Objective:To explore the value of preoperative 18F-fluorodeoxyglucose ( 18F-FDG) positron emission tomography (PET) metabolic heterogeneity parameters in predicting tumor deposits (TD) in colorectal cancer (CRC). Methods:A retrospective analysis was conducted on 91 CRC patients who underwent surgical treatment at the Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from February 2013 to March 2024. All patients underwent preoperative 18F-FDG PET/CT examination. The LIFEx-7.5.15 software was used to delineate the primary lesion with 40% of maximum standardized uptake value (SUV max) as the relative threshold, and metabolic parameters were extracted. Intratumoral metabolic heterogeneity parameters included cumulative SUV histogram area under the curve (AUC-CSH), heterogeneity index (HI), heterogeneity factor (HF), and coefficient of variation (CV). The presence of TD was confirmed by postoperative pathological examination. Differences in data between the TD group and non-TD (NTD) group were compared. Binary logistic regression analysis was used to identify independent risk factors for TD, and receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy of each parameter for TD. Results:Postoperative pathological diagnosis showed that 27 patients were included in the TD group and 64 in the NTD group. There were statistically significant differences between the TD group and NTD group in CV ( Z=-3.145, P=0.002) and the proportion of patients with carcinoembryonic antigen (CEA) >10 ng/ml (χ 2=10.751, P=0.001), while no statistically significant differences were found in HI, HF, or AUC-CSH (all P>0.05). Binary logistic regression analysis showed that CV was an independent risk factor for TD. ROC curve analysis showed that the area under the ROC curve (AUC) of CV for predicting TD was 0.709(95% CI: 0.593-0.826), which was higher than that of other metabolic heterogeneity parameters. Conclusions:The preoperative 18F-FDG PET/CT metabolic heterogeneity parameter CV has value in predicting TD in CRC patients.

Objective:To investigate the anatomical feasibility of the endoscopic transorbital approach (ETOA) to the orbital apex and lateral middle cranial fossa, to identify stable and recognizable surgical landmarks under endoscopic visualization, and to provide morphometric data for preoperative planning and intraoperative navigation.Methods:Stepwise anatomical dissection was performed on five formalin-fixed cadaveric heads and one fresh arterially injected cadaveric specimen to simulate the ETOA using a 0° endoscope. Key structures and their anatomical relationships were observed and recorded. Additionally, high-resolution CT scans of 50 adults were retrospectively analyzed. Three-dimensional reconstructions and measurements were performed using Mimics 17.0 software. Spatial validation was performed using 17 dry skulls to verify the consistency and reliability of osseous anatomical landmarks.Results:Cadaveric dissection identified the meningo-orbital band, superior orbital fissure, optic canal, foramen rotundum, and foramen ovale as reliable surgical landmarks for the ETOA. A topographic map of the surgical region was established based on the endoscopic view. CT measurements revealed the following distances (Mean±SD): the midpoint of the supraorbital rim to the foramen rotundum (57.31±3.59) mm and foramen ovale (71.46±3.42) mm; the lateral orbital rim to the lateral edge of the superior orbital fissure (37.38±2.52) mm; the distance from the superior orbital fissure to the optic canal (9.98±1.49) mm; and the distance from the anterior ethmoidal artery to the optic canal (19.98±2.05) mm. These measurements were consistent with dry skull data, indicating that these osseous landmarks had stable spatial relationships and were suitable for intraoperative localization.Conclusions:The ETOA provides favorable anatomical accessibility and clinical feasibility for lesions involving the orbital apex and lateral skull base. Key osseous structures demonstrate high identifiability and stable spatial relationships, serving as critical references for intraoperative navigation and preoperative pathway planning. The quantitative anatomical framework established in this study provides critical morphometric support for minimally invasive surgery targeting lesions in this region.

