Esophageal cancer is a prevalent malignant tumor of the digestive tract in China, and radical surgery remains the cornerstone of its comprehensive treatment. However, multifactorial challenges such as postoperative gastrointestinal tract reconstruction, traumatic stress, and tumor-related metabolic disturbances render esophageal cancer patients highly susceptible to malnutrition. Perioperative nutritional support therapy plays a crucial role in enhancing surgical safety, improving clinical outcomes, and elevating patients' quality of life by regulating metabolic homeostasis, preserving organ function, and optimizing the immune microenvironment. This article reviews the mechanisms underlying malnutrition in esophageal cancer, methods for nutritional status assessment, and precision intervention pathways based on multi-omics evaluations. The aim is to strengthen clinicians' awareness of standardized perioperative nutritional management for esophageal cancer patients and promote its clinical implementation, thereby facilitating postoperative recovery and improving long-term quality of life.

Hepatocellular carcinoma (HCC) imposes a major health and economic burden worldwide, with disproportionate effects in low- and middle-income countries (LMICs). Surveillance in high-risk populations, typically using semiannual ultrasound and alpha-fetoprotein testing, has been shown to be cost-effective by enabling earlier detection and improving survival. Yet, its overall value is reduced by poor adherence and the limited sensitivity of ultrasound, particularly in patients with metabolic-associated steatotic liver disease. Emerging approaches—including abbreviated magnetic resonance imaging, multi-biomarker models (e.g., gender, age, AFP, AFP-L3, and DCP), and liquid biopsy assays such as methylated DNA markers—demonstrate greater diagnostic accuracy and potential economic advantages compared with conventional methods. Integration of artificial intelligence into imaging may further enhance efficiency and reduce downstream costs. Moving toward precision surveillance, guided by individualized risk stratification that incorporates etiology, fibrosis stage, and molecular profiles, can optimize allocation of resources and maximize cost-effectiveness at the population level. Interventions to improve adherence, including mailed outreach and behavioral economic incentives, have shown both clinical benefit and cost savings, underscoring the role of implementation science. Because socioeconomic disparities influence both access and outcomes, economic models must explicitly address equity to achieve sustainable impact. Future research should prioritize prospective trials that evaluate not only clinical performance but also the real-world cost-effectiveness of novel technologies and stratified surveillance strategies. For LMICs, adapting proven models into affordable, context-appropriate programs is essential. By combining prevention, precision risk assessment, innovative technologies, and equitable implementation, HCC surveillance can deliver both clinical and economic value, reducing the global burden of disease.

Objective To gain insights into the biological characteristics of different populations of Culex tritaeniorhynchus within and around the Yellow Sea wetland from the perspective of the occurrence of resistance, we investigated the levels of resistance to deltamethrin and kdr gene mutation in the wetland and its peripheral areas. Methods Specimens were collected from Cx. tritaeniorhynchus populations at two monitoring sites in the Rare Bird National Nature Reserve and Tiaozi Ni Wetland Scenic Area, and also from two populations in Yancheng City and the Liuhe District of Nanjing, and the resistance of these mosquitoes to deltamethrin was determined using the CDC biotest bottle method. For each concentration of deltamethrin assessed, a random subset of exposed specimens was selected for amplification of the kdr gene fragment, followed by Sanger sequencing to identify and analyze resistance-associated mutations. Results The LC50 levels of deltamethrin among mosquitoes from the four populations in Luhe, Yancheng, the Rare Bird National Nature Reserve and the Tiaozi Ni Wetland Scenic Area were 2.048 5, 7.798 2, 3.473 3, and 17.695 5 mg/mL, respectively, with corresponding concentrations of deltamethrin ranging from 0.005 to 5.000,0.050 to 50.000,0.050 to 25.000 and 0.050 to 50.000 mg/mL, respectively. Furthermore, the ranges of the KT50 values were 11.76-107.43, 67.05-216.30,29.77-107.43 and 28.40-329.51 min; the 1-h knockdown rates were 34.58%-99.15%, 9.52%-43.80%, 55.09%-73.01%, and 10.09%-68.07%; and the 24-h mortality rates were 12.15%-67.52%,9.52%-79.56%,13.17%-82.21%, and 11.01%-78.99%, respectively. With respect to kdr gene mutation, we assayed a total of 63,70,59, and 57 mosquitoes for the four populations, for which we detected L1014F mutation frequencies of 14.29%, 35.00%, 20.34%, and 31.58%, respectively, with a majority of these mutations being heterozygous for resistance. In addition, five adult mosquitoes were identified has having synonymous mutations at site 1011[i. e. , AAT(asparagine)mutation to AAC(asparagine)]. Conclusions Our findings revealed the clear resistance of Cx. tritaeniorhynchus to deltamethrin in the Yancheng region of the Yellow Sea wetland, and the resistance phenotype and kdr frequency of Cx. tritaeniorhynchus in the wetland environment were comparable to those of Cx. tritaeniorhynchus in the wetland environment, thereby indicating that the resistance of different populations of Cx. tritaeniorhynchus was homogeneous under the pressure of different insecticide selection within and around the wetland. However, the underlying mechanisms need to be further studied.

