Ulcerative colitis （UC） is a chronic and relapsing inflammatory disease of the intestine. Intestinal fibrosis represents a severe co mplication and a potential risk factor for malignant transformation. Gentianopsis paludosa is one of the traditional Tibetan medicines commonly used for treating gastrointestinal disorders such as damp-heat diarrhea and dysentery. Its chemical composition is complex， encompassing xanthones， flavonoids， terpenoids， and other bioactive components， and it exhibits properties such as clearing heat， eliminating dampness， and detoxifying. This article reviews the research progress on the pharmacodynamic material basis and mechanisms of G. paludosa against UC and associated fibrosis. Findings suggest that its extracts （e.g.， aqueous extract， ethyl acetate extract） and active constituents （e.g.， 1-hydroxy-3，7，8-trimethoxyxanthone， ursolic acid， swertiamarin， luteolin） may inhibit inflammatory cytokines， combat oxidative stress， suppress cell apoptosis， regulate intestinal microbiota and their metabolites， protect the intestinal mucosal barrier， modulate immune responses， and inhibit epithelial-mesenchymal transition， through modulating relevant signaling pathways， such as nuclear factor-kappa B， B-cell lymphoma-2 （Bcl-2）/Bcl-2-associated X protein， and transforming growth factor-β 1 /Smad， thus exerting therapeutic effects against UC and its related fibrosis via these seven aspects.

AIM:This study aims to investigate the effects of Jiedu-Shengji ointment(JDSJG)on wound healing in diabetic rats by modulating the protein kinase R-like endoplasmic reticulum kinase(PERK)/inositol-requiring enzyme 1(IRE1)/nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)pathway in the context of endoplasmic reticulum stress(ERS).METHODS:Male Sprague-Dawley rats were randomly assigned to four groups:control group,model group,detoxification muscle ointment group,and sulfadiazine silver cream group.All groups,except the control,were administered an intraperitoneal injection of 45 mg/kg streptozotocin to induce diabetes.The control and model groups received daily applications of normal saline,while the detoxification myogen ointment and sulfadiazine silver cream groups received their respective treatments daily.After dressing changes,wounds were bandaged with sterile gauze.Following 14 d of continuous treatment,wound healing was assessed and healing rates calculated.Histopathologi-cal changes in wound tissues were analyzed using HE staining.Transmission electron microscopy was utilized to observe the number,morphology,and swelling of endoplasmic reticulum in the wound tissues.The expression and distribution of PERK,IRE1 and thioredoxin interacting protein(TXNIP)was assessed by immunohistochemistry,while Western blot was used to measure the levels of apoptosis-associated speck-like protein containing a caspase recruitment domain(ASC),TXNIP and NLRP3.ELISA was conducted to quantify the inflammatory cytokines interleukin-18(IL-18)and IL-1β.RE-SULTS:After 14 d of intervention,significant differences were observed in wound tissue parameters across the groups.The model group exhibited a significantly lower wound healing rate compared to the control group(P<0.01),with in-creased wound exudation,poor granulation tissue growth,and elevated the protein levels of PERK,IRE1,TXNIP,CHOP,NLRP3 and ASC(P<0.01),as well as significantly higher levels of IL-1β and IL-18(P<0.01).In contrast,the detoxification muscle ointment group showed a marked improvement in wound healing rate(P<0.01),reduced inflamma-tory exudation,improved granulation tissue growth,and significant decreases in TXNIP expression(P<0.01),along with lower levels of PERK,IRE1,CHOP,ASC and NLRP3(P<0.01).Additionally,the IL-1β and IL-18 were significantly reduced(P<0.01).CONCLUSION:Jiedu Shengji ointment alleviates excessive ERS and mitigates chronic inflammato-ry responses,thereby promoting the healing of diabetic wounds.These effects may be attributed to the inhibition of exces-sive activation of the PERK/IRE1/NLRP3 pathway.

