Rheumatoid arthritis （RA） is a common chronic systemic autoimmune disease with synovitis as the main manifestation， which often causes joint swelling and pain or even deformity. It is considered to be an incurable lifelong disease. Although the current Western medicine treatment can alleviate the progression of the disease， it has the clinical limitations of liver injury， cardiovascular complications， and other adverse reactions， along with easy recurrence. Traditional Chinese medicine （TCM） has a long history and has the advantages of individualized treatment and fewer adverse reactions. It can effectively relieve the symptoms of joint swelling and pain in RA patients and slow down the progression of bone destruction， which has attracted wide concern in the medical community. Janus kinase （JAK）/signal transducer and activator of transcription （STAT） signaling pathway is an important intracellular pathway involved in cell proliferation， differentiation， apoptosis， immune regulation， and other biological behaviors， and plays an important role in the pathophysiological process of RA. In recent years， many studies have confirmed that TCM monomers and compounds can inhibit inflammation and angiogenesis by regulating the JAK/STAT signaling pathway， induce apoptosis and inhibit proliferation of fibroblast-like synoviocytes （FLS）， regulate immune response， and thus exert an effect in the treatment of RA. However， there is still a lack of comprehensive and systematic induction and overview. Therefore， by searching the relevant literature in China National Knowledge Infrastructure （CNKI） and PubMed databases from 2009 to 2024， this study described the mechanism of the JAK/STAT signaling pathway in the occurrence and development of RA and summarized the research progress of TCM monomers and compounds in regulating the JAK/STAT signaling pathway in RA intervention. The study aims to provide new ideas and strategies for the clinical treatment of RA with TCM and the research and development of new drugs.

OBJECTIVE To investigate the predictive value of the advanced lung cancer inflammation index(ALI)for postoperative pharyngocutaneous fistula,recurrence,metastasis,and prognosis in patients with laryngeal squamous cell carcinoma(LSCC).METHODS This retrospective study analyzed the clinical data of 114 LSCC patients treated at Huangshi Central Hospital between January 2014 and December 2023.The data included tumor staging,ALI scores,age,gender,smoking history,alcohol history,diabetes,hypertension,hyperlipidemia,coronary heart disease,tumor differentiation,HPV infection,and tumor location.Based on the occurrence of pharyngocutaneous fistula,the patients were divided into the fistula group(10 cases)and the non-fistula group(104 cases).Single-factor and multi-factor logistic regression analyses were conducted to identify independent factors associated with postoperative pharyngocutaneous fistula.Patients were also classified into recurrence and metastasis groups(22 cases)and non-recurrence groups(92 cases),and further into poor prognosis(25 cases)and good prognosis groups(89 cases)based on follow-up results.Cox regression analysis was performed to identify factors influencing recurrence,metastasis,and prognosis.RESULTS Multivariate logistic regression analysis showed that tumor stage(stage Ⅰ-Ⅱ)[HR:0.040(95％CI:0.004-0.392)]and ALI score[HR:0.885(95％CI:0.805-0.972)]were independent protective factors for the occurrence of pharyngeal fistula(P<0.05).Multivariate Cox regression analysis further confirmed that tumor stage(stage Ⅰ-Ⅱ)[OR:0.180(95％CI:0.063-0.518)]and ALI score[OR:0.970(95％CI:0.939-0.992)]were independent protective factors for recurrence,metastasis,and poor prognosis(P<0.05).ROC curve analysis revealed that the AUC for ALI in predicting pharyngeal fistula was 0.910(95％CI:0.849-0.970),with a cutoffvalue of 29.877,sensitivity of 0.827,and specificity of 1.000.The AUC for ALI in predicting recurrence and metastasis was 0.804(95％CI:0.698-0.910),with a cutoffvalue of 34.398,sensitivity of 0.920,and specificity of 0.618.CONCLUSION The ALI score is an independent protective factor for the occurrence of postoperative pharyngocutaneous fistula,recurrence,metastasis,and poor prognosis in LSCC patients.It is a valuable predictor for early warning of postoperative complications,recurrence,metastasis,and prognosis,with potential clinical utility in guiding personalized treatment strategies.

