Objective To investigate the clinical features， genetic basis， and phenotypic heterogeneity mechanism of normokalemic periodic paralysis （normoKPP） associated with SCN4A-T704M mutation in the Chinese population， and to clarify its basis as an independent disease subtype. Methods Two Chinese families （13 patients） with normoKPP were included， and related clinical data were collected， including medical history， test results， electrophysiology， and muscle pathology. Sanger sequencing was used to identify SCN4A gene mutations， and a family co-segregation analysis and ACMG pathogenicity rating were used to validate the pathogenicity of the mutations. A literature review was performed to compare genotype-phenotype associations， and phenotypic heterogeneity and racial differences were also compared. Results All patients carried the heterozygous mutation of c.2111C>T （p.T704M） in the SCN4A gene （SCN4A-T704M）， which was in line with autosomal dominant inheritance， and the core phenotypes included disease onset in childhood （with a mean age of 1.5‒10 years）， paroxysmal proximal muscle weakness （induced by cold/hunger/strenuous exercise）， and normal blood potassium during the ictal period （3.5‒5.5 mmol/L）， as well as gastrocnemius hypertrophy and persistent muscle weakness in some patients. Electrophysiology and muscle pathology suggested myogenic damage， with significant phenotypic heterogeneity within the family， and family 2 had a significantly higher mean annual number of attacks than family 1 [（16.4±11.4）times/year vs （9.5±9.2）times/year].Functional speculation showed that the mutation triggered resting leakage current through defective slow inactivation of the sodium channel， resulting in an abnormally low threshold for muscle membrane excitability.Conclusion SCN4A-T704M mutation is a key pathogenic factor for normoKPP in Chinese families， and its clinical symptoms have the features of both episodic and chronic myopathy. Normal blood potassium and a lack of myotonic discharges support its attribute as an independent disease subtype. Phenotypic heterogeneity may be associated with the interaction between genetic modification and environmental factors， and calcium overload caused by sodium channel dysfunction may be a key mechanism of muscle fiber injury. This study provides new evidence for the precise diagnosis and treatment of normoKPP.

ObjectiveTo explore the effect of Polygonati Odorati Rhizoma polysaccharides on hyperlipidemia in mice by modulating the gut microbiota. MethodsNinety male C57BL/6J mice were randomized into the following groups （n=15）： control， model， simvastatin， low- （100 mg·kg^-1）， medium- （200 mg·kg^-1）， and high-dose （400 mg·kg^-1） Polygonati Odorati Rhizoma polysaccharides groups. Other groups except the control group were fed with a high-fat diet for the modeling of hyperlipidemia， and drug interventions lasted for 12 weeks. Serum levels of total cholesterol （TC）， triglycerides （TG）， low-density lipoprotein cholesterol （LDL-C）， and high-density lipoprotein cholesterol （HDL-C） were measured by an automatic biochemical analyzer. The pathological changes in the liver and epididymal fat were observed by hematoxylin-eosin staining， and lipid accumulation in the liver was assessed by oil red O staining. The gut microbiota was analyzed by 16S rRNA gene sequencing. ResultsCompared with the control group， the model group exhibited an increase in body weight （P<0.01）， along with marked elevations in serum levels of TC， TG， and LDL-C （P<0.05，P<0.01）. Furthermore， the model group showcased increase in the liver index and epididymal fat coefficient （P<0.05）， increased liver fat accumulation， enlargement of adipocytes in the epididymal fat， decreases in both alpha and beta diversity of the gut microbiota， and an increase in the relative abundance of Allobaculum （P<0.01）. Compared with the model group， Polygonati Odorati Rhizoma polysaccharides suppressed the increase in body weight （P<0.01）， lowered the serum levels of TC， TG， and LDL-C （P<0.05，P<0.01）， reduced the liver index and epididymal fat coefficient （P<0.05）， alleviated liver fat accumulation， and decreased the size of adipocytes in the epididymal fat. Furthermore， it enhanced the alpha and beta diversity of the gut microbiota in mice， reduced the relative abundance of Allobaculum， Erysipelotrichaceae， and Clostridium （P<0.01）， and increased the relative abundance of Akkermansia and Blautia （P<0.01）. ConclusionPolygonati Odorati Rhizoma polysaccharides can ameliorate hyperlipidemia induced by a high-fat diet in mice by regulating the diversity and composition of the gut microbiota.