Objective:To observe the intervention effect of personalized nutrition program combined with rehabilitation training in stroke rehabilitation patients.Methods:86 stroke rehabilitation patients who were admitted to our hospital from January 2023 to June 2024 were prospectively selected,they were divided into control group and study group according to the random number table method,with 43 cases in each group,the control group received rehabilitation training,while the study group received personalized nutrition program combine with rehabilitation training.Simple Fugl Meyer motor function(FMA)score,immune function indicators[immunoglobulin(Ig)A,IgG,complement C3,IgM,complement C4],National Institutes of Health Stroke Scale(NIHSS),nutritional status indicators[albumin(ALB),prealbumin(PA),total protein(TP),hemoglobin(HB)],Stroke Specific Quality of Life Scale(SS-QOL),Barthel Index(BI)score were compared between the two groups.Results:NIHSS score in the study group at 8 weeks after intervention was lower than that in the control group,and SS-QOL score,BI score,FMA score,IgM,IgA,IgG,complement C3,complement C4,ALB,HB,TP and PA were higher than those in the control group(P＜0.05).Conclusion:Personalized nutrition program combined with rehabilitation training in stroke rehabilitation patients,can reduce neurological damage,improve limb motor function,enhance nutritional status,immunity,and quality of life.

Objective:To explore the value of preoperative 18F-fluorodeoxyglucose ( 18F-FDG) positron emission tomography (PET) metabolic heterogeneity parameters in predicting tumor deposits (TD) in colorectal cancer (CRC). Methods:A retrospective analysis was conducted on 91 CRC patients who underwent surgical treatment at the Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from February 2013 to March 2024. All patients underwent preoperative 18F-FDG PET/CT examination. The LIFEx-7.5.15 software was used to delineate the primary lesion with 40% of maximum standardized uptake value (SUV max) as the relative threshold, and metabolic parameters were extracted. Intratumoral metabolic heterogeneity parameters included cumulative SUV histogram area under the curve (AUC-CSH), heterogeneity index (HI), heterogeneity factor (HF), and coefficient of variation (CV). The presence of TD was confirmed by postoperative pathological examination. Differences in data between the TD group and non-TD (NTD) group were compared. Binary logistic regression analysis was used to identify independent risk factors for TD, and receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy of each parameter for TD. Results:Postoperative pathological diagnosis showed that 27 patients were included in the TD group and 64 in the NTD group. There were statistically significant differences between the TD group and NTD group in CV ( Z=-3.145, P=0.002) and the proportion of patients with carcinoembryonic antigen (CEA) >10 ng/ml (χ 2=10.751, P=0.001), while no statistically significant differences were found in HI, HF, or AUC-CSH (all P>0.05). Binary logistic regression analysis showed that CV was an independent risk factor for TD. ROC curve analysis showed that the area under the ROC curve (AUC) of CV for predicting TD was 0.709(95% CI: 0.593-0.826), which was higher than that of other metabolic heterogeneity parameters. Conclusions:The preoperative 18F-FDG PET/CT metabolic heterogeneity parameter CV has value in predicting TD in CRC patients.

Objective:To observe the impact of ultra early neurorehabilitation combined with cognitive intervention training on the psychological state,neurological function,and quality of life of stroke patients.Methods:89 stroke patients who were admitted to our hospital from April 2023 to May 2024 were divided into control group(conventional rehabilitation intervention combined with cognitive intervention training,44 cases)and study group(control group combined with ultra early neurological rehabilitation,45 cases)by using random number table method.The neurological function,daily self-care ability,psychological state,quality of life,and satisfaction between two groups were compared.Results:14 d after intervention,the study group had lower scores on the national institutes of health stroke scale(NIHSS),self rating anxiety scale(SAS),and self rating depression Scale(SDS)compared to the control group,had higher scores of the comprehensive quality of life evaluation questionnaire-74(CQOLI-74)and the modified barthel index(MBI)(P＜0.05).The overall satisfaction rate of the study group was higher than that of the control group(P＜0.05).Conclusion:Ultra early neurorehabilitation combined with cognitive intervention training can effectively improve the neurological function and daily self-care ability of stroke patients,reduce anxiety and depression,improve their quality of life,and achieve good patient satisfaction.

