As the biggest tissue of human body, skin is the first barrier of resisting external aggression. Collagen is one of important parts of the skin, which could not only affect the aesthetics of skin, but also influence the health and normal function of skin. It is the great significance to find ways that could inhibit the loss of collagen. The mechanisms of the collagen degradation in skin are complex and multifaceted. Natural bioactive products have unique advantages in treating the loss of collagen, which have multi-targets and mechanisms. In this review, the mechanisms of skin collagen degradation are discussed, and the research progress of natural bioactive products in resisting skin aging through promoting collagen synthesis are reviewed, in order to provide references for futural research.

Objective To investigate the value of narrow band imaging-magnifying endoscopy(NBI-ME)and endoscopic ultrasonography(EUS)in diagnosing colorectal submucosal carcinoma and to analyze the specific imaging features of submucosal carcinoma.Methods A total of 259 pa-tients with early-stage colorectal cancer were selected as study subjects.All patients underwent NBI-ME and EUS examinations.The consistency between the results of NBI-ME,EUS,and pathological diag-nosis was analyzed.The diagnostic efficacy of NBI-ME,EUS alone,and their combined application for submucosal carcinoma was evaluated.The differences in clinical and imaging features between pa-tients with submucosal carcinoma and intramucosal carcinoma were compared.Results Among 259 patients,203 had intramucosal carcinoma and 56 had submucosal carcinoma.The judgments of tumor infiltration by NBI-ME and EUS showed good consistency with the pathological diagnosis results(Kappa=0.706,0.685,respectively,P＜0.001).The sensitivity and negative predictive value of NBI-ME combined with EUS in diagnosing submucosal carcinoma were higher than those of NBI-ME or EUS alone,while the specificity was lower,with statistically significant differences(P＜0.05).The proportions of patients with submucosal carcinoma having a lesion maximum diameter＞2 cm,easily bleeding lesions,and vascular dilation were 71.43％,46.43％,and 39.29％,respectively,which were higher than those in patients with intramucosal carcinoma(41.87％,28.57％,and 10.34％,respectively)(P＜0.05).Multivariate Logistic regression analysis showed that a lesion maximum diameter＞2 cm,easily bleeding lesions,and vascular dilation were all independent risk factors for submucosal carcinoma(P＜0.05).Conclusion NBI-ME and EUS have certain appli-cation value in diagnosing colorectal submucosal carcinoma and intramucosal carcinoma,and their combined application demonstrates better diagnostic efficacy.Patients with early-stage colorectal cancer having a lesion maximum diameter＞2 cm,easily bleeding lesions,and vascular dilation are at a higher risk of being diagnosed with submucosal carcinoma.

Objective To evaluate the application of deep learning reconstruction(DLR)in high-resolu-tion T2WI of the uterus and compare it with traditional reconstruction method.Methods A total of 45 pa-tients diagnosed with cervical cancer and undergoing pelvic MRI scans at the hospital from May to August 2024 were prospectively included in the study.DLR technology was used to reconstruct high-resolution T2WI images,which were then compared with high-resolution T2WI images obtained using traditional reconstruc-tion techniques.Likert-type scale was employed for subjective quality evaluation of artifacts and tissue con-trast in high-resolution T2WI images,while relative contrast(RC)between the lesion area and uterine myo-metrium was used for objective quality assessment of the images.Results The artifact score of high-resolu-tion T2WI images obtained using DLR technology showed no significant difference compared to traditional re-construction method(4.22±0.42 vs.4.16±0.37,P=0.18).However,the tissue contrast score was signifi-cantly higher than that of traditional reconstruction methods(4.38±0.49 vs.3.98±0.26,P＜0.001).The RC of high-resolution T2WI images obtained using DLR technology was superior to that of traditional recon-struction methods(0.74±0.06 vs.0.71±0.05,P＜0.001).Conclusion DLR demonstrates significant ad-vantages in high-resolution uterine T2WI.Although it shows no significant difference in artifact suppression compared to traditional methods,it improves tissue contrast and enhances lesion visualization.