Objective To evaluate the efficacy and safety of obinutuzumab(OBZ)in the treatment of refractory primary membranous nephropathy(pMN).Methods The clinical data of 15 patients with refractory pMN who received OBZ treatment in Department of Nephrology of The First Affiliated Hospital of Naval Medical University between Jan.2022 and Sep.2024 were retrospectively analyzed,and they included basic information,relevant laboratory indexes,clinical and immunological outcomes,and adverse events.Results Among the 15 patients with refractory pMN,14(93.3％)were phospholipase A2 receptor(PLA2R)-associated membranous nephropathy(10 cases with positive PLA2R by renal biopsy and 4 cases with no recorded PLA2R results by renal biopsy but with positive serum PLA2R antibodies).During the follow-up period,all 15 patients achieved clinical remission,with 4(26.7％)patients achieving complete remission and 11(73.3％)patients achieving partial remission.Of the 12 patients with positive serum PLA2R antibodies,11 patients had continuously positive serum PLA2R antibodies before OBZ treatment,and 9(81.8％)patients achieved immunological remission after OBZ treatment.All the 15 patients had previously received immunosuppressive therapy,and all of them were classified as refractory pMN,with 7(46.7％)patients having been treated with cyclophosphamide combined with corticosteroids,2(13.3％)patients having been treated with calcineurin inhibitor combined with corticosteroids,11(73.3％)patients having received rituximab.During the treatment,2(13.3％)cases of adverse events were observed:1 patient experienced transient liver dysfunction,and the transaminase returned to normal after discontinuing atorvastatin;another patient developed a positive T-cell spot test for Tuberculosis infection during the intertreatment interval and successfully completed the subsequent OBZ treatment and achieved clinical remission after treatment with isoniazid and rifampicin.Conclusion OBZ demonstrates favorable clinical efficacy in the treatment of refractory pMN,with a low incidence of adverse events.

Background and Aims:Acute pancreatitis(AP)is an acute inflammatory disease of the pancreas caused by abnormal activation of pancreatic enzymes.Although gallstones,hyperlipidemia,and alcohol use are the most common causes,a subset of patients develop AP secondary to rare etiologies that are often misdiagnosed or diagnosed late,leading to recurrence or inappropriate management.This study aims to summarize the clinical characteristics,diagnostic strategies,and treatment outcomes of four cases of AP caused by uncommon etiologies,supported by a literature review.Methods:Clinical data of 4 patients admitted to the Department of Hepatobiliary and Pancreatic Surgery,the Third Xiangya Hospital of Central South University,between November 2021 and September 2024,were retrospectively analyzed.Their etiological characteristics,diagnostic approaches,and treatment strategies were reviewed in combination with relevant literature.Results:The underlying causes of AP were intraductal papillary mucinous neoplasm,pancreatic neuroendocrine tumor,pancreatic ductal adenocarcinoma,and duodenojejunal intussusception.All cases initially presented as idiopathic AP.Three patients underwent definitive surgical treatment and recovered well,while one patient with pancreatic cancer received only palliative care due to delayed diagnosis and died three months later.Conclusion:AP secondary to rare etiologies often mimics common forms in clinical presentation but poses diagnostic challenges.For patients with recurrent or idiopathic AP,clinicians should emphasize etiological tracing and utilize advanced imaging and endoscopic modalities for early identification.Timely etiological intervention,particularly surgical management when appropriate,is essential for preventing recurrence and improving prognosis.

Mass spectrometry(MS)is one of the core technology in the field of clinical laboratory,which has a series of advantages include high sensitivity,high specificity,and the simultaneous analysis of multi-components.It shows great potential in metabolite detection,proteomic analysis,etc.,which can provide new pathways for early diagnosis and personalized treatment of complex diseases.In recent years,the research of MS technique appears rapid development trend in the field of clinical laboratory.This paper systematically combed the application status and research progress of MS techniques in clinical laboratory,which include mass spectrometry imaging(MSI),matrix-assisted laser desorption/ionization time-of-flight mass spectrometry(MALDI-TOF MS),inductively coupled plasma mass spectrometry(ICP-MS),cytometry by time-of-flight(CyTOF),and liquid chromatography-tandem mass spectrometry(LC-MS/MS).It focused on their practical applications in disease diagnosis,efficacy assessment,and prognosis judgment,and it anatomized the faced bottlenecks and problems of current technique.Based on the frontline technological trends,it explore the innovative directions of integrating MS technique with emerging bioinformatics,microfluidics,etc.,so as to provide theoretical basis and practical reference for promoting the standardized and intelligent development of MS technique in clinical laboratory,and help its wide application in clinical diagnosis and treatment.