Objective:To investigate the influencing factors and prognosis of early recurrence after gastrectomy for gastric cancer.Methods:The retrospective cohort study was conducted. The clinicopathological data of 2 078 patients who underwent gastrectomy for gastric cancer at six medical centers across China, including Fudan University Shanghai Cancer Center et al, between January 2012 and June 2023 were collected. There were 1 449 males and 629 females, aged (59±11) years. Patients were classified as early recurrence and late recurrence based on the time of post-operative recurrence. Observation indicators: (1) comparison of clinicopathological characteristics between gastric cancer patients with different recurrence types; (2) recurrence and metastasis of tumor; (3) survival of patients after postoperative recurrence of gastric cancer; (4) analysis of influencing factors for early recurrence after gastrectomy for gastric cancer. Comparison of measurement data with normal distribution between groups was conducted using the independent sample t test. Comparison of measurement data with skewed distribution between groups was conducted using the Mann-Whitney U test. Comparison of count data between groups was conducted using the chi-square test. Comparison of ordinal data between groups was conducted using the rank sum test. Multivariate analysis was conducted using the Logistic regression model. Kaplan-Meier method was used to calculate survival rate and plot survival curve, and Log-rank test was used for survival analysis. Results:(1) Comparison of clinicopathological characteristics between gastric cancer patients with different recurrence types. Among the 2 078 patients, 1 452 cases had early recurrence and 626 cases had late recurrence. There were significant differences in preoperative carcinoembryonic antigen, preoperative CA19-9, preoperative CA72-4, preoperative albumin, tumor diameter, neoadjuvant therapy, R 0 resection, combined organ resection, scope of gastric resection, nerve and vessel infiltration, degree of tumor differentiation, pathological N staging, pathological TNM staging between early and late recurrence patients ( P<0.05). (2) Recurrence and metastasis of tumor. Among the 2 078 patients, 200 cases had local recurrence, 1 213 cases had hematogenous metastases, 392 cases had distant lymph node metastases, and 731 cases had peritoneal metastases. Among the 1 452 early recurrence patients, 142 cases had local recurrence, 834 cases had hematogenous metastases, 289 cases had distant lymph node metastases, and 507 cases had peritoneal metastases. Among the 626 late recurrence patients, 58 cases had local recurrence, 379 cases had hematogenous metastases, 103 cases had distant lymph node metastases, and 224 cases had peritoneal metastases. One patient may have multiple forms of recurrence and metastasis. There was no significant difference in the above indica-tors between early and late recurrence patients ( χ2=0.13, 1.74, 3.40, 0.14, P>0.05). (3) Survival of patients after postoperative recurrence of gastric cancer. All 2 078 patients were followed up until death after recurrence, with a follow-up time of 31(range, 9?147)months. The 1-, 2-, 3-, and 5-year overall survival rates after recurrence were 33.5%, 17.2%, 10.1%, and 3.3% in early recurrence patients, versus 44.2%, 21.6%, 12.8%, and 5.8% in late recurrence patients, respectively, showing a significant difference in overall survival after recurrence between the two groups ( hazard ratio=0.84, 95% confidence interval as 0.76?0.92, P<0.05). (4) Analysis of influencing factors for early recurrence after gastrectomy for gastric cancer. Results of multivariate analysis showed that combined organ resection, total gastrectomy, pathological TNM staging as stage Ⅲ were independent risk factors for early recurrence after gastrectomy for gastric cancer ( odds ratio=1.31, 1.32, 1.34, 95% confidence interval as 1.01?1.70, 1.06?1.65, 1.05?1.71, P<0.05) and normal preoperative tumor markers, neoadjuvant therapy, R 0 resection were independent protective factors for early recurrence ( odds ratio=0.61, 0.50, 0.38, 95% confidence interval as 0.49?0.76, 0.35?0.72, 0.25?0.58, P<0.05). Conclusions:Compared with patients with late recurrence after gastric cancer surgery, patients with early recurrence have a poor prognosis, in which liver metastases is more common. Combine organ resection, total gastrectomy, pathological TNM staging as stage Ⅲ are independent risk factors for early recurrence, and normal preoperative tumor markers, neoadjuvant therapy, R 0 resection are independent protective factors for early recurrence after gastrectomy for gastric cancer.