Objective To investigate the effects of angelica polysaccharides on diabetic retinopathy(DR)and possi-ble mechanisms of action.Methods DR mouse models were established by injecting streptozotocin into 18 C57BL/6J mice.The mice were then divided randomly into an Angelica polysaccharide group(given 289 mg·kg-1 Angelica polysac-charides),a positive control group(given 217 mg·kg-1 calcium hydroxybenzenesulfonate),and a model group(given an equal volume of saline),6 mice in each group.6 normal mice were selected as a blank group(given an equal volume of sa-line).The drug was administered by gavage once a day for 28 consecutive days.ARPE-19 cells were exposed to a high-glu-cose(25 mmol·L-1)culture medium to establish DR cell models,which were divided into a negative control group(con-trol vector),a lncRNA MEG3 group(lncRNA MEG3 overexpression vector),and a model group(DR cells without vector transfection).Cells not treated with 25 mmol·L-1glucose were taken as a blank group.All cells were cultured for 24 h.Fasting blood glucose levels were detected in mice.Hematoxylin-Eosin(HE)staining was performed to study the his-topathological changes in the retinal tissue of mice.Quantitative polymerase chain reaction(qPCR)was performed to de-tect the expression level of lncMEG3 mRNAs in the retinal tissue of mice.CCK-8 assay was used to measure the activity of ARPE-19 cells.Enzyme linked immunosorbent assay(ELISA)was used to detect IL-1β and IL-6 levels in mouse retinal tis-sues and ARPE-19 cells.The Western blot analysis was made to detect the levels of cellular pyroptosis-related proteins(in-cluding Caspase-1,Cleaved-Caspase-1,GSDMD,GSDMD-N,NLRP3,IL-1 β,and IL-18)in mouse retinal tissues and ARPE-19 cells.Results Blood glucose levels in the mice of the model group were higher than those in the mice of the blank group and lower than those in the mice of Angelica polysaccharide and positive control groups(all P＜0.05).HE staining results showed that compared with those of the blank group,the mice in the mode group had significantly damaged retinal tissues and disordered and loose cell arrangement.The retinal tissue of the mice in Angelica polysaccharide and positive control groups was arranged more orderly and densely and suffered less damage,compared with that of the mice in the model group.The relative expression levels of lncMEG3 mRNAs in the retinal tissue of mice in the blank,model group,An-gelica polysaccharide,and positive control groups were 1.005±0 114,0.423±0.054,0.701±0.101 and 0.593±0.084,re-spectively.The retinal expression levels of lncMEG3 mRNAs in the mice of Angelica polysaccharide and positive control groups were significantly higher than those in the mice of the model group(both P＜0.01).CCK-8 results showed that the survival rates of ARPE-19 cells in the lncRNA MEG3 group at 48 and 72 h were higher than those in the negative control group(both P＜0.05).ELISA and Western blot results showed that the retinal expression levels of IL-1 β,IL-6 and cellular pyroptosis-related proteins in the mice of the model group were significantly higher than those in the mice of the blank group(all P＜0.01)and higher than those in the mice of Angelica polysaccharide group and positive control group(all P＜0.05).The expression levels of IL-1 β,IL-6,and cellular pyroptosis-related proteins in ARPE-19 cells of the model group were significantly higher than those in the blank group(all P＜0.01).The expression levels of IL-1 β,IL-6,and cellular py-roptosis-related proteins in ARPE-19 cells of the lncRNA MEG3 group were lower than those in the negative control group(all P＜0.05).Conclusion Angelica polysaccharides can improve DR by promoting lncRNA MEG3 expression and down-regulating IL-1 β,IL-6,Caspase-1,Cleaved-Caspase-1,GSDMD,GSDMD-N,NLRP3,IL-1β,and IL-18 protein ex-pression.

