BACKGROUND:Resveratrol is a naturally occurring polyphenolic compound in plants,recognized for its anti-inflammatory,antioxidant,and antiproliferative properties.Its role in preventing and treating various chronic diseases has been extensively documented.Recent evidence suggests that resveratrol may help delay exercise-induced fatigue,although the underlying mechanisms remain to be systematically elucidated.OBJECTIVE:To explore the possible role and mechanism of resveratrol in delaying exercise-induced fatigue,based on the mechanism of exercise-induced fatigue,in order to provide a theoretical basis for the research and application of resveratrol in the field of sports nutrition.METHODS:Chinese and English search terms were"resveratrol,exercise-induced fatigue,oxidative stress,inflammation,energy substance,muscle injury,mitochondrial quality,neurotransmitter."CNKI,WanFang Data,and PubMed were searched for relevant research literature published from January,1992 to August 2024.A total of 73 core related articles were obtained according to inclusion and exclusion criteria.RESULTS AND CONCLUSION:(1)Resveratrol is a naturally occurring polyphenolic compound commonly found in plants such as grape skins,berries,and peanuts.It exhibits multiple biological activities,including antioxidant,anti-aging,anticancer,and anti-inflammatory properties.Resveratrol shows potential for preventing and treating various chronic diseases and is also thought to delay the onset of exercise-induced fatigue.(2)Exercise-induced fatigue is a non-pathological fatigue phenomenon with a complex mechanism.It is related to peripheral mechanisms such as the depletion of energy substrates,the accumulation of metabolic by-products,inflammation,and oxidative stress,as well as central mechanisms,including protective inhibition by the central nervous system and neurotransmitter imbalances.(3)Resveratrol activates the kelch-like epichlorohydrin-associated protein 1/nuclear factor erythroid 2-related factor 2 pathway,upregulating antioxidant-related genes such as catalase and superoxide dismutase while downregulating genes such as malondialdehyde and 4-hydroxy-2-nonenal,ultimately reducing oxidative stress.Resveratrol also activates silent information regulator 1,inhibits the nuclear factor-kappaB and nucleotide-binding oligomerization domain-like receptor thermal protein domain associated protein 3 inflammasome pathways,and downregulates pro-inflammatory cytokines such as tumor necrosis factor-α,interleukin-6,and interleukin-1β,alleviating inflammation.Additionally,resveratrol increases short-chain fatty acid production by the gut microbiota,elevates the lactate/pyruvate ratio in the liver to promote gluconeogenesis,and enhances fatty acid oxidation,thereby improving energy substrate utilization.Furthermore,through silent information regulator 1/peroxisome proliferator-activated receptor-y coactivator-1α/nuclear respiratory factor 1 activation,resveratrol enhances mitochondrial biogenesis in skeletal muscle,promotes mitochondrial fusion and fission for optimal dynamics,and activates mitophagy,improving mitochondrial quality.It also diminishes plasma tryptophan levels,decreases excessive serotonin secretion in the brain,increases dopamine release,and reduces glutamate toxicity,helping regulate neurotransmitter imbalances.Moreover,resveratrol lowers plasma lactate and ammonia levels,promoting metabolic by-product clearance,thereby delaying the onset of exercise-induced fatigue.(4)While current evidence indicates that resveratrol is effective in delaying exercise-induced fatigue,the optimal dose,timing,and duration of supplementation remain uncertain.Moreover,the interactions between resveratrol and other supplements,such as caffeine and vitamins,remain underexplored.Thus,future research should focus on optimizing supplementation strategies for resveratrol.

Objective To investigate the natural progression of pulmonary ground-glass nodule(GGN)to invasive adenocarcinoma(IAC)and the diagnostic value of follow-up CT.Methods A retrospective analysis was performed on 45 GGN in 45 patients who were followed up for more than 2 years,surgically resected and pathologically confirmed.They were divided into IAC group(n=25)and non-IAC group(n=20),and the clinical and imaging characteristics between the two groups were compared.Results Significant differences were observed in initial volume(P=0.025),initial mass(P=0.005),margin(P=0.027),and time to GGN progression(P=0.005)between the IAC group and the non-IAC group.Multivariate logistic regression analysis indicated that initial mass and time to GGN progression were independent predictors for the diagnosis of IAC.The receiver operating characteristic(ROC)curve analysis results revealed that when using a maximum Youden's index of 0.456,the optimal cutoff for time to GGN progression was 30 months,with a sensitivity of 75.0%and a specificity of 70.6%,and an area under the curve(AUC)of 0.761[95%confidence interval(CI)0.606-0.916](P=0.005).When the maximum Youden's index reached 0.615,the sensitivity,specificity and AUC of the logistic regression model in the diagnosis of IAC were 79.2%,82.4%,and 0.860(95%CI 0.743-0.977)(P=0.001),respectively.The calibration curves demonstrated an excellent consistency between predicted and observed probabilities.Conclusion The optimal observation window for GGN is 30 months,during which IAC generally progresses.Close monitoring is recommended after the initiation of lesion growth.