BACKGROUND:Studies have shown that different durations of pressure application on normal muscles can produce varying physiological responses.OBJECTIVE:To explore the expression levels of inflammatory factors tumor necrosis factor α and nuclear κB in skeletal muscle under different pressure durations.METHODS:Twenty healthy male SPF-grade Sprague-Dawley rats were randomly divided into four groups:control group,10-second pressure group,20-second pressure group,and 30-second pressure group.The right leg of each rat was used for the experiment.The control group received no intervention,while rats in each pressure group were anesthetized by intraperitoneal injection of 2%pentobarbital sodium(35 mg/kg),and the thin femoral muscle of the rats was pressed continuously at a constant pressure of 200 kPa using a homemade mechanical pressure device for 10,20,and 30 seconds,respectively.Muscle tissue at the pressing site of the right hind limb was collected immediately after pressure.Hematoxylin-eosin staining was used to observe the morphological changes of skeletal muscle tissues and changes in the cross-sectional area of muscle fibers,and immunohistochemistry was used to detect the expression levels of tumor necrosis factor α and nuclear factor κB in rat skeletal muscle.RESULTS AND CONCLUSION:Hematoxylin-eosin staining results revealed that the pressure groups showed loosely arranged skeletal muscle fibers,reduced cross-sectional area and diameter,and enlarged intermuscular spaces.Compared with the control group,the cross-sectional area of muscle fibers was significantly reduced in the pressure groups(P<0.05),but there was no significant difference between the three pressure groups(P>0.05).The 10-second pressure group showed no significant presence of red blood cells in the interstitial spaces,while the 20-second pressure group exhibited a small amount of red blood cells,and the 30-second pressure group showed capillary dilation with red blood cells in the interstitial spaces.The expression level of tumor necrosis factor α in the 30-second pressure group was significantly higher than that in the control group(P<0.05).The expression level of nuclear factor κB in skeletal muscle showed no significant difference among groups(P>0.05).To conclude,skeletal muscle undergoes morphological changes and reduced cross-sectional area after pressure at 200 kPa,but there is no significant difference among the 10-,20-,and 30-second pressure groups.As the duration of pressure increases to 30 seconds,the inflammatory factor tumor necrosis factor α is activated,but nuclear factor κB remains unaffected,suggesting that inflammatory factors may express under short-term pressure,while transcription factors show no significant change.

Objective:To investigate the method and clinical efficacy of simultaneous correction of sunken upper eyelid during double eyelid plasty.Methods:A retrospective analysis was conducted on patients with single eyelids and sunken upper eyelid treated at the Department of Plastic Surgery, the First People’s Hospital of Zhengzhou, from October 2022 to February 2024. All patients underwent incisional double eyelid plasty with individualized correction based on depression severity. For mild depression, a combination of pretarsal orbicularis oculi muscle flap folding and orbital septum fat flap transposition was performed for correction. For moderate depression, additional autologous stromal vascular fraction (SVF)-gel grafting would be performed if residual depression persisted after the aforementioned approach. For severe depression, if the orbital fat was sufficient, the orbicularis oculi muscle flap folding, orbital fat flap repositioning and autologous SVF-gel transplantation were used. If there was insufficient orbital fat, the correction involved the use of a orbicularis oculi muscle flap and SVF-gel transplantation. Postoperative follow-up was conducted regularly, and related complications were statistically analyzed. Six months after the surgery, two blinded plastic surgeons evaluated outcomes via visual analog scale (VAS), including five aspects: symmetry of palpebral folds(including width and curvature of the double eyelid fold), fold contour, depression improvement, scar quality, overall eyelid aesthetics. Each aspect was rated on a scale from 1 to 10, with higher scores indicating better outcomes. Patient satisfaction was scored separately (1-5 per item), with higher scores indicating greater satisfaction.Results:A total of 64 patients were enrolled, including 4 males and 60 females; the age ranged from 19 to 66 years[ (32.0±9.7) years]. The degree of sunken upper eyelid was mild in 33 cases, moderate in 19 cases and severe in 12 cases. All patients underwent double eyelid plasty and orbicularis oculi flap folding. Based on this, 45 cases (33 mild and 12 moderate cases) underwent orbital septum fat flap transposition, 11 severe cases underwent SVF-gel grafting, and 8 cases (7 moderate and 1 severe