Gastric cancer with peritoneal metastasis (GCPM) is a common and lethal manifestation of advanced gastric cancer, with a median survival of only 5-11 months. This consensus was developed by 30 experts from Asia (China, Japan, Korea, and Singapore) using the Delphi method and the GRADE evidence grading system. A total of 29 statements were formulated, covering the diagnosis and assessment of GCPM, indications for laparoscopic exploration and NIPS (normothermic intraperitoneal and systemic treatment), treatment regimens, prevention and management of complications, criteria for conversion surgery, and postoperative intraperitoneal therapy. The consensus aims to standardize clinical practice and improve the prognosis of patients with GCPM.

Microglia are specialized immune cells in the brain, primarily responsible for clearing debris and responding to inflammation. One of the pathological features of Alzheimer's disease (AD) is the extensive activation of immune system in the brain, and the dynamic changes and dysfunction of microglia could become key factors for AD progression. This article reviews the research progress of regulated effect of microglial on AD pathology, and summarizes its potential value in AD treatment, in order to provide theoretical basis for exploring new therapeutic strategies and intervention targets for AD.

Microglia are specialized immune cells in the brain, primarily responsible for clearing debris and responding to inflammation. One of the pathological features of Alzheimer's disease (AD) is the extensive activation of immune system in the brain, and the dynamic changes and dysfunction of microglia could become key factors for AD progression. This article reviews the research progress of regulated effect of microglial on AD pathology, and summarizes its potential value in AD treatment, in order to provide theoretical basis for exploring new therapeutic strategies and intervention targets for AD.

Objective:To evaluate and compare the efficacy and safety of ultra-rapid lispro insulin (URLi) and humalog lispro (HL) in the treatment of type 2 diabetes mellitus.Methods:This was an international multicenter, double-blind, randomized controlled study. From May 2019 to January 2021, a total of 481 patients with type 2 diabetes mellitus, who had been using insulin for at least 90 days and had poor glycemic control, were included. These patients were recruited from 34 research centers in China, including Shanghai Jiao Tong University School of Medicine Affiliated Sixth People′s Hospital. They were assigned to either the URLi group (319 patients) or the HL group (162 patients) using stratified blocked randomization. The primary endpoint was the change in hemoglobin A 1c (HbA 1c) relative to baseline after 26 weeks of treatment. Secondary endpoints included the proportion of patients who achieved HbA 1c<7.0% and ≤6.5% after 26 weeks of treatment, 1-h postprandial glucose (1hPG) or 2-h postprandial glucose (2hPG) excursions during a mixed meal tolerance test at week 26, as well as safety parameters. Continuous variables were compared using mixed model repeated measures or analysis of covariance, and categorical variables were compared using logistic regression or Fisher′s exact test. Results:Data based on the Chinese subgroup showed that there were no statistically significant differences between the URLi and HL groups in terms of male percentage [56.1% (179/319) vs. 56.2% (91/162); P=0.990], age [(59.5±8.4) vs. (59.6±9.3) years; P=0.839] and other baseline characteristics. Regarding the change in HbA 1c relative to baseline, the URLi group was non-inferior to the HL group (-0.59%±0.05% vs. -0.66%±0.06%; P=0.312). There were no statistically significant differences between the URLi and HL groups in proportion of patients who achieved HbA 1c<7.0% [47.3% (138/292) vs. 45.2% (70/155); P=0.907] and≤6.5% [27.7% (81/292) vs. 27.7% (43/155); P=0.816]. The excursions in 1hPG [(6.20±0.21) vs. (6.90±0.25) mmol/L; P=0.001] and 2hPG [(8.10±0.27) vs. (9.30±0.31) mmol/L; P<0.001] were lower in the URLi group than the HL group, with statistically significant differences. In terms of safety, there were no statistically significant differences in the percentage of subjects who reported treatment-emergent adverse events between the URLi and HL groups [49.8% (159/319) vs. 50.0% (81/162); P=1.000]. The event rate of nocturnal hypoglycemia was lower in the URLi group than the HL group, with statistically significant differences [(0.53±0.10) vs. (0.89±0.16) events per patient -year; P=0.040]. Conclusions:With good glycemic control, URLi showed non-inferiority for HbA 1c improvement versus HL and was superior to HL for postprandial glucose excursion control. Meanwhile the rate and incidence of nocturnal hypoglycemia were lower in the URLi group than the HL group.

Objective To analyze the effect of intracranial pressure monitoring combined with ultrasound on treatment of patients with decompressive craniectomy.Methods Totally 200 patients with decompressive craniectomy were divided into control group and observation group,100 cases in each group.Control group was treated with standard decompressive craniectomy,while observation group was treated with intracranial pressure monitoring and ultrasound examination.Clinical effect was compared between two groups.Results The score of Glasgow prognosis score (GOS) in the observation group was significantly higher than that in the control group (P ＜ 0.05).The survival rate of the control group was 68％,which was significantly lower than 89％ of the observation group (P ＜ 0.05).Conclusion Intracranial pressure monitoring combined with ultrasound is effective in treatment of patients with decompressive craniectomy.

