Objective To compare the short-term outcomes of single-port video-assisted thoracoscopic(VATS)pulmonary surgery using a chest-wall-muscle-sparing incision versus a standard incision.Methods A total of 215 patients undergoing single-port video-assisted thoracoscopic lung surgery in the Department of Cardiothoracic Surgery,The First Hospital of Anhui University of Science&Technology from February 2024 to May 2025 were recruited in this clinical observation.Clinical data were retrospectively analyzed.The patients were divided into a chest wall muscle sparing incision group and a chest wall standard incision group.Short-term prognoses of the two groups were compared.Results A total of 180 patients was included:80 in the chest wall muscle sparing incision group and 100 in the chest wall standard incision group.The two groups had similar baseline characteristics,includ-ing body-mass index(23.86±3.70 vs.23.45±3.20 kg/m2;P>0.05).All procedures were completed successfully without perioperative mortality,conversion to thoracotomy,or extension of the incision.The standard incision group had 4 latissimus dorsi injuries and 5 patients with shoulder joint dysfunction on the 30th day after discharge,charac-terized by chest wall muscle tightness accompanied by chest pain and limited upper limb mobility(P<0.05).Although skin-to-skin incision time was slightly longer in the muscle-sparing group(P=0.06),pain scores at every assessed time point were significantly lower(P<0.05),and no patient developed shoulder dysfunction.No significant differences were observed in incisional fat-liquefaction rate,incision length,operative time,blood loss,or chest-tube duration(P>0.05).Conclusion The chest wall muscle sparing incision in single-port video-assisted thoracoscopic lung surgery not only preserves the latissimus dorsi and serratus anterior muscles,significantly reduces postoperative incision pain,and minimizes chest wall muscles and shoulder dysfunction,exhibiting clear minimally invasive advantages in single-port VATS lung surgery.

Objective To compare the short-term outcomes of single-port video-assisted thoracoscopic(VATS)pulmonary surgery using a chest-wall-muscle-sparing incision versus a standard incision.Methods A total of 215 patients undergoing single-port video-assisted thoracoscopic lung surgery in the Department of Cardiothoracic Surgery,The First Hospital of Anhui University of Science&Technology from February 2024 to May 2025 were recruited in this clinical observation.Clinical data were retrospectively analyzed.The patients were divided into a chest wall muscle sparing incision group and a chest wall standard incision group.Short-term prognoses of the two groups were compared.Results A total of 180 patients was included:80 in the chest wall muscle sparing incision group and 100 in the chest wall standard incision group.The two groups had similar baseline characteristics,includ-ing body-mass index(23.86±3.70 vs.23.45±3.20 kg/m2;P>0.05).All procedures were completed successfully without perioperative mortality,conversion to thoracotomy,or extension of the incision.The standard incision group had 4 latissimus dorsi injuries and 5 patients with shoulder joint dysfunction on the 30th day after discharge,charac-terized by chest wall muscle tightness accompanied by chest pain and limited upper limb mobility(P<0.05).Although skin-to-skin incision time was slightly longer in the muscle-sparing group(P=0.06),pain scores at every assessed time point were significantly lower(P<0.05),and no patient developed shoulder dysfunction.No significant differences were observed in incisional fat-liquefaction rate,incision length,operative time,blood loss,or chest-tube duration(P>0.05).Conclusion The chest wall muscle sparing incision in single-port video-assisted thoracoscopic lung surgery not only preserves the latissimus dorsi and serratus anterior muscles,significantly reduces postoperative incision pain,and minimizes chest wall muscles and shoulder dysfunction,exhibiting clear minimally invasive advantages in single-port VATS lung surgery.

Inflammatory bowel disease (IBD) is a complex condition resulting from environmental, microbial, immunologic, and genetic factors. With the advancement of Mendelian randomization research in IBD, we have gained new insights into the relationship between these factors and IBD. Many animal models of IBD have been developed using different methods, but few studies have attempted to model IBD by combining environmental factors and microbial factors. In this review, we examine how environmental factors and microbial factors affect the development and progression of IBD, and how they interact with each other and with the intestinal microbiota. We also summarize the current methods for creating animal models of IBD and compare their advantages and disadvantages. Based on the latest findings from Mendelian randomization studies on the role of environmental factors in IBD, we discuss which environmental and microbial factors could be used to construct a more realistic and reliable IBD experimental model. We propose that animal models of IBD should consider both environmental and microbial factors to better mimic human IBD pathogenesis and to reveal the underlying mechanisms of IBD at the immune and genetic levels.We highlight the importance of environmental and microbial factors in IBD pathogenesis and offer new perspectives and suggestions for improving experimental animal modeling. Our goal is to create a model that closely resembles the clinical picture of IBD.