cases) required combined approaches to correct depression. During the procedure, 19 cases (38 sides) received (1.8±0.8) ml of SVF-gel injection. Among these cases, one case with severe sunken upper eyelid who did not receive orbital fat transfer was injected with high density fat (left side: 0.6 ml, right side: 0.8 ml) due to insufficient SVF-gel volume. Two cases with severe sunken upper eyelid who only had autologous SVF-gel transplantation did not fully correct the depression within 3 months post-surgery received a second SVF-gel injection[(1.0±0.1) ml]. Follow-up was conducted for 6 to 12 months after surgery. All patients experienced varying degrees of eyelid edema, which typically lasted 2 to 3 months. Ecchymosis (34 sides), conjunctival congestion (3 sides), and temporary ptosis (5 sides) all resolved within 2 weeks. Pigmentation (14 sides) and scar hyperplasia (3 sides) disappeared or stabilized within 6 months. No patients developed complications such as incision infection, hematoma, fat liquefaction, local skin unevenness, or induration. The surgeons’ VAS scores of the above five indicators were all > 8 points, and the satisfaction scores of patients for the five indicators were all > 4 points. In both scoring, the improvement of sunken upper eyelid scored the highest, which were (9.2 ± 0.9) points and (4.8 ± 0.6) points respectively.Conclusion:For patients with single eyelids and varying degrees of sunken upper eyelid, performing double eyelid plasty and orbicularis oculi muscle flap folding, individualized correction is achieved through autologous fat redistribution techniques, based on the severity of the sunken upper eyelid and the amount of orbital fat. This single procedure can restore upper eyelid volume and rejuvenate the appearance, resulting in a natural and aesthetically pleasing double eyelid with minimal complications and high patient satisfaction.

Objective To investigate the effects and mechanisms of Huatan Quyu Decoction on learning and memory abilities in rats with vascular dementia(VD).Methods Totally 112 male SD rats were randomly selected with 16 rats as the sham-operation group,the remaining rats were used to prepare VD models by segmental ligation of the common carotid artery.The successfully modeled rats were randomly divided into model group,Huatan Quyu Decoction low-,medium-and high-dosage groups(6.1,12.1,24.2 g/kg),donepezil hydrochloride group(0.5 mg/kg)and combination group(Huatan Quyu Decoction 12.1 g/kg+donepezil hydrochloride 0.5 mg/kg),with 16 rats in each group.Each group was given the corresponding treatment measures for 4 weeks.The Morris water maze test was used to assess learning and memory abilities,neurological function was evaluated using Garcia score,HE staining was used to observe the morphology of the hippocampal tissue,ELISA was employed to detect the serum content of Aβ,immunohistochemistry was utilized to observe the β-catenin,LRP6 and GSK-3β protein expression in brain tissue.Results Compared with the sham-operation group,the escape latency of the model group rats was prolonged(P<0.01),the number of crossing platforms was reduced(P<0.01),and the neurological deficit score was decreased(P<0.01),the arrangement of hippocampal tissue cells was disorderly,and the tissue was severely damaged,the serum Aβ content increased(P<0.01),the expressions of β-catenin and LRP6 protein in brain tissue decreased,and the expression of GSK-3β protein increased(P<0.01).Compared with the model group,the escape latency of rats in each administration group was shortened,the number of crossing platforms increased,the neurological deficit score increased,the number of hippocampal cells was relatively more,the arrangement was more orderly,and the structure was relatively complete,the serum Aβ content decreased,the expressions of β-catenin and LRP6 proteins increased,and the expression of GSK-3β protein decreased.Among them,Huatan Quyu Decoction high-dosage group had a significantly better effect than Huatan Quyu Decoction low-and medium-dosage groups(P<0.01),and there was no statistical significance in various indicators compared with the donepezil hydrochloride group(P>0.05).Compared with the donepezil hydrochloride group,the combination group showed significant improvements in learning and memory abilities(P<0.01),the neurological deficit score significantly increased(P<0.01),the number of hippocampal cells significantly increased,arranged neatly,and structurally intact,the serum Aβ content significantly decreased(P<0.01),the expression of β-catenin and LRP6 proteins significantly increased,and the expression of GSK-3β protein significantly decreased(P<0.01).Conclusion Huatan Quyu Decoction can repair cognitive function in VD rats,improve learning and memory abilities,and alleviate VD symptoms by activating the Wnt/β-catenin signaling pathway to reduce serum Aβ content,decrease the apoptosis of nerve cells and alleviate the degree of pathological damage in hippocampal tissue.

