively reviewed the current clinical application status of right hemicolectomy in China,thoroughly examined the clinical necessity and technical feasibility of constructing an intelligent surgical assessment system,and systematically presented our center's cutting-edge research achievements in this field.Looking ahead,AI-driven intelligent evaluation systems are expected to standardize and quantify surgical skill assessment.Such innovation will not only transform surgical training programs and enhance the quality of multicenter clinical research,but also promote the standardization of precision surgical protocols.This advancement holds significant clinical value and societal importance by improving long-term patient outcomes and fostering more equitable distribution of medical resources.

In recent years, with continuous advancements in molecular biology and gene testing technologies, the diagnosis and treatment of colorectal cancer have been rapidly transitioning toward precision medicine. The application of molecular classification, target detection, and liquid biopsy technologies has driven ongoing updates to clinical guidelines. Multidisciplinary team colla-boration, innovations in precision surgical techniques, and the widespread adoption of neoadjuvant combination therapies have collectively promoted more individualized and scientific management of colorectal cancer. Looking ahead,the authors believe that as multi-omics biomarkers, organoid models, and artificial intelligence are increasingly integrated into clinical practice, precision diagnosis and treatment of colorectal cancer will deepen further, offering patients more efficient and personalized therapeutic options.