Objective To explore the factors influencing the occurrence of sarcopenia following esophageal cancer surgery and to as-sess the association between skeletal muscle fat infiltration and postoperative sarcopenia.Methods The retrospective study analyzed clin-ical data from patients who underwent radical esophagectomy in the Department of Thoracic Surgery at the Second Hospital of Lanzhou Uni-versity between January 2020 and December 2022.Based on whether the postoperative loss of skeletal muscle area exceeded 10％,pa-tients were categorized into a sarcopenia group(n=50)and a non-sarcopenia group(n=69).General clinical information,periopera-tive data,and imaging findings were collected.Statistical analyses were performed using R version 3.1.4,and cutoff values were deter-mined by receiver operating characteristic(ROC)curve analysis.Results There were statistically significant differences between the sar-copenia and non-sarcopenia groups in terms of postoperative chemotherapy,lymphocyte count,skeletal muscle area,skeletal muscle in-dex,prognostic nutritional index,and intramuscular fat content(P＜0.05).At the level of the third lumbar vertebra,intramuscular fat content was significantly correlated with the rate of postoperative skeletal muscle loss(r=0.21,P＜0.05),but showed no correlation with the preoperative skeletal muscle area(r=-0.07,P=0.45).Multivariate Logistic regression analysis revealed that preoperative in-tramuscular fat content,skeletal muscle index,and postoperative chemotherapy were independent predictors of postoperative sarcopenia.ROC curve analysis indicated that a cutoff value of-0.647 for preoperative intramuscular fat content at the third lumbar vertebra provided the optimal predictive efficacy for postoperative sarcopenia in esophageal cancer patients[area under the curve(AUC)=0.630,sensitivi-ty=80.00％,specificity=47.80％].Conclusions The degree of skeletal muscle fat infiltration at the L3 level is significantly associat-ed with the development of postoperative sarcopenia in patients with esophageal cancer.Early nutritional support and rehabilitation training in patients with high fat infiltration may help prevent the occurrence of postoperative sarcopenia.

Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.

Objective To explore the factors influencing the occurrence of sarcopenia following esophageal cancer surgery and to as-sess the association between skeletal muscle fat infiltration and postoperative sarcopenia.Methods The retrospective study analyzed clin-ical data from patients who underwent radical esophagectomy in the Department of Thoracic Surgery at the Second Hospital of Lanzhou Uni-versity between January 2020 and December 2022.Based on whether the postoperative loss of skeletal muscle area exceeded 10％,pa-tients were categorized into a sarcopenia group(n=50)and a non-sarcopenia group(n=69).General clinical information,periopera-tive data,and imaging findings were collected.Statistical analyses were performed using R version 3.1.4,and cutoff values were deter-mined by receiver operating characteristic(ROC)curve analysis.Results There were statistically significant differences between the sar-copenia and non-sarcopenia groups in terms of postoperative chemotherapy,lymphocyte count,skeletal muscle area,skeletal muscle in-dex,prognostic nutritional index,and intramuscular fat content(P＜0.05).At the level of the third lumbar vertebra,intramuscular fat content was significantly correlated with the rate of postoperative skeletal muscle loss(r=0.21,P＜0.05),but showed no correlation with the preoperative skeletal muscle area(r=-0.07,P=0.45).Multivariate Logistic regression analysis revealed that preoperative in-tramuscular fat content,skeletal muscle index,and postoperative chemotherapy were independent predictors of postoperative sarcopenia.ROC curve analysis indicated that a cutoff value of-0.647 for preoperative intramuscular fat content at the third lumbar vertebra provided the optimal predictive efficacy for postoperative sarcopenia in esophageal cancer patients[area under the curve(AUC)=0.630,sensitivi-ty=80.00％,specificity=47.80％].Conclusions The degree of skeletal muscle fat infiltration at the L3 level is significantly associat-ed with the development of postoperative sarcopenia in patients with esophageal cancer.Early nutritional support and rehabilitation training in patients with high fat infiltration may help prevent the occurrence of postoperative sarcopenia.

Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.