Objective:To explore the impact of group interpersonal psychotherapy (IPT-G) on depressive symptoms and social cognitive function of adolescents with depression.Methods:From June 2021 to December 2023, a total of 75 adolescent inpatients diagnosed with depression were recruited from Hangzhou Seventh People’s Hospital. They were divided into intervention group and control group according to the general information matching principle.Finally, 30 patients in each group completed the study.The patients in control group received antidepressant medication, psychiatric care, and general recreational activities.While the patients in intervention group received IPT-G based on the treatment of control group. Children's depression inventory (CDI), interpersonal trust scale (ITS), self-esteem scale (SES) and the adolescent cognitive style questionnaire (ACSQ) were adopted to assess the depressive symptoms and social cognitive function of adolescent inpatients before and after the intervention and at 3 and 6 months of follow-up, respectively. SPSS 25.0 software was used for statistical analysis. Chi-square test, independent sample t-test and repeated measure ANOVA were used for inter or intra group comparisons. Results:1.Comparison of depression: The time and group interaction effect of CDI scores between the two groups was significant ( F=6.405, P<0.01). Inter group comparison showed that the CDI scores of the intervention group at 3 and 6 months (12.10±5.20, 7.93±2.98) were lower than those of the control group(18.13±7.28, 15.77±5.52) (both P<0.05), and the scores of both groups at the end of the intervention, 3 months after the intervention, and 6 months after the intervention were lower than that before intervention (all P<0.05).2.Comparison of social cognitive function: (1)There were significant time and group interaction effect of ITS score and SES score( F=5.871, 6.594, both P<0.01).Inter group comparison showed that the ITS score(78.97±7.63, 83.03±7.42) and the SES score(28.00±4.00, 30.30±3.21) of intervention group at 3 months and 6 months after intervention were all higher than those of control group(ITS: (71.70±12.29, 73.90±12.79); SES: (24.37±5.08, 25.80±4.10)(all P<0.05).Intra group comparison showed that the ITS and the SES scores of the intervention group at 3 months and 6 months after intervention were all higher than before intervention( P<0.05).The ITS score of the control group at 6 months after intervention was higher than before intervention( P<0.05).The SES scores of the control group at three time points after intervention were all higher than those before intervention(all P<0.05).(2)Comparison of ACSQ scores: There were significant time and group interaction effects for the scores of academic stability, academic specificity, interpersonal introversion and extroversion, and interpersonal stability, interpersonal specificity( F=5.414, 9.294, 3.440, 8.231, 10.669, all P<0.05). Inter group comparison showed that the academic stability, academic specificity, interpersonal stability, and interpersonal specificity scores of the intervention group were lower than those of the control group at 3 and 6 months after intervention (all P<0.05).Intra group comparison showed that the academic stability, academic specificity, interpersonal introversion and extroversion, interpersonal stability, and interpersonal specificity scores of the intervention group at 3 months and 6 months after the intervention were lower than those before the intervention (all P<0.05).After 3 and 6 months of intervention, the academic stability, academic specificity, interpersonal introversion and extroversion, interpersonal stability, and interpersonal specificity scores of the control group were all lower than those before intervention (all P<0.05). Conclusion:IPT-G can not only alleviate depressive symtoms, but also improve social cognitive function.

Diabetes-related cognitive impairment(DCI)is a major complication of type 2 diabetes melli-tus(T2DM).Although exercise is essential in alleviating DCI,the underlying mechanisms remain un-clear.The aim of this study is to investigate the role and mechanism of exosomal miR-126a-5p induced by exercise in ameliorating DCI.Twenty-four 16-week-old male db/db mice were randomly divided into dia-betes group(n=12;DM)and exercise intervention group(n=12;DE).The control group consisted of male m/m mice of the same age group(n=12;CON).The DE group underwent 8 weeks of moderate in-tensity treadmill training(10 m/min,5 days a week).In the MWM experiment,compared to the CON group,the DM group exhibited prolonged escape latency(P<0.01),reduced swimming speed and target quadrant time(P<0.001),and decreased expression of miR-126a-5p and EX-miR-126a-5p in hipp-ocampal tissue(P<0.001).After exercise intervention,the DE group showed improved performance with decreased escape latency(P<0.05),increased swimming speed and target quadrant time(P<0.05),and elevated levels of exosomal miR-126a-5p(P<0.001).Morphological staining revealed a de-crease in the expression and proportion of NeuN in hippocampal neurons and an increase in the expression and proportion of glial cells in the CA1 and CA3 regions of DM group mice compared to CON group mice(P<0.05),while DE group mice showed increased fluorescence intensity and proportion of neurons(P<0.05).Western blotting analysis revealed that the DM group also showed significant upregulation of amy-loid β(Aβ),high mobility group box 1(Hmgb1),and NF-κB in the hippocampus(P<0.05),which were reduced after exercise(P<0.05).Moreover,exosomal miR-126a-5p overexpression greatly de-creased the levels of Hmgb1,NF-κB,and amyloid precursor protein(APP)in HT22 cells and TNF-α,IL-1β in supernatant exposed to HG(P<0.05),while inhibition of miR-126a-5p led to increased levels of these proteins(P<0.05).In conclusion,eight weeks of treadmill exercise improved cognitive function in db/db mice,likely through the EXs-miR-126/HMGB1/NF-κB pathway to reduce inflammation in hip-pocampal tissue.

