Objective To investigate the application of cardiovascular magnetic resonance feature tracking(CMR-FT)in assessing myocardial strain in dilated cardiomyopathy(DCM)patients residing at high altitudes.Methods We retrospectively enrolled 29 DCM patients living at high altitudes(DCM-H),27 DCM patients living in a low-altitude plain environment(DCM-P),23 healthy volunteers living at a high altitude(HV-H),and 24 healthy volunteers living in a low-altitude plain environment(HV-P).All subjects underwent cine MRI scanning using a 3.0T rapid steady-state free precession sequence.The CMR images thus acquired were analyzed using cvi42,a post-processing software,to obtain left ventricular function and myocardial strain parameters.Results Compared with the HV-H group,the DCM-H group showed higher left ventricle end-diastolic volume(LVEDV)and left ventricle end-systolic volume(LVESV),and lower left ventricular ejection fraction(LVEF)and stroke volume(LVSV)(all P＜0.01).No significant difference was observed in cardiac function between the DCM-H and DCM-P groups(all P＞0.05).The absolute values of global radial strain(GRS),global circumferential strain(GCS),and global longitudinal strain(GLS)in the DCM-H group were lower than those in the HV-P group([14.5±6.5]％vs.[34.2±10.7]％,[-11.1±4.4]％vs.[-19.9±2.8]％,and[-7.7±3.2]％vs.[-13.6±4.1]％,respectively),with the differences being statistically significant(all P＜0.001).The DCM-H group had higher absolute GRS,GCS,and GCS values than the DCM-P group did([14.5±6.5]％vs.[7.0±2.7]％,[-11.1±4.4]％vs.[—5.4±2.2]％,and[—7.7±3.2]％vs.[—4.3±1.7]％,respectivley,all P＜0.01).Conclusion Myocardial strain in DCM patients living at a high altitude is lower than that in healthy volunteers living at a high altitude,but higher than that in DCM patients living in a low-altitude plain environment.CMR-FT can be used to quantitatively assess myocardial contractility in DCM patients living at a high altitude,showing promise for clinical application.

Dose estimation of radiopharmaceutical therapy is essential for the accurate evaluation of its efficacy and safety, as well as for guiding subsequent clinical research. The dosimetry estimation process typically requires understanding of the in vivo spatial distribution and dynamic transportation of radionuclides, followed by calculation of the energy deposition in tumor target volume and organs at risk from ionizing radiation of varying types and energies released by accumulated radionuclides. This review focuses on advancements in the aforementioned research aspects and the relationship between internal radiation dose and biological effects. Furthermore, this review prospectively discusses future research directions, aiming to enhance comprehension of internal radiation dose estimation and provides theoretical frameworks and technical references for improving clinical evaluation accuracy in radiopharmaceutical therapy.

With the application of immunotherapy in locally advanced gastric cancer becoming a current research hotspot, the organic integration of immunotherapy with preoperative neoadjuvant treatment modalities is expected to further achieve tumor downstaging, pathological remission, and radical resection. This also makes it possible for more patients to undergo gastric function-preserving surgery. This article aims to provide a general overview of neoadjuvant immunotherapy and gastric function-preserving surgery, and to focus on discussing the technical key points of gastric function-preserving surgery after neoadjuvant immunotherapy, including the selection of surgical timing, the scope of lymph node dissection, representative function-preserving gastric surgery.

With the application of immunotherapy in locally advanced gastric cancer becoming a current research hotspot, the organic integration of immunotherapy with preoperative neoadjuvant treatment modalities is expected to further achieve tumor downstaging, pathological remission, and radical resection. This also makes it possible for more patients to undergo gastric function-preserving surgery. This article aims to provide a general overview of neoadjuvant immunotherapy and gastric function-preserving surgery, and to focus on discussing the technical key points of gastric function-preserving surgery after neoadjuvant immunotherapy, including the selection of surgical timing, the scope of lymph node dissection, representative function-preserving gastric surgery.