Objective: To investigate the association between 24 h movement behaviors (physical activity, sleep, and screen time) and fundamental motor skills (FMS) in preschool children, in order to provide the reference and basis for ensuring the longterm development of childrens motor skills. Methods: A total of 607 children aged 3 to 5 years old were selected from 6 kindergartens of 6 urban districts in Taiyuan in March 2022, through a combination of convenient sampling and stratified cluster random sampling method, and the baseline test was conducted to collect data on the childrens 24 h movement behaviors and FMS; the followup test after one year was carried out in March 2023 to collect FMS data. The test of gross motor development-3rd was used to assess the childrens FMS levels. Physical activity and sleep duration were measured using ActiGraph GT3X+ accelerometers, while screen time was reported by parents. Pearson correlation analysis, hierarchial and binary Logistic regression analyses were used to analyze the association of 24 h movement behavior with FMS. Results: The results of baseline showed that total of physical activity (TPA) at baseline was positively associated with manipulation skills, mobility skills and total score of TGMD-3 (β=0.40, 3.87, 4.27, P<0.01). The followup results after one year indicated that lowintensity physical activity (LPA) and screen time at baseline were negatively associated with increased TGMD-3 scores one year later (β=-1.93, -0.79, P<0.01). Conversely, baseline moderatetovigorousintensity physical activity (MVPA), TPA and sleep duration were positively associated with increased TGMD-3 scores after one year (β=4.62, 4.51, 3.19, P<0.01). The followup results showed that meeting 2 or 3 items of the 24 h movement behavior guidelines was significantly associated with an increased likelihood of achieving motor skill proficiency (OR=2.31, 3.32, P<0.01) compared to not meeting any 24 h movement behavior guideline after one year. Conclusions MVPA and enough sleep could positively affect FMS improvement, whereas LPA and long screen time could negatively affect FMS improvement at one year followup. Schools and families should ensure that preschool children meet the recommended standards of the 24 h movement behavioral guidelines to promote longterm development of FMS.

Robotic natural orifice specimen extraction surgery for right colon cancer has been conducted with progressive refinements. To facilitate the standardized implementation of this surgical technique, the adoption of rigorous quality control measures is paramount. The present article outlines the key aspects of quality control for robotic natural orifice specimen extraction right hemicolectomy surgery, encompassing the preoperative, intraoperative, and postoperative phases, as well as the training and credentialing requirements for the operating surgeons, with the aim of providing a reference framework to facilitate the safe and reliable implementation and dissemination of this minimally invasive approach for right colon cancer.

Objective:To compare the surgical outcomes of robotic natural orifice specimen extraction surgery (NOSES) and robotic-assisted radical resection for rectal cancer.Methods:A retrospective analysis using propensity score matching (PSM) was conducted on 547 patients who had undergone radical resection of rectal cancer at the First Affiliated Hospital of Nanchang University from June 2018 to March 2024. The study cohort comprised 157 patients in the robotic NOSES group and 390 in the robotic-assisted group. PSM was used in a 1:1 manner to match relevant general clinical preoperative data of the study patients (age, sex, body mass index, preoperative comorbidities, abnormal preoperative carcinoembryonic antigen (>6.5 μg/L) and carbohydrate antigen 19-9 levels (>27 kU/L), preoperative American Society of Anesthesiologists score, tumor diameter, tumor distance from the anal margin, and TNM stage), with a clamp value of 0.05. After performing PSM to match the general clinical data of the two groups of patients, 77 patients in each of the robotic NOSES and robotic-assisted groups were included in the analysis. We found no statistically significant difference in preoperative general clinical data between the robot NOSES and robot-assisted groups ( P>0.05). We compared the surgical outcomes, postoperative recovery, postoperative pathological data, and incidence of complications between the robotic NOSES and robot-assisted groups. Results:Compared with the robot-assisted groups. the robot NOSES group had a significantly shorter time to first postoperative passage of flatus (48 [38, 50] hours vs. 56 [50, 60] hours, Z=-7.513, P<0.001), time to taking a liquid diet (60 [54,63] hours vs. 66 [62, 72] hours, Z=-6.303, P<0.001), lower pain scores (3 [3, 4] vs. 4 [4, 5], Z=-5.237, P<0.001), and lower incision infection rates (0 vs. 5 [6.5%], χ 2=5.237, P=0.028) within 24 hours after surgery ( P<0.05). However, there were no significant differences in surgical time, intraoperative blood loss, postoperative hospital stay, postoperative anastomotic complications, or incidence of other complications between the two groups (all P>0.05). Conclusion:Robotic NOSES surgery is a safe and feasible procedure for resecting rectal cancer and postoperative recovery is faster after robotic NOSES than after standard robot-assisted surgery.