BACKGROUND:Studies have shown that different durations of pressure application on normal muscles can produce varying physiological responses.OBJECTIVE:To explore the expression levels of inflammatory factors tumor necrosis factor α and nuclear κB in skeletal muscle under different pressure durations.METHODS:Twenty healthy male SPF-grade Sprague-Dawley rats were randomly divided into four groups:control group,10-second pressure group,20-second pressure group,and 30-second pressure group.The right leg of each rat was used for the experiment.The control group received no intervention,while rats in each pressure group were anesthetized by intraperitoneal injection of 2%pentobarbital sodium(35 mg/kg),and the thin femoral muscle of the rats was pressed continuously at a constant pressure of 200 kPa using a homemade mechanical pressure device for 10,20,and 30 seconds,respectively.Muscle tissue at the pressing site of the right hind limb was collected immediately after pressure.Hematoxylin-eosin staining was used to observe the morphological changes of skeletal muscle tissues and changes in the cross-sectional area of muscle fibers,and immunohistochemistry was used to detect the expression levels of tumor necrosis factor α and nuclear factor κB in rat skeletal muscle.RESULTS AND CONCLUSION:Hematoxylin-eosin staining results revealed that the pressure groups showed loosely arranged skeletal muscle fibers,reduced cross-sectional area and diameter,and enlarged intermuscular spaces.Compared with the control group,the cross-sectional area of muscle fibers was significantly reduced in the pressure groups(P<0.05),but there was no significant difference between the three pressure groups(P>0.05).The 10-second pressure group showed no significant presence of red blood cells in the interstitial spaces,while the 20-second pressure group exhibited a small amount of red blood cells,and the 30-second pressure group showed capillary dilation with red blood cells in the interstitial spaces.The expression level of tumor necrosis factor α in the 30-second pressure group was significantly higher than that in the control group(P<0.05).The expression level of nuclear factor κB in skeletal muscle showed no significant difference among groups(P>0.05).To conclude,skeletal muscle undergoes morphological changes and reduced cross-sectional area after pressure at 200 kPa,but there is no significant difference among the 10-,20-,and 30-second pressure groups.As the duration of pressure increases to 30 seconds,the inflammatory factor tumor necrosis factor α is activated,but nuclear factor κB remains unaffected,suggesting that inflammatory factors may express under short-term pressure,while transcription factors show no significant change.

Objective To evaluate the correlation of L4-5 multifidus muscle(MM)fat infiltration(FI)with lumbar range of motion(LROM)and quality of life in patients with degenerative spinal deformity(DSD).Methods Thirty patients with DSD were included.The Cobb angle,lumbar lordosis(LL),thoracic kyphosis(TK)and TK/LL were measured after the full-length spinal tablet was completed.Thirity-five healthy volunteers were included as the control group.The general conditions and history of underlying diseases were collected for both populations.FI of L4-5 MM was obtained by single-voxel MR spectroscopy(SV-MRS).The forward flexion,posterior extension,left/right lateral flexion LROM were measured.The lower back pain was assessed using visual analogue scale(VAS).The quality of life was assessed using Roland-Morris Disability Questionnaire(RDQ).Individual activity intensity was assessed using International Physical Activity Questionnaire(IPAQ).By comparing the difference in LROM,MM FI,RDQ scores between DSD group and control group,the correlation of RDQ scores in DSD group with MM FI,LROM,Cobb angle,LL,TK,and TK/LL were analyzed,respectively.Results The VAS score was higher in DSD group than that in control group(P＜0.05).In terms of consistency,the DSD group had good forward flexion and posterior extension reliability,strong convex lateral flexion reliability and general concave lateral flexion reliability.The control group had good reliability of forward flexion and posterior extension,while the left/right lateral flexion reliability was general.There was no statistically significant difference in IPAQ score between two groups and FI of the left/right MM in the control group(P＞0.05).Bilateral MM FI was negatively correlated with posterior extension in DSD group(r=-0.395),MM FI(convex side)was negatively correlated with VAS(r=-0.381),RDQ scores was negatively correlated with forward flexion and sagittal ROM,respectively(r=-0.441,-0.425),Cobb angle was positively correlated with posterior extension(r=0.372),TK was positively correlated with MM FI on the concave side(r=0.460)and negatively correlated with forward flexion and sagittal ROM(r=-0.406,-0.410),LL was positively correlated with FI on the concave side(r=0.412),TK/LL was negatively correlated with forward flexion,sagittal ROM and lateral flexion(convex side)(r=-0.424,-0.370,-0.576).Stepwise linear regression analysis indicated that the RDQ score=13.070-flexion×0.228+VAS×1.900.Conclusions Patients with DSD showed a decreased LROM,an increased MM FI and a decreased RDQ score.Clinically,the LROM and paravertebral muscle degeneration should be evaluated comprehensively in DSD.