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.

Public health laboratory testing involves a wide range of sample types,complex matrices,diverse target analytes with varying concentrations,and multiple application contexts with different analytical requirements.As a critical step in public health laboratory analysis and testing,sample pretreatment plays a decisive role in ensuring the reproducibility and efficiency of the analytical methods.It directly affects the accuracy,sensitivity,and reliability of testing results,as well as the feasibility of downstream analyses.Traditional sample pretreatment techniques face persistent challenges,including low efficiency,limited throughput,restricted universal applicability,high organic solvent consumption,and poor compatibility with downstream analytical procedures.These limitations constrain their capacity to meet the evolving demands of research and practice in public health and preventive medicine.In recent years,technological advances have focused on improving efficiency and automation,enhancing selectivity and sensitivity,facilitating online testing capabilities,and promoting environmental sustainability.Sample pretreatment techniques in public health laboratory testing have been undergoing progressive upgrades,and numerous novel technologies have emerged.The paper provides a comprehensive review of new technologies and applications in the field.We focused on the development of new materials,the application of artificial intelligence,connections for online processing,and the approaches tailored to the demands of specific testing settings.We also discussed sample processing for omics analyses and mass spectrometry imaging methods relevant to public health laboratory testing.These advances are expected to support the development of greener and higher-throughput sample pretreatment and foster innovation in the public health laboratory testing system.

Due to the unique nature of its anatomical location, the adenocarcinoma of esophagogastric junction (AEG) has been a subject of controversy and disagreement including its definition, staging, and treatment strategies. Chinse expert Consensus on Surgical Treatment of Adenocarcinoma of Esophagogastric Junction in China (2018 Edition) had been released in September 2018 and had played a pioneering role in unifying thoracic and general surgeons in China on surgical treatment strategies for AEG. Over the past five years, the emergence of several clinical research results on AEG has provided new clinical evidence for the selection of key surgical treatment strategies. Therefore, to further standardize the surgical treatment of AEG in China, Chinese Expert Consensus on Surgical Treatment of Adenocarcinoma of Esophagogastric Junction in China (2024 Edition) was released in 2024 by Chinese expert panel including 25 gastrointestinal surgeons and 24 thoracic surgeons. Based on the highest-level clinical research evidence in recent 5 years, this consensus ultimately formulates 29 recommendations on hotspots and key points on surgical treatment of AEG and summary 5 issues that are still awaiting further exploration. This review will provide a summary and detailed interpretation of the recommendations outlined in this consensus.

Due to the unique nature of its anatomical location, the adenocarcinoma of esophagogastric junction (AEG) has been a subject of controversy and disagreement including its definition, staging, and treatment strategies. Chinse expert Consensus on Surgical Treatment of Adenocarcinoma of Esophagogastric Junction in China (2018 Edition) had been released in September 2018 and had played a pioneering role in unifying thoracic and general surgeons in China on surgical treatment strategies for AEG. Over the past five years, the emergence of several clinical research results on AEG has provided new clinical evidence for the selection of key surgical treatment strategies. Therefore, to further standardize the surgical treatment of AEG in China, Chinese Expert Consensus on Surgical Treatment of Adenocarcinoma of Esophagogastric Junction in China (2024 Edition) was released in 2024 by Chinese expert panel including 25 gastrointestinal surgeons and 24 thoracic surgeons. Based on the highest-level clinical research evidence in recent 5 years, this consensus ultimately formulates 29 recommendations on hotspots and key points on surgical treatment of AEG and summary 5 issues that are still awaiting further exploration. This review will provide a summary and detailed interpretation of the recommendations outlined in this consensus.

Humans ; Clavicle ; Fractures, Bone/surgery*

Objective To analyze and diagnose the chromosomal genetic etiology of male patients with azoospermia or oligozoospermia,and investigate the clinical application value of combined detection of chromosomal karyotype and Y-chromosome microdeletion in azoospermia or oligozoospermia.Methods The clinical data and peripheral blood samples of 240 male patients with azoospermia or oli-gospermia in Luzhou district of Sichuan were collected.The karyotype analysis of peripheral blood lymphocytes were analyzed by G-ban-ding in conventional chromosomal culture.Multiplex PCR technology was used to detect Y chromosome microdeletions.Results A-mong the 240 male patients with azoospermia or oligospermia,179 cases of azoospermia and 61 cases of severe oligospermia were found.The detection rate of chromosome karyotype abnormalities was 22.92％(55/240),including 30 cases of chromosome number abnor-malities,21 chromosome structure abnormalities and 4 combined abnormalities.The detection rate of Y chromosome microdeletion ab-normalities was 10.42％(25/240)with the highest deletion rate of 7.08％for AZFc abnormalities.The combined detection rate for the abnormalities of karyotype and Y chromosome microdeletion was 30.83％(74/240),among which 6 patients showed abnormalities in both detections.The detection rate of combined detections by the two methods was higher than that of single method(x2=30.24,P＜0.001).Conclusion This study systematically reported the incidence and types of karyotypes and Y chromosome microdeletions in male azoospermia or oligospermia patients in Luzhou district of Sichuan.We suggest that the combined application of the two methods may improve the detection rate of abnormality,which provides important guidance for the etiological diagnosis of male infertility pa-tients,genetic counseling and reproductive therapy.

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.

Dickkopf-1 (DKK-1) plays an important role in the initiation and progression of many human cancers. It can induce apoptosis of a wide variety of tumor cells in vivo through both the canonical Wnt/β-catenin signal transduction pathway and the non-canonical Wnt signal transduction pathway. In addition, DKK-1 can modulate bone metastasis and promote the invasion and infiltration of some tumor cells.