Globally, over 300 million surgeries are performed each year, and more than 50% of surgeries involve patients aged 65 and older. Aging poses significant challenges to perioperative brain health, as the deterioration of brain structure and function increases susceptibility to postoperative neurological complications. Protecting perioperative brain health remains a worldwide clinical challenge. With senescence, the brain undergoes a progressive decline in homeostasis across various molecular, cellular, and regional functions. Anesthetics and surgical stimuli may accelerate the disruption of brain homeostasis and exacerbate age-related neurodegeneration. This review provides a framework for understanding how anesthesia and surgery can affect brain health in the aging population and contribute to postoperative neurological complications, with a particular focus on perioperative neurocognitive disorder.

Objective To systematically evaluate the factors affecting taste alteration in patients undergoing cancer chemotherapy.Methods PubMed,Cochrane Library,Web of Science,CINAHL,Embase,CBM,CNKI,WanFang Data and VIP were searched from the establishment until August 1,2024.The retrieved literature was independently screened,evaluated and the data were extracted by 2 researchers,and statistical analysis was performed using Stata 17.0 software.Results A total of 18 studies were included,involving 4 686 patients.The incidence of taste changes is 73.46％.Totally 9 influencing factors were extracted through quantitative analysis,including oral mucositis(OR=1.98),dry mouth(OR=1.82),nausea(OR=3.05),loss of appetite(OR=2.41),use of triple antiemetic drugs(OR=2.45),gynecological cancers(OR=0.67),lung cancer(OR=0.57),paclitaxel types of chemotherapy d rugs(OR=2.86),and smoking(β=9.38).Conclusion The alteration of taste in cancer chemotherapy patients is in-fluenced by multiple factors.Nurses should regularly and dynamically assess changes in taste and implement individualized and refined nursing interventions in clinical practice to prevent or delay the development of taste alterations,thereby improving patients' quality of life and treatment adherence.

Objective To systematically evaluate the factors affecting taste alteration in patients undergoing cancer chemotherapy.Methods PubMed,Cochrane Library,Web of Science,CINAHL,Embase,CBM,CNKI,WanFang Data and VIP were searched from the establishment until August 1,2024.The retrieved literature was independently screened,evaluated and the data were extracted by 2 researchers,and statistical analysis was performed using Stata 17.0 software.Results A total of 18 studies were included,involving 4 686 patients.The incidence of taste changes is 73.46％.Totally 9 influencing factors were extracted through quantitative analysis,including oral mucositis(OR=1.98),dry mouth(OR=1.82),nausea(OR=3.05),loss of appetite(OR=2.41),use of triple antiemetic drugs(OR=2.45),gynecological cancers(OR=0.67),lung cancer(OR=0.57),paclitaxel types of chemotherapy d rugs(OR=2.86),and smoking(β=9.38).Conclusion The alteration of taste in cancer chemotherapy patients is in-fluenced by multiple factors.Nurses should regularly and dynamically assess changes in taste and implement individualized and refined nursing interventions in clinical practice to prevent or delay the development of taste alterations,thereby improving patients' quality of life and treatment adherence.

Objective:To investigate the clinical efficacy of three-connections and four-screwings technique in the treatment of high double column acetabular fractures through a single ilioinguinal approach.Methods:A retrospective study was conducted to analyze the data of 42 patients who had been treated for high double column acetabular fractures from June 2017 to June 2020 at Trauma Ward 2, Department of Orthopedics and Traumatology, The First Hospital of Traditional Chinese Medicine of Changde. There were 19 males and 23 females with an age of (42.7±25.6) years. 29 injuries were due to a traffic accident, 12 ones to fall from a height, and one to fall. The time from injury to operation was (4.5±2.1) days. All the patients were treated by the three-connections and four-screwings technique through a single ilioinguinal approach. Briefly, the anterior column was connected and secured to the main bone using 3 routes, and the posterior column was attached and fixated to the anterior column reset using 2 or 3 of the 4 screwings. The operation time, intraoperative blood loss, fracture reduction quality, fracture healing time, hip function at the last follow-up and complications during the follow-up were recorded.Results:For this cohort, the operation time was (150.0±30.5) min, and intraoperative blood loss (300.0±50.0) mL. According to the Matta scale for postoperative acetabular fracture reduction, 34 cases were excellent, 6 cases good, and 2 cases acceptable, with an excellent and good rate of 95.2% (40/42). After operation one patient had fat liquefaction and wound exudation which responded to drainage and dressing change. The 42 patients were followed up for (15.0±3.4) months. All fractures healed after (11.0±2.0) months. By the modified Merle d'Aubigné & Postel scoring system, the hip function was evaluated at the last follow-up as excellent in 33 cases, as good in 6 cases, and as fair in 3 cases, yielding an excellent and good rate of 92.9% (39/42).Conclusions:In the treatment of high double column acetabular fractures, the three-connections and four-screwings technique through a single ilioinguinal approach can lead to fine reduction and rigid fixation by lag screw compression and neutralization plate protection. Consequently, early functional exercises can be performed to secure good therapeutic outcomes for the patients.