BACKGROUND:Resveratrol is a naturally occurring polyphenolic compound in plants,recognized for its anti-inflammatory,antioxidant,and antiproliferative properties.Its role in preventing and treating various chronic diseases has been extensively documented.Recent evidence suggests that resveratrol may help delay exercise-induced fatigue,although the underlying mechanisms remain to be systematically elucidated.OBJECTIVE:To explore the possible role and mechanism of resveratrol in delaying exercise-induced fatigue,based on the mechanism of exercise-induced fatigue,in order to provide a theoretical basis for the research and application of resveratrol in the field of sports nutrition.METHODS:Chinese and English search terms were"resveratrol,exercise-induced fatigue,oxidative stress,inflammation,energy substance,muscle injury,mitochondrial quality,neurotransmitter."CNKI,WanFang Data,and PubMed were searched for relevant research literature published from January,1992 to August 2024.A total of 73 core related articles were obtained according to inclusion and exclusion criteria.RESULTS AND CONCLUSION:(1)Resveratrol is a naturally occurring polyphenolic compound commonly found in plants such as grape skins,berries,and peanuts.It exhibits multiple biological activities,including antioxidant,anti-aging,anticancer,and anti-inflammatory properties.Resveratrol shows potential for preventing and treating various chronic diseases and is also thought to delay the onset of exercise-induced fatigue.(2)Exercise-induced fatigue is a non-pathological fatigue phenomenon with a complex mechanism.It is related to peripheral mechanisms such as the depletion of energy substrates,the accumulation of metabolic by-products,inflammation,and oxidative stress,as well as central mechanisms,including protective inhibition by the central nervous system and neurotransmitter imbalances.(3)Resveratrol activates the kelch-like epichlorohydrin-associated protein 1/nuclear factor erythroid 2-related factor 2 pathway,upregulating antioxidant-related genes such as catalase and superoxide dismutase while downregulating genes such as malondialdehyde and 4-hydroxy-2-nonenal,ultimately reducing oxidative stress.Resveratrol also activates silent information regulator 1,inhibits the nuclear factor-kappaB and nucleotide-binding oligomerization domain-like receptor thermal protein domain associated protein 3 inflammasome pathways,and downregulates pro-inflammatory cytokines such as tumor necrosis factor-α,interleukin-6,and interleukin-1β,alleviating inflammation.Additionally,resveratrol increases short-chain fatty acid production by the gut microbiota,elevates the lactate/pyruvate ratio in the liver to promote gluconeogenesis,and enhances fatty acid oxidation,thereby improving energy substrate utilization.Furthermore,through silent information regulator 1/peroxisome proliferator-activated receptor-y coactivator-1α/nuclear respiratory factor 1 activation,resveratrol enhances mitochondrial biogenesis in skeletal muscle,promotes mitochondrial fusion and fission for optimal dynamics,and activates mitophagy,improving mitochondrial quality.It also diminishes plasma tryptophan levels,decreases excessive serotonin secretion in the brain,increases dopamine release,and reduces glutamate toxicity,helping regulate neurotransmitter imbalances.Moreover,resveratrol lowers plasma lactate and ammonia levels,promoting metabolic by-product clearance,thereby delaying the onset of exercise-induced fatigue.(4)While current evidence indicates that resveratrol is effective in delaying exercise-induced fatigue,the optimal dose,timing,and duration of supplementation remain uncertain.Moreover,the interactions between resveratrol and other supplements,such as caffeine and vitamins,remain underexplored.Thus,future research should focus on optimizing supplementation strategies for resveratrol.

