Objective:To explore the real-life experiences of patients six months after laparoscopic sleeve gastrectomy (LSG), aiming to provide a reference for developing intervention plans.Methods:This was a descriptive phenomenological study. Purposeful sampling and maximum variation sampling were used to select 24 patients who underwent LSG at the Affiliated Hospital of Zunyi Medical University from February to August 2023. Semi-structured in-depth interviews were conducted, and the Colaizzi 7-step analysis method was applied to inductively extract and refine the themes.Results:A total of six main themes and ten sub-themes were identified through analysis. The main themes were: desires to improve postoperative physical symptoms (gastrointestinal symptoms, hair loss, neurological symptoms, and general symptoms) ; perception of subjective emotions (anxiety, regret, fear, and confidence) ; decreased social adaptability (decline in work ability, impaired social skills) ; general low compliance; desire for professional guidance; and postoperative benefit finding.Conclusions:Six months after LSG, patients primarily experienced physical symptom disturbances, poor psychological states, decreased social adaptability, low compliance, and a desire for professional guidance. However, they also recognized various benefits of the surgery. Healthcare providers should strengthen dynamic symptom assessments and management, guide patients psychologically, enhance social support, and actively improve follow-up and continuous care to help patients improve self-coping abilities and weight loss outcomes.

Gastric cancer(GC) ranks among the most prevalent cancers and is a leading cause of cancer-related mortality globally. Recently, artificial intelligence(AI) has enhanced the dia-gnosis and treatment of GC, as well as the accuracy and sensitivity of personalized treatment strategies due to its efficient computational and learning capabilities. The authors review the clinical applications of AI-based medical imaging and digital pathology in GC diagnosis and treatment, inclu-ding early screening and diagnosis, differential diagnosis, lymph node and peritoneal metastasis, molecular typing, monitoring of treatment efficacy, and prognostic assessment. In addition, future directions and challenges in the field are discussed, emphasizing the importance of integrating AI technology into clinical practice.

Gastric cancer(GC) ranks among the most prevalent cancers and is a leading cause of cancer-related mortality globally. Recently, artificial intelligence(AI) has enhanced the dia-gnosis and treatment of GC, as well as the accuracy and sensitivity of personalized treatment strategies due to its efficient computational and learning capabilities. The authors review the clinical applications of AI-based medical imaging and digital pathology in GC diagnosis and treatment, inclu-ding early screening and diagnosis, differential diagnosis, lymph node and peritoneal metastasis, molecular typing, monitoring of treatment efficacy, and prognostic assessment. In addition, future directions and challenges in the field are discussed, emphasizing the importance of integrating AI technology into clinical practice.

Objective:To explore the real-life experiences of patients six months after laparoscopic sleeve gastrectomy (LSG), aiming to provide a reference for developing intervention plans.Methods:This was a descriptive phenomenological study. Purposeful sampling and maximum variation sampling were used to select 24 patients who underwent LSG at the Affiliated Hospital of Zunyi Medical University from February to August 2023. Semi-structured in-depth interviews were conducted, and the Colaizzi 7-step analysis method was applied to inductively extract and refine the themes.Results:A total of six main themes and ten sub-themes were identified through analysis. The main themes were: desires to improve postoperative physical symptoms (gastrointestinal symptoms, hair loss, neurological symptoms, and general symptoms) ; perception of subjective emotions (anxiety, regret, fear, and confidence) ; decreased social adaptability (decline in work ability, impaired social skills) ; general low compliance; desire for professional guidance; and postoperative benefit finding.Conclusions:Six months after LSG, patients primarily experienced physical symptom disturbances, poor psychological states, decreased social adaptability, low compliance, and a desire for professional guidance. However, they also recognized various benefits of the surgery. Healthcare providers should strengthen dynamic symptom assessments and management, guide patients psychologically, enhance social support, and actively improve follow-up and continuous care to help patients improve self-coping abilities and weight loss outcomes.

With the application of accelerated rehabilitation surgery mode in metabolic bariatric surgery, the postoperative hospital stay of patients is gradually shortened, but it also leads to the lack of postoperative knowledge of patients after discharge. Adequate guidance on discharge readiness is beneficial for improving the self-management ability of patients and improving dietary, medication and exercise compliance. This paper reviews the status quo, assessment tools, influencing factors and intervention measures of discharge readiness of patients undergoing metabolic bariatric surgery, in order to provide references and ideas for developing discharge readiness evaluation tools and related studies for patients undergoing metabolic bariatric surgery in China.

