Gastric cancer is one of the common malignant tumors worldwide. Due to the popularization of gastroscopy technology and the improvement of patients' awareness of health checkups, the detection rate of early gastric cancer has been increasing year by year, and the five-year survival rate of early gastric cancer is up to more than 90% after surgery, and along with the high survival rate, the postoperative quality of life is particularly important for patients. The surgical treatment of gastric cancer has also experienced the course of transformation from traditional radical gastrectomy to function-preserving surgery. Function-preserving gastrectomy is not only an anatomical-morphological gastrectomy, but also based on oncological theories such as the physiology of the stomach (motility, secretion) and the histological changes of its background gastric mucosa. Reasonable design of the surgical pattern to reduce surgical invasion and ensure maximum preservation of the function of the residual stomach itself, and the function of the surrounding related organs (liver, gallbladder, pancreas, and intestines) after surgery will greatly improve the quality of postoperative survival. This article summarizes the main research results and progress of function-preserving surgery for surgical gastric cancer in recent years, with a view to providing reference for clinical work.

With the development of medical technology towards precision and individualization, the protection of gastric function and the postoperative quality of life of patients are increasingly receiving the attention and emphasis of surgeons. In the context of the booming development of function-preserving gastrectomy, the combined approach using both laparoscopy and endoscopy also presents a trend of diversity and innovation. The laparoscopic and endoscopic cooperative surgery not only addresses for the limitations of each method, but also plays a role in locating the tumor precisely, narrowing the scope of gastrectomy, preserving the anatomical structure and function of the stomach, maintaining the continuity of the gastric wall, precise lymphadenectomy, and preserving the vagus nerve in function-preserving gastrectomy. In this paper, the author expounds on the above advantages and scope of application of dual-scope cooperative surgery and recognizes the significance of dual-scope cooperative surgery in future development.

OBJECTIVES: To analyze the distribution of Y chromosome azoospermia factor (AZF) microdeletions and their association with testicular development in male pediatric patients with congenital reproductive system disorders, including hypospadias, cryptorchidism, and disorders of sex development (DSD). METHODS: A prospective cohort study was conducted on pediatric patients admitted to the Department of Urology of Shanghai Children's Hospital from November 2021 to December 2023. The observation group included boys with hypospadias, cryptorchidism, or DSD, while the control group comprised boys with phimosis, indirect inguinal hernia, or hydrocele. Blood samples were collected for AZF microdeletion analysis using multiplex PCR to detect 15 sequence-tagged sites. Testicular ultrasound was performed to record testicular position and volume. Propensity score matching (PSM) was used to balance the groups. After matching, testicular volume differences were assessed. Stratified analyses compared testicular volume among children with AZF microdeletions, the control group, and children without micro-deletions in observation group. RESULTS: A total of 493 children were enrolled (observation group: 463; control group: 30). No Y chromosome microdeletions were detected in the control group. Four boys in the observation group had AZF microdeletions: one with cryptorchidism (AZFc+AZFd), one with isolated hypospadias (AZFc), and two with DSD (one with AZFb+AZFc+AZFd and one with AZFa). Ultrasonography measured 888 testicles. After PSM, testicular volume was significantly smaller in the observation group than in the control group (P<0.01). Stratified analysis revealed that among children under 9 years, those with AZF microdeletions tended to be older but had smaller testicular volumes compared to the control group and those without microdeletions in the observation group, although differences were not statistically significant (all P>0.05). Among children over 9 years, ages were comparable, but children with AZF microdeletions had smaller testicular volumes than the other two groups (statistical analysis was not performed due to small sample size). CONCLUSIONS The prevalence of Y chromosome microdeletions is higher in male children with congenital reproductive system disorders compared to the general population, particularly in those with DSD. Hypospadias, cryptorchidism, DSD, and AZF microdeletions may be associated with delayed testicular development in these children.