Objective To analyze the effect of intracranial pressure monitoring combined with ultrasound on treatment of patients with decompressive craniectomy.Methods Totally 200 patients with decompressive craniectomy were divided into control group and observation group,100 cases in each group.Control group was treated with standard decompressive craniectomy,while observation group was treated with intracranial pressure monitoring and ultrasound examination.Clinical effect was compared between two groups.Results The score of Glasgow prognosis score (GOS) in the observation group was significantly higher than that in the control group (P ＜ 0.05).The survival rate of the control group was 68％,which was significantly lower than 89％ of the observation group (P ＜ 0.05).Conclusion Intracranial pressure monitoring combined with ultrasound is effective in treatment of patients with decompressive craniectomy.

Objective To study the acceptability and associated factors of pre-exposure prophylaxis (PrEP) based on different sexual purpose among human immunodeficiency virus (HIV) male serodiscordant couples.Methods HIV-negative female spouses of HIV-positive male in Guigang,Guiping and Pingnan county in Guangxi Zhuang Autonomous Region were recruited by the existing epidemic database and the method of cluster random sampling.A face-to-face questionnaire survey was conducted during June 2013 to November 2016.Information including the general condition and acceptability of PrEP was surveyed.x2 test and Logistic regression were used to analyze the data.Results A total of 526 qualified questionnaires were collected.The intention rate of PrEP based on physiological sexual purpose was 66.9％ (352/526),the intention rate of PrEP based on fertility purpose was 93.3％ (491/526).The difference was statistically significant (x =139.48,P＜0.01).The reasons of refusal included worrying about its safety,effectiveness poor confidentiality and low self-assessment risk of infection.Logistic analysis showed that the associated factors of the intention rate of PrEP based on physiological sexual purpose included cognition of PrEP (OR=0.70,P=0.014),the number of lifetime partners (OR=0.55,P＜0.01),frequency of sexual behavior (OR=1.33,P=0.016),willingness of condom use (OR=0.16,P＜0.01),infection risk self-assessment (OR =0.22,P＜0.01),male viral load (OR=1.25,P=0.035),male CD4+ T lymphocyte count (OR=0.37,P＜0.01) and male usefulness of medication or not (OR=1.59,P＜0.01).The influencing factors of the intention rate of PrEP based on physiological sexual purpose included with or without children (OR =1.70,P＜0.01),cognition of PrEP (OR=0.72,P=0.026),willingness of using condom (OR=0.18,P＜0.01),infection risk self-assessment (OR=0.14,P＜0.01) and male CD4+ T lymphocyte count (OR=0.45,P＜0.01).Conclusions The acceptability of PrEP based on fertility purpose is significantly higher than that on the physiological purpose.It is more feasible to conducting clinical trials of PrEP in peri-conceptional period HIV serodiscordant couples.The main influencing factors include the uninfected individual behavior characteristics and infection features of HIV infected men,and have nothing to do with the general social demographic characteristics.

Objective To establish a novel method to screen for anti-varicella-zoster virus (VZV) compounds with our previously generated reporter cell line for VZV, MV9G. MethodsMV9G cells were directly infected with cell-free virus of Oka vaccine strain (vOka) for 2 hours( CFV direct-infection) or cocultured with vOka-infected MeWo cells containing cell-associated virus for 48 hours (CAV co-culture) to promote expression of the reporter gene firefly luciferase. Antiviral compounds including heparin, mannose-6-phosphate( M-6-P), acyclovir( ACV ), resveratrol and roscovitine were added in the medium before or after the virus infection. Inhibitory effects( IC50 ) of the antiviral compounds were analyzed by comparing firefly luciferase activities of MV9G cells in the presence of antiviral compounds with those in the absence. Results Antiviral compounds inhibited luciferase activities of MV9G cells activated by CFV direct-infection and/or CAV co-culture in different levels. The reductions of luciferase activities statistically correlated with those of viral foci shown by immunostaining with a monoclonal antibody against VZV immediate early 62 antigens (IE62) in controls. Among these compounds, heparin, M-6-P, and 2.5 μmol/L of roscovitine inhibited CFV-activated more strongly than CAV-activated luciferase activities, whereas ACV and resveratrol inhibited CAV-activated more strongly than CFV-activated luciferase activities. Cell-associated ACV-resistant strains,Kanno and rOka YSR, activated luciferase activities of MV9G cells, too. However, the inhibitory concentrations (IC50) of ACV to the ACV-resistant strains were much higher than those to the ACV-sensitive strains,pOka and CaGu. ConclusionThe CFV direct-infection and CAV co-culture assays were useful to screen for antiviral compounds targeting the early and late phases of VZV infection, respectively. The VZV reporter cell-based assays may provide a simple, rapid, sensitive, and high-throughput method to screen for anti-VZV compounds.