ObjectiveBy exploring the volatile components， polysaccharide composition and changes in the contents of five carbohydrate components of Polygonatum cyrtonema rhizoma before and after processing， and then the effect of yellow rice wine on the odour formation of P. cyrtonema rhizoma was investigated. MethodThe volatile components of P. cyrtonema rhizoma before and after processing were detected by headspace gas chromatography-mass spectrometry（HS-GC-MS）， and sample data were subjected to principal component analysis（PCA） and orthogonal partial least squares-discriminant analysis（OPLS-DA） using SIMCA 14.1， then the differences between these components of P. cyrtonema rhizoma before and after processing were screened according to the principle of variable importance in the projection（VIP） value>1. Crude carbohydrate components in raw and wine-processed P. cyrtonema rhizoma were subjected to oxime and silylation， the carbohydrate components were analyzed by gas chromatography-mass spectrometry（GC-MS/MS）， and the relative contents of various components were calculated by peak area normalization， then quantitative analysis of four carbohydrate components was also carried out. ResultA total of 23 volatile components were identified from the raw products and the wine-processed products， including 15 components in raw products and 20 components in wine-processed products. Among them， 2-methylbutyraldehyde and isovaleraldehyde had a sweet odor and their contents increased after processing， but the contents of hexanal and caproic acid decreased， new components such as 2-acetylfuran and 5-methylfuranal were produced after processing. PCA and OPLS-DA results showed that there were significant differences between raw products and the wine-processed products， a total of 13 differential compounds were screened out， of which 7 showed an upward trend in relative content and 6 showed a downward trend. A total of 7 carbohydrate components， including 5 monosaccharides and 2 disaccharides， were identified in raw products and the wine-processed products. The results of determination showed that the contents of fructose， glucose， mannose and sucrose in P. cyrtonema rhizoma increased after wine-processing， and their increases were 4.54， 1.51， 2.93， 3.66 times， respectively. ConclusionAfter processing， the increase of aromatic flavor of P. cyrtonema rhizoma may be related to the increase of the contents of aldehydes such as 2-methylbutyraldehyde and isovaleraldehyde， while the decrease of raw flavor may be related to the decrease of the contents of volatile components such as hexanal and hexanoic acid， the increase of sweet flavor may be related to the increase of the contents of monosaccharides and oligosaccharides such as fructose and sucrose.

Objective To systematically evaluate the intervention effect of social psychological intervention on the health status of patients with bariatric surgery(BS).Methods 8 databases,including PubMed,PsycInfo,and Embase and Clinic Trials,were retrieved to recruit randomized controlled trials with computer from database establishing time to Sep.2022.Independent quality evaluation was conducted by 2 researchers,and Meta-analysis was performed by the RevMan5.3 software.Results Totally 23 RCTs were included.The meta-analysis showed that psychosocial interventions in BS patients improve emotional eating and binge eating behavior[SMD=-0.44,95％CI(-0.78,-0.09),P=0.010;MD=-5.88,95％CI(-8.65,-3.11),P＜0.001],promote better quality of life[SMD=0.30,95％CI(0.02,0.59),P=0.040]and physical mobility,alleviates anxiety and depression[SMD=-0.37,95％CI(-0.67,-0.08),P=0.010;SMD=-0.59,95％CI(-0.84,-0.33),P＜0.001].However,the effect on improving eating disorders[MD=-0.01,95％CI(-0.19,0.18),P=0.950]is not significant,and subgroup analysis results of different intervention measures and follow-up times showed that there was no statistically significant difference in weight changes between the social psychological intervention group and the control group.Conclusion Psychosocial intervention can effectively improve the mental state and eating behavior of the bariatric surgery patients,improve the quality of life and increase physical activity of patients.However,the effect of intervention on eating disorder and weight change is still unclear.More high-quality clinical studies need to be carried out for further verification.