Objective To map the super-enhancers remodeling of intestinal gastric cancer and reveal the tumor biological functions of the super-enhancers and the downstream target genes that may be activated.Methods A total of 31 normal gastric mucosal tissues,23 intestinal gastric cancer tissues and 9 intestinal gastric cancer organoids were collected from the Department of Gastroenterology of Army Medical Center of PLA from January to December 2022.Chromatin targeting histone H3K27ac modified chromatin targeting cleavage under targets and tagmentation(CUT&Tag)sequencing was conducted on above tissues.The remodeling profiles of super-enhancers in intestinal gastric cancer were analyzed and the key target genes were identified based on bioinformation tools.CRISPRi technology was used to intervene with the super-enhancers,the expression of target genes was detected with Western blotting,and the proliferation,migration and invasion abilities were detected by CCK-8 assay and Transwell chambers in the control group and the intervention group.Results There was a significant difference in the signal of super-enhancers between intestinal gastric cancer tissues and normal gastric mucosal tissues(P<0.05),and the active super-enhancers in cancer tissues may be involved in biological processes such as negative regulation of the immune system and cell adhesion.The expression of up-regulated cell migration-inducing protein(CEMIP)in tumor cells was regulated by the super-enhancers,and intervening the super-enhancers down-regulated the expression of CEMIP(P<0.05),and inhibited the cell proliferation,invasion and migration abilities of tumor cells(P<0.05).Conclusion Super-enhancer remodeling is observed in intestinal gastric cancer,and they can up-regulate the expression of CEMIP gene and promote the growth,migration and invasion of cancer cells.

Objective To identify the enhancer profile marked by histone H3K27ac modification in high-grade intraepithelial neoplasia(HGIN)in order to reveal the novel regulatory mechanism of HGIN pathogensis.Methods Gastric tissue samples were collected from Department of Gastroenterology of Army Medical Center of PLA between June 2022 and June 2023,including 14 normal gastric tissues(Nor group),31 HGIN tissues(HGIN group)and 17 gastric cancer tissues(GC group).Cleavage under targets and tagmentation(CUT&Tag)technique was employed to capture enhancer regions modified by histone H3K27ac.Multi-omics analysis was performed to identify HGIN-specific active enhancers and their potentially regulated genes.Immunohistochemical profiling was performed to assess differential expression of the gene of interest across clinically stratified specimens,combined with CRISPR-dCas9-mediated ablation of active enhancers to monitor the gene of interest transcriptional dynamics and validate enhancer-mediated regulatory mechanisms.Results Epigenomic sequencing obtained the data with excellent quality,and indicated that obvious remodeling was observed in H3K27ac enhancers in HGIN and GC groups(P<0.05),though no significant difference in the genome-wide distribution of H3K27ac modification among the 3 groups.Combining transcriptome data revealed that enhancer remodeling may up-regulate the expression of the proliferation-related target gene,CD24,in the HGIN tissue;while,inhibiting enhancer activity can notably reduce CD24 expression level(P<0.05).Immunohistochemical assay displayed a positive correlation between the expression levels of CD24 and Ki-67(P<0.001).Conclusion The remodeling of H3K27ac enhancer represents a significant epigenetic feature of the transformation from normal condition to HGIN.Remodeling of H3K27ac enhancer up-regulates CD24,which may facilitate the abnormal proliferation of gastric epithelial cells.

Objective To analyze clinical characteristics of mesenchymal-subtype gastric cancer(Mes-GC)by integrating multi-omics data and explore the characteristics of tumor cells and microenvironment associated with the risk for recurrence.Methods Gastric tumor tissue samples were collected from the patients who visited Department of Gastroenterology of Army Medical Center of PLA from January 2022 to December 2023.Transcriptome and genome sequencing were applied for these tissue samples,including 19 cases of diffuse-type gastric cancer,22 cases of intestinal-type gastric cancer,and 23 cases of mixed-type gastric cancer patients.Bioinformatics analysis was employed to investigate the differences in clinical characteristics and tumor microenvironment between Mes-GC and non-mesenchymal-subtype gastric cancer(non-Mes-GC)by integrating data resources including The Cancer Genome Atlas(TCGA),Gene Expression Omnibus(GEO),and National Genomics Data Center(NGDC).Results Compared to non-Mes-GC patients,Mes-GC ones were characterized by later clinical stages,deeper tumor infiltration,and higher rates of lymph node metastasis.Kaplan-Meier survival analysis confirmed that Mes-GC patients were associated with shorter survival time,poor prognosis as well as increased risk of cancer recurrence(P<0.05).Single-cell RNA sequencing data revealed that tumor cells in Mes-GC showed higher expression levels of the genes related to stemness,metastasis(P<0.05),and epithelial-mesenchymal transition(EMT).And in the tumor microenvironment,there were significant more myeloid cells,smooth muscle cells,endothelial cells and fibroblasts,with the most pronounced elevation in the proportion of fibroblasts(P<0.05).Moreover,the patients with larger proportion of fibroblasts were associated with poorer prognosis.Conclusion Mes-GC tumor cells exhibit higher stemness and EMT characteristics,and stromal cells such as myeloid cells,endothelial cells,and fibroblasts are enriched in the tumor microenvironment.These features may be key factors contributing to poor prognosis and high recurrence rate of Mes-GC.