Objective:To investigate the prevalence and risk factors of overweight and obesity among Chinese children aged 3-18 years from 11 provinces, antonomous regions, or municipalities.Methods:This national cross-sectional community health survey utilized a multistage stratified cluster-random sampling method to recruit 193 997 nationally representative participants from 11 provinces, autonomous regions, or municipalities between January 2017 and December 2019. All participants underwent physical examinations, and their caregivers completed questionnaires assessing participants′ dietary, lifestyle, familial, and perinatal information. Multilevel multinomial logistic regression models were employed to identify the potential risk factors.Results:The cohort comprised 193 997 children (102 178 boys, 91 819 girls),aged (10±4) years. Overall prevalence rates were 30 574(15.8%)overweight children and 17 217(8.9%) obesity children. Boys exhibited higher overweight and obesity rates than girls (17.0% (17 368/102 178) vs. 14.4% (13 206/102 178), 11.3% (11 553/91 819) vs. 6.2% (5 664/91 819), χ2=249.12,1 578.69,both P<0.001). The detection rates of obesity in Tanner stage 2 and 3 were the highest in boys and girls, with 13.4%(2 231/16 665) and 8.6%(880/10 221) respectively. Risk factors for obesity included parental overweight (paternal OR=2.34 and maternal OR=2.29), annual household income of 100 000-200 000 yuan (compared with<100 000 yuan, OR=1.04), higher paternal education (compared with below high school,high school and a college education OR=1.09,1.14), birth weight >4.0 kg (≤5 and>5 years old OR=1.74, 1.44,respectively), and western food consumption≥1 time/month (compared with<1, 1-2, 3-4,>4 times/month OR=1.36, 1.30, 1.67(≤5 years), 1.19, 1.16, 1.15 (>5 years), respectively) (all P<0.05). Conversely, coarse grain intake≥1 times/week (compared with<1 times/week, every day, 3-4, 1-2 times/week OR=0.74, 0.80, 0.71 (≤5 years), 0.75, 0.87, 0.90(>5 years), respectively, all P<0.05) was associated with reduced obesity risk. Conclusions:Obesity epidemiology in children demonstrates significant heterogeneity across age, gender, geographic regions, and pubertal stages. It is necessary to establish a personalized prevention and control strategy.

Objective:To evaluate the safety and feasibility of Da Vinci robot-assisted proximal gastrectomy (PG) for proximal gastric cancer (PGC) and adenocarcinoma of the esophagogastric junction (AEG).Method:Twenty-five patients (PGC: n=7; AEG: n=18) undergoing Da Vinci-assisted PG at the First Affiliated Hospital of Dalian Medical University from Jan 2021 to Mar 2025 were divided into (indocyanine green ,ICG) ( n=9) and non-ICG ( n=16) groups based on whether intraoperative ICG navigation was used. Perioperative outcomes and pathological data were compared. Results:All operations were successfully completed without conversion to open surgery. The median proximal resection margin was 3.0 cm (2.5-3.0) cm, and the median distal resection margin was 4.0 cm (3.0-5.0) cm. Operative time in the ICG and non-ICG groups was (294.4±41.3) min and (354.4±67.4) min, respectively, with a statistically significant difference ( t=2.760， P< 0.05). The total number of lymph nodes harvested, as well as D 1 and D 2 LN stations, was (29.3±14.8) vs. (21.8±6.3), 17.0 (10.0-24.8) vs. 14.0 (11.0-22.5), and 10.0 (2.0-17.0) vs. 7.2 (2.0-7.5) in the ICG and non-ICG groups, respectively. Although the ICG group showed a trend toward higher LN yield, the difference was not statistically significant ( P>0.05). Conclusions:Da Vinci robotic assisted proximal gastrectomy is safe and feasible for treating PGC and AEG. ICG fluorescence imaging demonstrates promising clinical value.