ObjectiveBy comparing the difference of volatile components of the decoction pieces before and after being processed by braising method of Jianchangbang and steaming method included in the 2020 edition of Chinese Pharmacopoeia， the influence of processing methods on the flavor formation of Polygoni Multiflori Radix （PMR） was compared. MethodHeadspace-gas chromatography-mass spectrometry （HS-GC-MS） was used to detect the volatile components of 30 batches of PMR samples from 3 origins with 3 processing methods. The GC was performed under programmed temperature （starting temperature of 40 ℃， rising to 150 ℃ at 5 ℃·min^-1， and then rising to 195 ℃ at 10 ℃·min^-1） with high purity helium as carrier gas and the split ratio of 10∶1. Mass spectrometry conditions were electron impact ion source （EI） and the detection range of m/z 50-650， the peak area normalization method was used to calculate the relative mass fraction of each component. The chromaticity values of different processed products were measured by a precision colorimeter， the relationship between chromaticity values and relative contents of volatile components was investigated by OriginPro 2021， principal component analysis （PCA） and orthogonal partial least squares-discriminant analysis （OPLS-DA） were performed on the sample data by SIMCA14.1. The differential components of different processed products of PMR were screened according to the principle of variable importance in the projection （VIP） value>1.5， and the material basis of different odor formation of PMR and its processed products was explored. ResultA total of 59 volatile components were identified， among which 34 were raw products， 33 were braised products， and 27 were steamed products. PCA and OPLS-DA results showed that there were significant differences between the three， but there was no significant difference between samples from different origins of the same processing method. Color parameters of a^*， b^*， E^*ab had no significant correlation with contents of volatile components， while L^* was negatively correlated with contents of 2-methyl-2-butenal， 2-methyltetrahydrofuran-3-one and 2，3-dihydro-3，5-dihydroxy-6-methyl-4（H）-pyran-4-one （P<0.05）. The contents of pungent odor components such as caproic acid， nonanoic acid and synthetic camphor decreased after processing， while the contents of sweet flavor components such as 2-methyl-2-butenal， furfural and 5-hydroxymethylfurfural increased after processing， and the contents of furfural， 5-methyl-2-furanmethanol， 5-hydroxymethylfurfural and other aroma components in the braised products were significantly higher than that in the steamed products. ConclusionHS-GC-MS can quickly identify the volatile substance basis that causes the different odors of PMR and its processed products. The effect of processing methods on the odor is greater than that of origin. There is a significant correlation between the color parameter of L^* and contents of volatile components， the "raw" taste of PMR may be related to volatile components such as caproic acid， pelargonic acid and synthetic camphor， the "flavor" after processing may be related to the increase of the contents of 2-methyl-2-butenal， furfural， 5-hydroxymethylfurfural， methyl maltol and furfuryl alcohol.

Purpose: This study aimed to identify prognostic factors for patients with distant lymph node-involved gastric cancer (GC) using a machine learning algorithm, a method that offers considerable advantages and new prospects for high-dimensional biomedical data exploration. Materials and Methods: This study employed 79 features of clinical pathology, laboratory tests, and therapeutic details from 289 GC patients whose distant lymphadenopathy was presented as the first episode of recurrence or metastasis. Outcomes were measured as anycause death events and survival months after distant lymph node metastasis. A prediction model was built based on possible outcome predictors using a random survival forest algorithm and confirmed by 5×5 nested cross-validation. The effects of single variables were interpreted using partial dependence plots. A contour plot was used to visually represent survival prediction based on 2 predictive features. Results: The median survival time of patients with GC with distant nodal metastasis was 9.2 months. The optimal model incorporated the prealbumin level and the prothrombin time (PT), and yielded a prediction error of 0.353. The inclusion of other variables resulted in poorer model performance. Patients with higher serum prealbumin levels or shorter PTs had a significantly better prognosis. The predicted one-year survival rate was stratified and illustrated as a contour plot based on the combined effect the prealbumin level and the PT. Conclusions Machine learning is useful for identifying the important determinants of cancer survival using high-dimensional datasets. The prealbumin level and the PT on distant lymph node metastasis are the 2 most crucial factors in predicting the subsequent survival time of advanced GC.Trial Registration: ChiCTR Identifier: ChiCTR1800019978

Licking behavior is important for water intake. The deep mesencephalic nucleus (DpMe) has been implicated in instinctive behaviors. However, whether the DpMe is involved in licking behavior and the precise neural circuit behind this behavior remains unknown. Here, we found that the activity of the DpMe decreased during water intake. Inhibition of vesicular glutamate transporter 2-positive (VGLUT2⁺) neurons in the DpMe resulted in increased water intake. Somatostatin-expressing (SST⁺), but not protein kinase C-δ-expressing (PKC-δ⁺), GABAergic neurons in the central amygdala (CeA) preferentially innervated DpMe VGLUT2⁺ neurons. The SST⁺ neurons in the CeA projecting to the DpMe were activated at the onset of licking behavior. Activation of these CeA SST⁺ GABAergic neurons, but not PKC-δ⁺ GABAergic neurons, projecting to the DpMe was sufficient to induce licking behavior and promote water intake. These findings redefine the roles of the DpMe and reveal a novel CeA^SST-DpMe^VGLUT2 circuit that regulates licking behavior and promotes water intake.