Robotic natural orifice specimen extraction surgery for right colon cancer has been conducted with progressive refinements. To facilitate the standardized implementation of this surgical technique, the adoption of rigorous quality control measures is paramount. The present article outlines the key aspects of quality control for robotic natural orifice specimen extraction right hemicolectomy surgery, encompassing the preoperative, intraoperative, and postoperative phases, as well as the training and credentialing requirements for the operating surgeons, with the aim of providing a reference framework to facilitate the safe and reliable implementation and dissemination of this minimally invasive approach for right colon cancer.

Objective:To compare the surgical outcomes of robotic natural orifice specimen extraction surgery (NOSES) and robotic-assisted radical resection for rectal cancer.Methods:A retrospective analysis using propensity score matching (PSM) was conducted on 547 patients who had undergone radical resection of rectal cancer at the First Affiliated Hospital of Nanchang University from June 2018 to March 2024. The study cohort comprised 157 patients in the robotic NOSES group and 390 in the robotic-assisted group. PSM was used in a 1:1 manner to match relevant general clinical preoperative data of the study patients (age, sex, body mass index, preoperative comorbidities, abnormal preoperative carcinoembryonic antigen (>6.5 μg/L) and carbohydrate antigen 19-9 levels (>27 kU/L), preoperative American Society of Anesthesiologists score, tumor diameter, tumor distance from the anal margin, and TNM stage), with a clamp value of 0.05. After performing PSM to match the general clinical data of the two groups of patients, 77 patients in each of the robotic NOSES and robotic-assisted groups were included in the analysis. We found no statistically significant difference in preoperative general clinical data between the robot NOSES and robot-assisted groups ( P>0.05). We compared the surgical outcomes, postoperative recovery, postoperative pathological data, and incidence of complications between the robotic NOSES and robot-assisted groups. Results:Compared with the robot-assisted groups. the robot NOSES group had a significantly shorter time to first postoperative passage of flatus (48 [38, 50] hours vs. 56 [50, 60] hours, Z=-7.513, P<0.001), time to taking a liquid diet (60 [54,63] hours vs. 66 [62, 72] hours, Z=-6.303, P<0.001), lower pain scores (3 [3, 4] vs. 4 [4, 5], Z=-5.237, P<0.001), and lower incision infection rates (0 vs. 5 [6.5%], χ 2=5.237, P=0.028) within 24 hours after surgery ( P<0.05). However, there were no significant differences in surgical time, intraoperative blood loss, postoperative hospital stay, postoperative anastomotic complications, or incidence of other complications between the two groups (all P>0.05). Conclusion:Robotic NOSES surgery is a safe and feasible procedure for resecting rectal cancer and postoperative recovery is faster after robotic NOSES than after standard robot-assisted surgery.