Gastric cancer is one of the common malignant tumors worldwide. Due to the popularization of gastroscopy technology and the improvement of patients' awareness of health checkups, the detection rate of early gastric cancer has been increasing year by year, and the five-year survival rate of early gastric cancer is up to more than 90% after surgery, and along with the high survival rate, the postoperative quality of life is particularly important for patients. The surgical treatment of gastric cancer has also experienced the course of transformation from traditional radical gastrectomy to function-preserving surgery. Function-preserving gastrectomy is not only an anatomical-morphological gastrectomy, but also based on oncological theories such as the physiology of the stomach (motility, secretion) and the histological changes of its background gastric mucosa. Reasonable design of the surgical pattern to reduce surgical invasion and ensure maximum preservation of the function of the residual stomach itself, and the function of the surrounding related organs (liver, gallbladder, pancreas, and intestines) after surgery will greatly improve the quality of postoperative survival. This article summarizes the main research results and progress of function-preserving surgery for surgical gastric cancer in recent years, with a view to providing reference for clinical work.

With the development of medical technology towards precision and individualization, the protection of gastric function and the postoperative quality of life of patients are increasingly receiving the attention and emphasis of surgeons. In the context of the booming development of function-preserving gastrectomy, the combined approach using both laparoscopy and endoscopy also presents a trend of diversity and innovation. The laparoscopic and endoscopic cooperative surgery not only addresses for the limitations of each method, but also plays a role in locating the tumor precisely, narrowing the scope of gastrectomy, preserving the anatomical structure and function of the stomach, maintaining the continuity of the gastric wall, precise lymphadenectomy, and preserving the vagus nerve in function-preserving gastrectomy. In this paper, the author expounds on the above advantages and scope of application of dual-scope cooperative surgery and recognizes the significance of dual-scope cooperative surgery in future development.

Objective:To investigate the prevalence and risk factors of overweight and obesity among Chinese children aged 3-18 years from 11 provinces, antonomous regions, or municipalities.Methods:This national cross-sectional community health survey utilized a multistage stratified cluster-random sampling method to recruit 193 997 nationally representative participants from 11 provinces, autonomous regions, or municipalities between January 2017 and December 2019. All participants underwent physical examinations, and their caregivers completed questionnaires assessing participants′ dietary, lifestyle, familial, and perinatal information. Multilevel multinomial logistic regression models were employed to identify the potential risk factors.Results:The cohort comprised 193 997 children (102 178 boys, 91 819 girls),aged (10±4) years. Overall prevalence rates were 30 574(15.8%)overweight children and 17 217(8.9%) obesity children. Boys exhibited higher overweight and obesity rates than girls (17.0% (17 368/102 178) vs. 14.4% (13 206/102 178), 11.3% (11 553/91 819) vs. 6.2% (5 664/91 819), χ2=249.12,1 578.69,both P<0.001). The detection rates of obesity in Tanner stage 2 and 3 were the highest in boys and girls, with 13.4%(2 231/16 665) and 8.6%(880/10 221) respectively. Risk factors for obesity included parental overweight (paternal OR=2.34 and maternal OR=2.29), annual household income of 100 000-200 000 yuan (compared with<100 000 yuan, OR=1.04), higher paternal education (compared with below high school,high school and a college education OR=1.09,1.14), birth weight >4.0 kg (≤5 and>5 years old OR=1.74, 1.44,respectively), and western food consumption≥1 time/month (compared with<1, 1-2, 3-4,>4 times/month OR=1.36, 1.30, 1.67(≤5 years), 1.19, 1.16, 1.15 (>5 years), respectively) (all P<0.05). Conversely, coarse grain intake≥1 times/week (compared with<1 times/week, every day, 3-4, 1-2 times/week OR=0.74, 0.80, 0.71 (≤5 years), 0.75, 0.87, 0.90(>5 years), respectively, all P<0.05) was associated with reduced obesity risk. Conclusions:Obesity epidemiology in children demonstrates significant heterogeneity across age, gender, geographic regions, and pubertal stages. It is necessary to establish a personalized prevention and control strategy.