In January 2021, an acute chemical poisoning incident occurred at a fluorine polymerization plant. Through the analysis of the occupational health situation of the enterprise, combined with the clinical manifestations of the poisoned patients and the laboratory examination results, it was determined that the incident was an acute poisoning incident caused by the inhalation of organic fluorine mixed gas in the fluorine polymerization plant. Subsequently, it was clarified that the accident was caused by the illegal operation of the employees of the fluorine polymerization plant, which caused the discharge of the organic fluorine mixed gas containing high concentration of octafluoroisobutene, resulting in the poisoning of the on-site construction personnel. In order to avoid the occurrence of similar incidents, enterprises should implement the main responsibility of safety production, regularly organize supervision and inspection, eliminate illegal operations, conduct safety education and training for the staff of the unit and outsourced staff, and improve the emergency rescue ability of sudden poisoning incidents.

In January 2021, an acute chemical poisoning incident occurred at a fluorine polymerization plant. Through the analysis of the occupational health situation of the enterprise, combined with the clinical manifestations of the poisoned patients and the laboratory examination results, it was determined that the incident was an acute poisoning incident caused by the inhalation of organic fluorine mixed gas in the fluorine polymerization plant. Subsequently, it was clarified that the accident was caused by the illegal operation of the employees of the fluorine polymerization plant, which caused the discharge of the organic fluorine mixed gas containing high concentration of octafluoroisobutene, resulting in the poisoning of the on-site construction personnel. In order to avoid the occurrence of similar incidents, enterprises should implement the main responsibility of safety production, regularly organize supervision and inspection, eliminate illegal operations, conduct safety education and training for the staff of the unit and outsourced staff, and improve the emergency rescue ability of sudden poisoning incidents.

Chronic atrophic gastritis (CAG) and gastric intestinal metaplasia (GIM) significantly increase the risk of gastric cancer. Blocking the development of CAG and GIM would help to decrease the incidence of gastric cancer. It was revealed that eradication of Helicobacter pylori could reverse gastric mucosa atrophy. Recent studies reported that GIM could be reversed to a certain extent. Clinical studies demonstrated that Lamb′s tripe extract and vitamin B12 capsule exhibited significant reversal effects on GIM. The present study systemically reviewed the diagnosis and treatment of CAG and clinical application of Lamb′s tripe extract and vitamin B12 capsule, and established the specialist instruction that would guide the reversal treatment of CAG and GIM.

Chronic atrophic gastritis (CAG) and gastric intestinal metaplasia (GIM) significantly increase the risk of gastric cancer. Blocking the development of CAG and GIM would help to decrease the incidence of gastric cancer. It was revealed that eradication of Helicobacter pylori could reverse gastric mucosa atrophy. Recent studies reported that GIM could also be reversed to a certain extent. Clinical studies demonstrated that Lamb’s tripe extract and vitamin B12 capsule exhibited significant reversal effect on GIM. The present study systemically reviewed the diagnosis and treatment of CAG and clinical application of Lamb’s tripe extract and vitamin B12 capsule, and established the specialist instruction that would guide the reversal treatment of CAG and GIM.