Objective:To compare the clinical characteristics of patients with cryptogenic cirrhosis and hepatitis B cirrhosis in order to provide a basis for the diagnosis of cryptogenic cirrhosis.Methods:A retrospective study was performed. The clinical data of inpatients with cryptogenic cirrhosis from 2010 to 2020 were collected from Peking University First Hospital. The clinical baseline data were analyzed. Patients with hepatitis B cirrhosis hospitalized during the same period were used as the control group, and 1:1 matching was performed according to the age range (±5 years) and the same year of admission. The basic clinical data between the groups were analyzed. The t-test, X2-test or Mann-Whitney U test was used for intergroup comparison.Results:A total of 232 cases with cryptogenic cirrhosis were collected. A total of 207 cases were collected after excluding cases with missing data, including 95 males (45.9%) and 112 females (54.1%), with a median age of 66 (57-76) years. A total of 182 pairs were matched according to the matching criteria for the control study. Compared with the hepatitis B cirrhosis group, the patients with cryptogenic cirrhosis had higher blood triglycerides (0.89 mmol/L vs. 0.80 mmol/L, P=0.002)and total cholesterol (3.73 mmol/L vs. 3.55 mmol/L, P=0.048), alanine transaminase (21.0 U/L vs. 24.5 U/L, P=0.003) and aspartate transaminase (29.5 U/L vs. 33.0 U/L, P=0.008) were lower, the prothrombin time was shorter (12.4 s vs. 13.0 s, P=0.003), and the INR was lower (1.18 vs. 1.21, P=0.015) with statistically significant differences ( P<0.05). The proportion of patients with cryptogenic cirrhosis combined with hepatocellular carcinoma (15.9% vs. 35.7%, P<0.001), hepatic encephalopathy (2.7% vs. 7.7%, P=0.034), and hepatorenal syndrome (1.6% vs. 5.5%, P=0.048),were relatively low, and the differences were statistically significant ( P<0.05). Conclusions:Cryptogenic cirrhosis at our hospital may be associated with metabolic syndrome and cannot be excluded as a cause of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis in some of these patients.

Dose estimation of radiopharmaceutical therapy is essential for the accurate evaluation of its efficacy and safety, as well as for guiding subsequent clinical research. The dosimetry estimation process typically requires understanding of the in vivo spatial distribution and dynamic transportation of radionuclides, followed by calculation of the energy deposition in tumor target volume and organs at risk from ionizing radiation of varying types and energies released by accumulated radionuclides. This review focuses on advancements in the aforementioned research aspects and the relationship between internal radiation dose and biological effects. Furthermore, this review prospectively discusses future research directions, aiming to enhance comprehension of internal radiation dose estimation and provides theoretical frameworks and technical references for improving clinical evaluation accuracy in radiopharmaceutical therapy.

Objective:To compare the clinical characteristics of patients with cryptogenic cirrhosis and hepatitis B cirrhosis in order to provide a basis for the diagnosis of cryptogenic cirrhosis.Methods:A retrospective study was performed. The clinical data of inpatients with cryptogenic cirrhosis from 2010 to 2020 were collected from Peking University First Hospital. The clinical baseline data were analyzed. Patients with hepatitis B cirrhosis hospitalized during the same period were used as the control group, and 1:1 matching was performed according to the age range (±5 years) and the same year of admission. The basic clinical data between the groups were analyzed. The t-test, X2-test or Mann-Whitney U test was used for intergroup comparison.Results:A total of 232 cases with cryptogenic cirrhosis were collected. A total of 207 cases were collected after excluding cases with missing data, including 95 males (45.9%) and 112 females (54.1%), with a median age of 66 (57-76) years. A total of 182 pairs were matched according to the matching criteria for the control study. Compared with the hepatitis B cirrhosis group, the patients with cryptogenic cirrhosis had higher blood triglycerides (0.89 mmol/L vs. 0.80 mmol/L, P=0.002)and total cholesterol (3.73 mmol/L vs. 3.55 mmol/L, P=0.048), alanine transaminase (21.0 U/L vs. 24.5 U/L, P=0.003) and aspartate transaminase (29.5 U/L vs. 33.0 U/L, P=0.008) were lower, the prothrombin time was shorter (12.4 s vs. 13.0 s, P=0.003), and the INR was lower (1.18 vs. 1.21, P=0.015) with statistically significant differences ( P<0.05). The proportion of patients with cryptogenic cirrhosis combined with hepatocellular carcinoma (15.9% vs. 35.7%, P<0.001), hepatic encephalopathy (2.7% vs. 7.7%, P=0.034), and hepatorenal syndrome (1.6% vs. 5.5%, P=0.048),were relatively low, and the differences were statistically significant ( P<0.05). Conclusions:Cryptogenic cirrhosis at our hospital may be associated with metabolic syndrome and cannot be excluded as a cause of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis in some of these patients.

With features such as high-definition magnification of the surgical field, filtering of hand tremor, and robotic arm with multi-degree-of-freedom rotatable wrist, surgical robot has unique advantages in various aspects of digestive tract reconstruction (DTR) after robotic gastrectomy (RG). Currently, there is still controversy about the selection and standardized application of DTR after RG for gastric cancer. To standardize the selection and implementation of DTR, we describe various aspects of quality control before DTR, selection of indications, principles of DTR, and prevention and management of postoperative complications of DTR. We also comment on the operation details of robotic-assisted and total robotic DTR, including manual suture, linear anastomosis with linear stapler, and circular anastomosis with circular stapler. Meanwhile, we propose our prospects on the potential application of new technology in robotic DTR for gastric cancer.