OBJECTIVE To investigate the role of glyceraldehyde-3-phosphate dehydrogenase(GAPDH)in regulating ferroptosis,malignant biological behavior,and cisplatin resistance in laryngeal squamous cell carcinoma(LSCC)under hypoxic conditions.METHODS Human laryngeal cancer Hep-2 and TU212 cell lines were cultured in vitro under hypoxic(1%O2)and normoxic(21%O2)conditions without serum.Hep-2 cells were divided into five experimental groups:DMSO control group,Erastin treatment group,Hypoxia+Erastin group,Hypoxia+Erastin+NC-GAPDH group,and Hypoxia+Erastin+Silenced GAPDH group,to study the cellular response under various experimental conditions.Quantitative polymerase chain reaction(qPCR)and Western blot(WB)techniques were employed to analyze GAPDH mRNA and protein expression levels in each cell line.Cell Counting Kit-8(CCK-8),colony formation,and Transwell invasion assays were used to assess the vitality,proliferation,and invasion capabilities of each group of laryngeal cancer cells.Additionally,CCK-8 assays were used to determine cell resistance to various concentrations of cisplatin(5,15,20 μg/ml).Kit methods were used to evaluate intracellular malondialdehyde(MDA)and glutathione(GSH)levels.WB was employed to detect the expression levels of glutathione peroxidase 4(GPX4)and 4-hydroxynonenal(4-HNE)proteins.Fe2+probes and reactive oxygen species(ROS)fluorescence probes were used to measure intracellular Fe2+content and ROS levels.Transmission electron microscopy was utilized to observe mitochondrial morphology changes to assess ferroptosis occurrence.RESULTS Compared to normoxic conditions,hypoxia significantly increased the expression of GAPDH mRNA and protein in Hep-2 and Tu212 cells(P<0.05).Under hypoxic conditions,the number of cell colonies,migration capacity,and cell viability at 15 and 20 μg/ml cisplatin treatment were significantly higher than those under normoxic conditions(P<0.05).When GAPDH was silenced,these hypoxia-induced enhancements were reversed.Under normoxic conditions,compared to the DMSO control group,Erastin treatment significantly reduced the number of colonies,migration capacity,and cell viability at 15 and 20 μg/ml cisplatin treatment(P<0.05).However,under hypoxic conditions,the inhibitory effect of Erastin was weakened.Additionally,in the hypoxia+Erastin+si-GAPDH group,the number of colonies,migration capacity,and cell viability at 15 and 20 μg/ml cisplatin treatment were significantly lower than those in the hypoxia+Erastin+NC-GAPDH group(P<0.05).CONCLUSION This study reveals that silencing GAPDH under hypoxic conditions can reverse the inhibition of ferroptosis in LSCC cells,thereby suppressing their malignant biological behavior and cisplatin resistance.

Objective To explore the correlation between hyponatremia at admission and all-cause mortality within one year after discharge in elderly patients with intestinal obstruction.Methods The 331 cases of elderly patients with intestinal obstruction(aged ≥ 60 years)who visited the General Surgery Department of Nanjing Meishan Hospital from January 2017 to December 2020 were selected as the research objects for retrospective cohort study analysis.According to the patient's blood sodium level at admission,they are divided into two groups:the hyponatremia group(Na＜135 mmol/L)and the non hyponatremia group(Na≥135 mmol/L).Divided into death group and survival group based on whether death occurred within one year after discharge.SPSS 25.0 software was used for statistical analysis.Independent sample t test,x2 test,Kaplan Meier method,and multivariate Cox regression analysis were used to observe the correlation between admission hyponatremia and all-cause mortality within one year after discharge in elderly patients with intestinal obstruction.Results A total of 331 patients were enrolled.The incidence of hyponatremia was 32.3％,and 56 deaths occurred within one year,accounting for 16.92％.The one-year mortality rate in the hyponatremia group was 23.4％(25/107),which was higher than 13.8％(31/224)in the non hyponatremia group.The difference was statistically significant(P＜0.05).The survival analysis(Kaplan Meier)results showed that the survival rate of the hyponatremia group was lower than that of the non hyponatremia group(Log Rank P＜0.05).After adjusting for other confounding factors in multivariate Cox regression analysis,hyponatremia(HR=1.88,95％CI:1.07-3.29)was an independent risk factor for one-year all-cause mortality in elderly patients with intestinal obstruction(P＜0.05).Conclusion Hyponatremia at admission is an independent risk factor for all cause mortality in elderly patients with intestinal obstruction within one year after discharge.

Standardized reporting is a crucial factor affecting the use of patient guidelines （PGs）， particularly in the reporting and presentation of recommendations. This paper introduced the current status of PG reporting， including the research on PG content and presentation formats， and provided comprehensive recommendations for PG reporting from aspects such as overall framework， recommendations， presentation format， and readability. First， the presentation of PG recommendations should include clearly defined clinical questions， recommendations and their rationale， and guidance on how patients should implement the interventions； for specific content in the PG， such as level of evidence， level of recommendation， it is recommended to explain in text the reasons for giving different levels of recommendation， i.e.， to present the logic behind giving the level of recommendation to the patient； additional information needed in the recommendation framework should be supplemented by tracing references or authoritative textbooks and literature that support the recommendations. Subsequently， the PG text should be written based on the Reporting Checklist for Public Versions of Guidelines （RIGHT-PVG） reporting framework. Finally， to enhance readability and comprehension， it is recommended to refer to the Patient Education Materials Assessment Tool （PEMAT） for translating PG content. To enhance the readability of PGs， it is suggested to present the PG content in a persona-lized and layered manner.