Objective To investigate the natural progression of pulmonary ground-glass nodule(GGN)to invasive adenocarcinoma(IAC)and the diagnostic value of follow-up CT.Methods A retrospective analysis was performed on 45 GGN in 45 patients who were followed up for more than 2 years,surgically resected and pathologically confirmed.They were divided into IAC group(n=25)and non-IAC group(n=20),and the clinical and imaging characteristics between the two groups were compared.Results Significant differences were observed in initial volume(P=0.025),initial mass(P=0.005),margin(P=0.027),and time to GGN progression(P=0.005)between the IAC group and the non-IAC group.Multivariate logistic regression analysis indicated that initial mass and time to GGN progression were independent predictors for the diagnosis of IAC.The receiver operating characteristic(ROC)curve analysis results revealed that when using a maximum Youden's index of 0.456,the optimal cutoff for time to GGN progression was 30 months,with a sensitivity of 75.0%and a specificity of 70.6%,and an area under the curve(AUC)of 0.761[95%confidence interval(CI)0.606-0.916](P=0.005).When the maximum Youden's index reached 0.615,the sensitivity,specificity and AUC of the logistic regression model in the diagnosis of IAC were 79.2%,82.4%,and 0.860(95%CI 0.743-0.977)(P=0.001),respectively.The calibration curves demonstrated an excellent consistency between predicted and observed probabilities.Conclusion The optimal observation window for GGN is 30 months,during which IAC generally progresses.Close monitoring is recommended after the initiation of lesion growth.

Purpose: The 21-gene recurrence score (RS) can guide adjuvant chemotherapy decisions in the multidisciplinary treatment (MDT) of patients with early breast cancer. This study aimed to evaluate the influence of the 21-gene RS assay on patient’ compliance with MDT and its association with disease outcomes. Methods: Patients diagnosed with pN0-1, hormone receptor-positive, human epidermal growth factor receptor-2-negative breast cancer between January 2013 and June 2019 were enrolled. A logistic regression model was used to identify parameters associated with treatment adherence. Prognostic indicators were evaluated using the Cox proportional hazard models. Results: After the assay, patients were less likely to violate the treatment plan (14.9% vs. 23.1%, p < 0.001), and higher compliance rates were observed for chemotherapy (p = 0.042), radiotherapy (p = 0.012), and endocrine therapy (p < 0.001). Multivariable analysis demonstrated that the 21-gene RS assay (odds ratio [OR], 1.43; 95% confidence interval [CI], 1.09–1.88; p = 0.009) was independently associated with MDT compliance. Moreover, compliance with MDT was independently associated with better disease-free survival (hazard ratio, 0.43; 95% CI, 0.29–0.64; p < 0.001), regardless of the 21-gene RS assay (interaction p = 0.842). Conclusion The 21-gene RS assay improved the MDT compliance rate in patients with early breast cancer. Adherence to MDT is associated with a better prognosis.

Objective To analyze the risk factors for non-sentinel lymph node (NSLN) metastasis in patients with sentinel lymph node (SLN)-negative breast cancer. Methods Patients with breast cancer who underwent mastectomy and SLN biopsy at our center between January 2009 and August 2024 were retrospectively included. Univariate and multivariate analyses were performed in SLN-negative populations underwent low axillary lymph node dissection to identify risk factors for NSLN metastasis. Results A total of 2 387 SLN-negative patients were included, including 2 288 (95.9%) without NSLN metastasis and 99 (4.1%) with NSLN metastasis. Univariate and multivariate analyses showed that lymphovascular invasion (LVI) was an independent risk factor for NSLN metastasis in SLN-negative patients (13.5% versus 3.5%; OR=4.14，95% CI: 2.27-7.56，P<0.001). Patients with multicentric breast cancer showed a trend towards higher risk of NSLN metastasis compared to other types of breast cancer (9.5% versus 4.1%; OR=2.08，95% CI： 0.90-4.81，P=0.089). Conclusions Patients with SLN-negative biopsy who have LVI or multicentric breast cancer are at higher risk for NSLN metastasis.

Objective To evaluate the safety of immediate breast reconstruction using deep inferior epigastric perforator (DIEP) flaps in the patients after neoadjuvant treatment. Methods From January 2019 to February 2021, the data of patients with breast cancer undergoing total mastectomy and immediate breast reconstruction using DIEP flap in Comprehensive Breast Health Center, Department of General Surgery, Ruijin Hospital were collected. Comparison of clinicopathological features was done between neoadjuvant treatment group and control group. Univariate analysis was used to compare the rate of surgical complications between two groups. Results A total of 110 patients were enrolled with 23 cases (20.9%) in neoadjuvant treatment group and 87 cases (79.1%) in control group. None of carcinoma in situ (0 vs. 19.5%, P=0.003) and higher pTNM stage (P<0.001) was present in neoadjuvant treatment group compared with those in control group. However, there were no significant differences in the number of flap perforator of DIEP (P=0.472), the proportion of bipedicled flaps (P=0.489), operative time (P=0.651) and hospital length of stay (P=0.275) between two groups. No significant difference was found in the incidence of postoperative complications between two groups. Breast seroma was the most common recipient complication (13.0%, 3 cases) without donor complication in neoadjuvant treatment group. The most common complication was fat necrosis (12.6%, 11 cases) in recipient site and abdominal seroma (3.4%, 3 cases) in donor site of control group. Reoperation was done in one case (4.3%) of neoadjuvant treatment group and 4 cases (4.6%) of control group. DIEP flap necrosis with total flap loss occurred in 2 cases (2.3%) in control group, but none in neoadjuvant treatment group. Conclusions The imme-diate breast reconstruction with epigastric free flap for breast cancer patients after neoadjuvant treatment would be a safe surgical scheme.