Objective To identify the enhancer landscape marked by histone H3K27ac modifications in diffuse-type gastric cancer(DGC)tissues,and to elucidate the epigenetic remodeling mechanisms by which active enhancers regulate cachexia-related genes.Methods Gastric mucosal tissue samples were collected from Department of Gastroenterology of Army Medical Center of PLA during January 2022 to March 2023,including 10 normal gastric mucosa tissues(Normal group),10 DGC tissues diagnosed with cachexia(DGC group),and 10 organoids derived from DGC tissues(Organoid group).Using H3K27ac chromatin targeting cleavage and tagmentation(CUT&Tag)technology,genomic modification regions were captured to screen specific active enhancers and their potential target genes in DGC tissues.CRISPR-dCas9 gene editing technology was used to intervene with the enhancers,and the expression of target genes was detected with Western blotting and qRT-PCR.Sixteen female SPF-grade BALB/c Nude mice(6～8 weeks old,weighing 18～21 g)were utilized to establish an orthotopic xenograft tumor model using the human diffuse-type gastric cancer cell line MKN45.Cachexia-related phenotypes were evaluated in 3 groups:normal group(n=4),silencing group(n=6),and control group(n=6).Results Significant differential enhancer regions were identified between DGC and normal gastric mucosa tissues.DGC tissues exhibited a marked increase in enhancer abundance(P<0.05)and signal intensity when compared with the normal counterparts.Integrated analysis of transcriptome data revealed that some of these active enhancers up-regulated the expression of GDF15,a cachexia-associated target gene in DGC.Targeted silencing of the active enhancer of GDF15 using CRISPR/dCas9-KRAB plasmid technology resulted in a significant reduction in GDF15 expression at both mRNA levels(P<0.05)and protein.Results from orthotopic transplantation experiments of DGC demonstrated that silencing of active enhancers alleviated the cachexia phenotype in nude mice(P<0.05).Conclusion DGC exhibits enhancer remodeling,which regulates the expression of the cachexia-associated gene GDF15,and thereby contributes to the pathogenesis and progression of cancer cachexia.

For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

Objective:To preliminarily evaluate the accuracy of a segmented rotational motion-based osteotomy module for autonomous dental implant robots in immediate implant placement in the anterior region through an in vitro model experiment, providing references for clinical practice. Methods:Twenty-three identical commercial maxillary resin models with dentition defects for immediate implant placement were divided into three groups: a fully guided static computer-assisted implant surgery (sCAIS) group ( n=5), a robotic computer-assisted implant surgery (rCAIS) group based on conventional coronal-apical linear motion osteotomy (rCAIS-C, n=9) and a rCAIS group based on segmented rotational motion osteotomy (rCAIS-S, n=9). Two implants were placed in each model using the corresponding surgical protocols. Intraoral scan data of pre-and post-operative models were imported into software to evaluate deviations between the actual and planned implant positions. Results:In the rCAIS-S group, the global deviations at the implant platform and apex were 0.50 (0.32) mm and 0.52 (0.22) mm, respectively, with an angular deviation of 1.08° (0.49°). These values were significantly smaller than those in the sCAIS group [platform: 0.88 (0.50) mm, apex: 1.44 (0.50) mm, angular deviation: 2.86° (1.76°), P<0.05]. rCAIS-S group also showed significantly smaller platform and apex deviations compared to rCAIS-C group [platform: 0.69 (0.12) mm, apex: 0.94 (0.16) mm, P<0.05], though angular deviations of rCAIS-S group did not differ significantly from rCAIS-C group [1.27° (0.56°), P>0.05]. Conclusions:Within the limitation of this study, the segmented rotational motion-based osteotomy module for dental implant robots demonstrates superior accuracy in immediate implant placement in the anterior area compared to sCAIS and rCAIS based on conventional coronal-apical linear motion osteotomy.

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an immune-mediated demyelinating peripheral neuropathy characterized by symmetric limb weakness, sensory disturbances, and diminished tendon reflexes. Its pathogenesis involves the interplay of T cells, B cells, and the complement system. Current first-line therapies including intravenous immunoglobulin, corticosteroids and plasma exchange exhibit limited efficacy, with approximately 30% of patients experiencing relapse or poor treatment response. In recent years, novel immunomodulatory therapies including anti-CD20 monoclonal antibodies, neonatal Fc receptor inhibitors, complement inhibitors, Bruton tyrosine kinase inhibitors, autologous hematopoietic stem cell transplantation, and chimeric antigen receptor T-cell therapy, have emerged as promising options for refractory CIDP, ushering in a new era of immunomodulatory treatment.