Objective: To evaluate the safety and efficacy of Compound Huangdai Tablets (Realgar-Indigo Naturalis formula, RIF) combined with all-trans retinoic acid (ATRA) to treat acute promyelocytic leukemia (APL). Methods: This study was registered in PROSPERO (CRD42018108118). The relevant literatures on RIF treatment of APL were systematically searched in the following databases: China National Knowledge Infrastructure, Wanfang, VIP Medical Information System, Chinese Biomedical Database, EMBASE, Cochrane Library, and PubMed. The quality of the included studies was evaluated and Review Manager 5.3 software and Stata 13.0 software were used to perform the Meta-analysis. In addition, this study used the method of network pharmacology to conduct a preliminary exploration of the mechanism of RIF on APL. Results: The study included 12 studies involving 775 APL patients. The Meta-analysis showed that there was no significant difference (P 0.05) between the RIF group and the arsenic trioxide (ATO) group for primary outcomes, secondary outcomes apart from liver dysfunction. The incidence of liver dysfunction (P = 0.006) in the RIF group were significantly lower than those in the ATO group. In addition, the cost of maintenance therapy in the RIF group was significantly lower (P 0.05) than the ATO group. Besides, the active ingredients in RIF mainly act on targets proteins such as ACHE, NCOA2, RXRA, and then play a role in the treatment of APL through regulating multiple molecular mechanisms, such as TP53 regulates transcription of cell cycle genes, nuclear receptor transcription pathway. Conclusion: There was no significant difference in efficacy of oral RIF combined with ATRA compared with intravenous ATO combined with ATRA for the treatment of APL. The oral RIF exposed patients to less risk, offered more convenience and had lower prices. RIF can treat APL by multi-target and multi-pathway interventions that inducing apoptosis of APL cells and inhibiting the proliferation of APL cells, and so on. Therefore, oral RIF in the treatment of APL is worthy of further research and development.

This corrects the article “Analysis of Tau Protein Expression in Predicting Pathological Complete Response to Neoadjuvant Chemotherapy in Different Molecular Subtypes of Breast Cancer” in volume 23 on page 47.This article was initially published on the Journal of Breast Cancer with a misspelled the abbreviation in figure 3. The abbreviation ‘HP’ should be corrected as ‘HR’.

PURPOSE: Tau is a microtubule-associated protein that can be found in both normal and abnormal breast cells. Whether the expression of Tau protein can predict the response to neoadjuvant chemotherapy (NACT) is still unclear. In this study, we assessed the role of Tau protein expression in predicting a pathological complete response (pCR) to NACT for different subtypes of breast cancer. METHODS: Four hundred and sixty-eight eligible patients were retrospectively recruited in our study. The relationship between clinicopathologic factors, including Tau protein expression, and pCR in different subtypes was evaluated using logistic regression analysis. Correlation between Tau and disease-free survival (DFS) and overall survival (OS) was performed using Kaplan–Meier analysis. RESULTS: The expression of Tau protein was negatively correlated with pCR, especially in triple-negative breast cancer (TNBC). No significant difference was observed in the luminal human epidermal growth factor receptor-2 (HER2)-negative subtype and HER2-positive subtype. Patients with pCR were associated with better DFS and OS (p < 0.05). However, Tau protein expression had no association with either DFS or OS (p > 0.05). CONCLUSION Tau protein expression can predict pCR before NACT in TNBC, but there was no correlation between Tau expression and DFS or OS.

Objective To investigate the clinical efficacy and application value of submucosal tunneling endoscopic resection(STER)for upper gastrointestinal submucosal tumors(SMTs). Methods A retrospective analysis was performed on the endoscopic and clinical data of 44 cases with SMTs who received STER from January 2015 to June 2016 in Chinese PLA General Hospital. Results The rate of complete resection was 88.6%(39/44). The operating time was 60.1±30.6 min. The hospitalization time was 10.1± 3.3 days. The rate of complications was 6.8%(3/44). The diagnosis of SMTs by pathology and endoscopic ultrasonography(EUS),the size of SMTs measured by EUS and ruler after STER,and the growing direction judged by EUS and CT were consistent. Conclusion STER for SMTs has a higher complete resection rate, shorter operating time and hospitalization time, and fewer complications. EUS combined with CT is an effective method for preoperative evaluation.