Inflammatory bowel disease(IBD)is an immune-mediated inflammatory disorder with high heterogeneity.The safety of its treatment,particularly adverse reactions,is a crucial area that physicians need to focus on.Currently,the biologic agents and small molecule drugs for treating IBD,such as anti-tumor necrosis factor-α agents,anti-integrin agents,interleukin(IL)-12/IL-23-targeting biologic agents,Janus kinase(JAK)inhibitors,and sphingosine-1-phosphate(S1P)receptor modulators,can induce both acute and chronic adverse reactions.Chronic adverse reactions mainly manifest as opportunistic infections,malignancies in different organs,especially lymphomas,as well as adverse reactions in the cardiovascular and nervous systems.The adverse reactions caused by the above-mentioned drugs exhibit both homogeneity and heterogeneity.Employing artificial intelligence(AI)techniques to summarize the patterns of biologic agents and small molecule drugs in the treatment of IBD and constructing models to predict the adverse reactions in heterogeneous individuals might be an important technological approach to enhance the safety of biologic treatments for IBD.This article reviews the research progress on the adverse reactions of biologic agents and small molecule drugs in the treatment of IBD.

Inflammatory bowel disease(IBD)is an immune-mediated inflammatory disorder with high heterogeneity.The safety of its treatment,particularly adverse reactions,is a crucial area that physicians need to focus on.Currently,the biologic agents and small molecule drugs for treating IBD,such as anti-tumor necrosis factor-α agents,anti-integrin agents,interleukin(IL)-12/IL-23-targeting biologic agents,Janus kinase(JAK)inhibitors,and sphingosine-1-phosphate(S1P)receptor modulators,can induce both acute and chronic adverse reactions.Chronic adverse reactions mainly manifest as opportunistic infections,malignancies in different organs,especially lymphomas,as well as adverse reactions in the cardiovascular and nervous systems.The adverse reactions caused by the above-mentioned drugs exhibit both homogeneity and heterogeneity.Employing artificial intelligence(AI)techniques to summarize the patterns of biologic agents and small molecule drugs in the treatment of IBD and constructing models to predict the adverse reactions in heterogeneous individuals might be an important technological approach to enhance the safety of biologic treatments for IBD.This article reviews the research progress on the adverse reactions of biologic agents and small molecule drugs in the treatment of IBD.

Gastrointestinal tumors(GT)are characterized by both high malignancy and high mortality and have become the major diseases for prevention in the elderly.GT often present detectable changes, including bleeding and abnormal mucosal morphology.However, many technical difficulties remain in accurately monitoring the tumor itself and related abnormal lesions mentioned above, which are the key factors affecting the early detection rate of gastrointestinal tumors.In recent years, with progresses in artificial intelligence(AI)applications for digestive endoscopy image analysis, biosensors, new biomarkers and other areas, AI holds promise for the detection of bleeding, morphological and structural abnormalities of the mucosa, tumors and other major disorders.Here we review the progress of AI applications in geriatric digestive diseases affecting digestive organs and the mucosa in light of morphology and function, to provide a reference for reducing the incidence of both geriatric emergencies and GT.

Objective:To evaluate modified Lanza score (MLS) of gastric mucosa for predicting the prognosis of geriatric patients with sepsis.Methods:Data of 50 patients with sepsis, who were over 60 years old and underwent gastroscopy for suspected gastrointestinal bleeding in the Department of Geriatric Critical Care Medicine of Guangdong Provincial People's Hospital from January 2019 to April 2022, were retrospectively analyzed. Patients were divided into the death group ( n=32) and the survival group ( n=18) according to their regression within 28 days after gastroscopy. Their gastric mucosa was scored by using MLS system, and the mortality of patients with MLS≥1 was calculated, then the patients were further divided into 2 groups, MLS=0-2 ( n=23, less than 2 regions of lesions ) and MLS=3-5 ( n=27, two or more regions of lesions). The relationship between MLS and acute physiology and chronic health status evaluation (APACHE) Ⅱ score, risk factor of death and mortality in each group were compared. The correlation between MLS and mortality was analyzed. The influence of geriatric sepsis risk factors affecting the prognosis of patients within 28 days were analyzed by using logistic regression. Results:Among the 50 geriatric patients with sepsis, those with gastric mucosal lesions, i.e., MLS ≥1, accounted for 68.00% (34/50), including 84.38% (27/32) patients with MLS≥1 in the death group, which was significantly higher than the 38.89% (7/18) patients with MLS≥1 in the survival group ( χ 2=10.593, P<0.001). Patients with MLS=3-5 had significantly higher APACHE Ⅱ scores (26.09±6.47 VS 18.57±7.66, t=3.527, P=0.001) and higher mortality [85.19% (23/27) VS 39.13% (9/23), χ 2=11.434, P=0.001] compared with MLS=0-2. Correlation analysis showed a significant correlation between MLS and mortality ( r=0.886, P=0.019). Multivariate logistic regression analysis showed that MLS=4-5 was an independent risk factor for death in geriatric patients with sepsis ( OR=17.055, 95% CI: 1.387-209.744, P=0.027). Conclusion:MLS presents high sensitivity in predicting 28-day outcomes for geriatric patients with sepsis. Two or more than 2 regions of gastric mucosal lesions can significantly increase the risk of death in geriatric patients with sepsis.