Objective:To evaluate the feasibility and efficacy of 68Ga-PSMA PET/CT-guided targeted prostate biopsy for the diagnosis of clinically significant prostate cancer(csPCa). Methods:This retrospective analysis allocated 89 patients with elevated PSA levels between 4.0-20.0 ng/ml to PET group(n=48) or TRUS group(n=41) between September 2017 and June 2019. Patients with PSMA-avid lesions (SUV max≥8.0) underwent PET-TB via a single-puncture percutaneous transgluteal approach (n=19), while patients with negative PSMA-PET underwent systematic TRUS-GB (n=29). Patients in the TRUS group who did not get 68Ga-PSMA PET/CT examination underwent TRUS-GB directly (n=41). The mean age, prostate volume, PSA value of PET group and TURS group were (71.2±9.1) years vs. (68.0±12.0) years, (62.9±29.1)ml vs. (65.4±38.9)ml , 8.8(6.6, 13.6) ng/ml vs. 9.8(7.1, 13.1)ng/ml, respectively (all P>0.05). The diagnostic efficacy and difference of PCa and csPCa between the two groups were compared. PET-TB adopts a new mode of percutaneous gluteus approach and carries out precise image fusion of PSMA-PET/CT and pelvic CT in the same machine and in the same position (prone position). Under the direct guidance of CT, the biopsy is performed with only one precise puncture. Results:PCa and csPCa were detected in 27/89(30.3%)and 20/89(22.5%)in all patients. PET group detected significantly more cases of PCa and csPCa than those of TRUS group [PCa: 41.7%(20/48) vs. 17.1%(7/41), χ2=6.328; csPCa: 33.3%(16/48) vs. 9.8%(4/41), χ2=7.055, P<0.01]. Of 19 patients with PSMA-PET positive, PET-TB detected 16 cases of PCa(84.2%) by a single needle puncture, and the proportions of cancer tissues were ≥80% in 2, 50%-79% in 8, and <50% in 6 cases. Among these, Gleason score was underestimated by biopsy histopathology in 2 patients. Of 3 patients with PET-TB negative, 1 case of low-risk PCa(Gleason 3+ 3) was detected by complementary TRUS-GB. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy of 68Ga-PSMA PET/CT(SUV max≥8.0) for the diagnosis of csPCa were 73.9%(14/19), 93.1%(27/29), 87.5%(14/16), 81.3%(26/32)and 85.4%(41/48), respectively. For PET-TB, only one patient had slight symptoms of haematuria after the puncture, no cases of hematochezia, hemospermia, urinary retention or pelvic infection were observed. Conclusions:68Ga-PSMA PET/CT is a feasible novel puncture technique that may serve as a triage tool for prostate biopsy, and PET-TB may improve the detection rate of csPCa compared with TURS-GB, especially in patients with serum PSA 4.0-20.0 ng/ml.

Objective: To investigate the feasibility and dosimetric characteristics of using dual-arc volumetric modulated arc therapy and multiple partial-arc VMAT for T3 lung cancer. Methods: From June 2016 to May 2018, thirteen lung cancer patients with large planning target volume were replanned with dual full arcs VMAT(F-VMAT) and six partial-arc s VMAT(P-VMAT)on RayStation v4.5 RayArc function.PTV volume median was 550.9cm³(ranged 402.2-834.8cm³) and to a prescribed dose of 60 Gy in 30 fractions.Equivalent target coverage was required for all plans, and clinical goals were evaluated using various dose-volume metrics.These included PTV dose conformity, mean lung/heart dose, lung V₅, V₁₀, V₂₀, V₃₀, heart V₃₀ and V₄₀, and Dmax of spinal canal.The total monitor units (MUs) were also examined. Results: All VMAT plans satisfied the treatment criteria.F-VMAT achieved better homogeneity index(HI) and MUs than P-VMRT(t=-3.904, P=0.002), and the conformal number(CN) of tumor volumes was likely clinically indistinguishable.However, F-VMAT significantly reduced lung V₅, V₁₀ and mean lung dose[V5: (51.31±5.36)% vs.(43.44±5.28)%, t=6.908, P=0.00; V10: (38.34±3.26)% vs.(34.05±3.74)%, t=4.632, P=0.001; Dmean: (1 449±117.19)cGy vs.(1 375.38±148.98)cGy, t=4.93, P=0.00], and heart dosimetric parameters were also observed in favor of P-VMRT[V₃₀: (20.6±10.4)% vs.(16.4±8.9)%, t=3.822, P=0.02; V₄₀: (14.6±7.5)% vs.(11.88±7.1)%, t=3.096, P=0.009; Dmean: (1 442.9±651.2)cGy vs.(1 263.5±605.6)cGy, t=3.986, P=0.02], and there were no statistically significant differences in lung V₂₀, V₃₀ and spinal cord Dmax between the two groups(all P>0.05). Conclusion VMAT is an effective treatment for stage T3 lung cancer patients.The primary advantage of P-VMAT was the reduction in low dose area and decreased risk of symptomatic radioactive lung injury.It may be a priority for pulmonary malignancy patients with the large planning target volume.