Objective:To observe the intervention effect of personalized nutrition program combined with rehabilitation training in stroke rehabilitation patients.Methods:86 stroke rehabilitation patients who were admitted to our hospital from January 2023 to June 2024 were prospectively selected,they were divided into control group and study group according to the random number table method,with 43 cases in each group,the control group received rehabilitation training,while the study group received personalized nutrition program combine with rehabilitation training.Simple Fugl Meyer motor function(FMA)score,immune function indicators[immunoglobulin(Ig)A,IgG,complement C3,IgM,complement C4],National Institutes of Health Stroke Scale(NIHSS),nutritional status indicators[albumin(ALB),prealbumin(PA),total protein(TP),hemoglobin(HB)],Stroke Specific Quality of Life Scale(SS-QOL),Barthel Index(BI)score were compared between the two groups.Results:NIHSS score in the study group at 8 weeks after intervention was lower than that in the control group,and SS-QOL score,BI score,FMA score,IgM,IgA,IgG,complement C3,complement C4,ALB,HB,TP and PA were higher than those in the control group(P＜0.05).Conclusion:Personalized nutrition program combined with rehabilitation training in stroke rehabilitation patients,can reduce neurological damage,improve limb motor function,enhance nutritional status,immunity,and quality of life.

Objective:To explore the impact of group interpersonal psychotherapy (IPT-G) on depressive symptoms and social cognitive function of adolescents with depression.Methods:From June 2021 to December 2023, a total of 75 adolescent inpatients diagnosed with depression were recruited from Hangzhou Seventh People’s Hospital. They were divided into intervention group and control group according to the general information matching principle.Finally, 30 patients in each group completed the study.The patients in control group received antidepressant medication, psychiatric care, and general recreational activities.While the patients in intervention group received IPT-G based on the treatment of control group. Children's depression inventory (CDI), interpersonal trust scale (ITS), self-esteem scale (SES) and the adolescent cognitive style questionnaire (ACSQ) were adopted to assess the depressive symptoms and social cognitive function of adolescent inpatients before and after the intervention and at 3 and 6 months of follow-up, respectively. SPSS 25.0 software was used for statistical analysis. Chi-square test, independent sample t-test and repeated measure ANOVA were used for inter or intra group comparisons. Results:1.Comparison of depression: The time and group interaction effect of CDI scores between the two groups was significant ( F=6.405, P<0.01). Inter group comparison showed that the CDI scores of the intervention group at 3 and 6 months (12.10±5.20, 7.93±2.98) were lower than those of the control group(18.13±7.28, 15.77±5.52) (both P<0.05), and the scores of both groups at the end of the intervention, 3 months after the intervention, and 6 months after the intervention were lower than that before intervention (all P<0.05).2.Comparison of social cognitive function: (1)There were significant time and group interaction effect of ITS score and SES score( F=5.871, 6.594, both P<0.01).Inter group comparison showed that the ITS score(78.97±7.63, 83.03±7.42) and the SES score(28.00±4.00, 30.30±3.21) of intervention group at 3 months and 6 months after intervention were all higher than those of control group(ITS: (71.70±12.29, 73.90±12.79); SES: (24.37±5.08, 25.80±4.10)(all P<0.05).Intra group comparison showed that the ITS and the SES scores of the intervention group at 3 months and 6 months after intervention were all higher than before intervention( P<0.05).The ITS score of the control group at 6 months after intervention was higher than before intervention( P<0.05).The SES scores of the control group at three time points after intervention were all higher than those before intervention(all P<0.05).(2)Comparison of ACSQ scores: There were significant time and group interaction effects for the scores of academic stability, academic specificity, interpersonal introversion and extroversion, and interpersonal stability, interpersonal specificity( F=5.414, 9.294, 3.440, 8.231, 10.669, all P<0.05). Inter group comparison showed that the academic stability, academic specificity, interpersonal stability, and interpersonal specificity scores of the intervention group were lower than those of the control group at 3 and 6 months after intervention (all P<0.05).Intra group comparison showed that the academic stability, academic specificity, interpersonal introversion and extroversion, interpersonal stability, and interpersonal specificity scores of the intervention group at 3 months and 6 months after the intervention were lower than those before the intervention (all P<0.05).After 3 and 6 months of intervention, the academic stability, academic specificity, interpersonal introversion and extroversion, interpersonal stability, and interpersonal specificity scores of the control group were all lower than those before intervention (all P<0.05). Conclusion:IPT-G can not only alleviate depressive symtoms, but also improve social cognitive function.