Objective:To investigate the relationship of plasma cholinesterase (ChE) with triglyceride (TG) levels in newly diagnosed patients with type 2 diabetes (T2DM).Methods:Clinical data and biochemical parameters of 321 patients with newly diagnosed T2DM admitted to the Department of Endocrinology of People′s Hospital of Shanghai Putuo from January 2018 to June 2020 were retrospectively collected. The patients were classified into four groups based on the plasma ChE level: Q1group ( n=81, <6 915 U/L), Q2 group ( n=80, 6 916-8 268 U/L), Q3 group ( n=80, 8 269-9 578 U/L), and Q4 group ( n=80, ≥9 579 U/L). The correlation of plasma ChE with TG level was analyzed. Results:With the increased ChE level, TG level significantly increased ( P<0.001). Correlation analysis showed that ChE was positively correlated with body weight, body mass index (BMI), TG, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), uric acid (UA), alanine aminotransferase (ALT), aspartate aminotransferase (AST)( r=0.35, 0.39, 0.35, 0.31, 0.27, 0.24, 0.25, 0.11, P<0.05, P<0.01 or P<0.001)while negatively correlated with age, systolic blood pressure, blood urea nitrogen (BUN), creatinine, and glycated albumin (GA)( r=-0.46、-0.14、-0.20、-0.14、-0.21, P<0.05 or P<0.001). Multivariate stepwise regression analysis showed that ChE was an independent risk factor for TG ( β=0.270, P<0.001). Logistic Multivariate regression analysis showed that after adjustment for sex, age, body weight, hemoglobin, leukocytes, total protein, albumin, globulin, ALT, BUN, creatinine, uric acid, smoking history, drinking history, HbA 1C, GA, TC, and LDL-C, the risk of hypertriglyceridemia in Q4 was 6.024 folds higher than Q1 group ( P=0.011). With the TG (1.70 mmol/L) as cut-off value, the optimal cut-off point of the ChE was 7 801 U/L, as calculated by receiver operating characteristic(ROC) curve analysis of ChE and hypertriglyceridemia. Conclusions:ChE level is positively correlated with TG in newly diagnosed patients with T2DM.

Multi-gene assays have emerged as crucial tools for risk stratification in early-stage breast cancer. This study aimed to evaluate the prognostic significance of the 21-gene recurrence score (RS) in Chinese patients with pN0-1, estrogen receptor-positive (ER
Biomarkers, Tumor/genetics* ; Breast Neoplasms/pathology* ; Female ; Humans ; Neoplasm Recurrence, Local/pathology* ; Neoplasm Staging ; Prognosis ; Receptor, ErbB-2/genetics* ; Receptors, Estrogen

Purpose: This retrospective study aimed to evaluate the distribution pattern and prognostic value of 21-gene recurrence score (RS) in Chinese patients with mucinous breast cancer (MC) and compared with infiltrating ductal carcinoma (IDC). Materials and Methods: Patients diagnosed with MC or IDC from January 2010 to January 2017 were retrospectively recruited. Reverse transcriptase–polymerase chain reaction assay of 21 genes was conducted to calculate the RS. Univariate and multivariate analyses were performed to assess the association between RS and clinicopathological factors. Survival outcomes including disease-free survival (DFS) and overall survival (OS) were estimated by Kaplan-Meier method and compared by log-rank test. Results: The MC cohort included 128 patients and the IDC cohort included 707 patients. The proportions of patients with a low (RS < 18), intermediate (18-30), or high risk (RS > 30) were 32.0%, 48.4%, and 19.5% in MC cohort, and 26.9%, 46.8% and 26.3% in IDC cohort. The distribution of RS varied significantly according to different Ki-67 index and molecular subtype in both cohorts. Moreover, the receipt of chemotherapy was associated with RS in both cohorts. Among patients with MC, tumor stage was related to the DFS (p=0.040). No significant differences in DFS and OS were found among MC patients in different RS risk groups (OS, p=0.695; DFS, p=0.926). Conclusion RS was significantly related to Ki-67 index and molecular subtypes in MC patients, which is similar in IDC patients. However, RS was not able to predict DFS and OS in patients with MC.