With features such as high-definition magnification of the surgical field, filtering of hand tremor, and robotic arm with multi-degree-of-freedom rotatable wrist, surgical robot has unique advantages in various aspects of digestive tract reconstruction (DTR) after robotic gastrectomy (RG). Currently, there is still controversy about the selection and standardized application of DTR after RG for gastric cancer. To standardize the selection and implementation of DTR, we describe various aspects of quality control before DTR, selection of indications, principles of DTR, and prevention and management of postoperative complications of DTR. We also comment on the operation details of robotic-assisted and total robotic DTR, including manual suture, linear anastomosis with linear stapler, and circular anastomosis with circular stapler. Meanwhile, we propose our prospects on the potential application of new technology in robotic DTR for gastric cancer.

Objective To establish a hypobaric hypoxia rat model in a real high-altitude environment,to investigate the effects of the real high-altitude environment on rat bone mass and bone microstructure using multiple methods such as Micro CT,blood biochemistry,and pathology,and to explore the potential mechanisms involved.Methods Sprague Dawley(SD)rats were transported to the Yushu Plateau Laboratory(at 4250 m above sea level)in Qinghai Province and kept there for 4,or 8,or 18 months.These groups were designated as H-4,H-8,and H-18,respectively.Upon completion of the high-altitude exposure,these animals were transported to the Molecular Imaging Laboratory,West China Hospital,Sichuan University(at 500 m above sea level)in Chengdu for relevant testing and comparison with the control animals raised in a low-altitude environment for the same durations(designated L-4,L-8,and L-18).The tests performed included blood biochemistry,Micro CT imaging,and pathological assessments such as ELISA,Western blot,and HE and TRAP staining.Results Compared with that of the control group,the body mass of rats in the H-4 and H-18 groups decreased significantly(H-4 group vs.L-4 group:[513.75±35.10]g vs.[649.18±60.03]g,P＜0.01;H-18 group vs.L-18 group:[535.58±66.65]g vs.[670.86±44.96]g,P＜0.01).The serum Ca2+concentration was higher in the H-8 group and H-18 group compared to that in the control group(H-8 group vs.L-8 group:[2.48±0.09]mmol/L vs.[2.38±0.07]mmol/L,P＜0.05;H-18 group vs.L-18 group:[2.55±0.11]mmol/L vs.[2.13±0.27]mmol/L,P＜0.05).No statistically significant difference was observed in the concentration of P3+.Bone metabolism indicator cross-linked carboxy-terminal telopeptide of type Ⅰ collagen(CTX-Ⅰ)was significantly increased in all high-altitude groups compared to the low-altitude groups(H-4 group vs.L-4 group:[1.44±0.08]ng/mL vs.[0.70±0.13]ng/mL,P＜0.01;H-8 group vs.L-8 group:[1.52±0.10]ng/mL vs.[0.75±0.10]ng/mL,P＜0.01;H-18 group vs.L-18 group:[2.70±0.13]ng/mL vs.[1.94±0.15]ng/mL,P＜0.01).In addition,CT results showed a decrease in bone volume fraction of trabecular bone in the three high-altitude groups(H-4 group vs.L-4 group:[7.48±2.35]％vs.[10.40±2.93]％,P＜0.05;H-8 group vs.L-8 group:[7.17±2.68]％vs.[10.09±2.95]％,P＜0.05;H-18 group vs.L-18 group:[2.90±2.91]％vs.[8.68±4.11]％,P＜0.01),and increased trabecular separation in the three high-altitude groups(H-4 group vs.L-4 group:[0.70±0.12]mm vs.[0.60±0.06]mm,P＜0.05;H-8 group vs.L-8 group:[0.68±0.07]mm vs.[0.59±0.05]mm,P＜0.01;H-18 group vs.L-18 group:[0.80±0.09]mm vs.[0.70±0.09]mm,P＜0.05).TRAP staining showed an increase in osteoclasts in the H-4 and H-18 groups.Western blot results indicated an increase in the expression of receptor activator of nuclear factor-κB ligand(RANKL)and hypoxia inducible factor-1α(HIF-1α)in high-altitude environment,while the expression of osteoprotegerin(OPG)was inhibited.Conclusion The impact of high-altitude environment on rat femurs is characterized primarily by a reduction in trabecular bone mass and damage to bone microstructure.