Objective:To investigate the clinical efficacy and prognostic factors of neoadju-vant chemotherapy (NACT) and radical resection on adenocarcinoma of esophagogastric junction (AEG) and gastric adenocarcinoma (GC).Methods:The propensity score matching and retrospec-tive cohort study was conducted. The clinicopathological data of 263 patients with AEG and GC who were admitted to Peking University Cancer Hospital from March 2017 to March 2022 were collected. There were 204 males and 59 females, aged (60±10)years. Of the 263 patients, 81 cases with AEG were set as the AEG group, and 182 cases with GC were set as the GC group. Observation indicators: (1) propensity score matching and comparison of clinicopathological characteristics of patients between the two groups after matching; (2) evaluation of the efficacy of NACT and pathological conditions; (3) intraoperative and postoperative conditions; (4) follow-up; (5) analysis of factors affecting prognosis of patients. 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 rank sum test. Comparison of count data between groups was conducted using the chi-square test. Comparison of ordinal data between groups was conducted using the nonparametric rank sum test. The Cox proportional hazard model was used for univariate and multivariate analyses. The Kaplan-Meier method was used to calculate survival rate and draw survival curve. The Log-rank test was used for survival analysis. Propensity score matching was done by the 1:1 nearest neighbor matching method with a caliper value of 0.02. Results:(1) Propensity score matching and comparison of clinicopathological charac-teristics of patients between the two groups after matching. Of 263 patients, 156 cases were succe-ssfully matched, including 78 cases in the AEG group and 78 cases in the GC group. After propensity score matching, the elimination of age and degree of tumor differentiation confounding bias ensured comparability between the two groups. (2) Evaluation of the efficacy of NACT and pathological condi-tions. After propensity score matching, cases with pathological complete response were 2 in the AEG group, versus 9 in the GC group, showing a significant difference between the two groups ( χ2=4.793, P<0.05). (3) Intraoperative and postoperative conditions. After propensity score matching, the operation time of AEG group was 225(200,283)minutes. The resection range (whole stomach, distal stomach, proximal stomach) were 68, 0, 10, respectively. The digestive tract reconstruction methods (Roux-en-Y, Billroth Ⅰ/Ⅱ/Uncut Roux-en-Y, esophageal residual gastric, double channel) were 68, 0, 5, 5, respectively. Duration of postoperative hospital stay was 12(10,16)days. Total hospi-talization expense was (114 400±4 828)yuan. The above indicators of the GC group were 200(174,234)minutes, 22, 55, 1, 21, 56, 0, 1, 10(9,11)days, (98 790±2 549)yuan, respectively. There were significant differences in the above indicators between the two groups ( Z=-3.813, χ2=85.875, 88.487, Z=-4.060, t=2.524, P<0.05). Cases of complication and cases of serious complication were 32 and 9 in the AEG group, versus 22 and 5 in the GC group, showing no significant difference between the two groups ( χ2=2.832, 1.256, P>0.05). (4) Follow-up. All 156 patients after propensity score matching were followed up after surgery, with a follow-up time of 51(range, 3-84)months. Number of death in the AEG group and GC group were 26 and 25 during the follow-up. The postoperative 3-, 5-year overall survival rate were 70.4%, 58.3% in patients of the AEG group, versus 75.7%, 62.6% in patients of the GC group, showing no significant difference in overall survival between the two groups ( χ2=0.141, P>0.05). (5) Analysis of factors affecting prognosis of patients. Results of multivariate analysis showed that NACT, average tumor diameter after NACT, vascular tumor emboli were independent factors affecting prognosis of patients with AEG and GC after NACT and radical resection before propensity score matching ( hazard ratio=1.864, 1.807, 4.551, 95% confidence interval as 1.137-3.056, 1.124-2.903, 2.709-7.645, P<0.05). Conclusions:Compared with patients of GC, patients of AEG have a lower proportion of pathological complete response after NACT, but there is no signifi-cant difference in the incidence of complication and survival of patients with AEG and GC after NACT and radical resection. NACT, average tumor diameter after NACT, vascular tumor emboli are indepen-dent factors affecting prognosis of patients with AEG and GC after NACT and radical resection.

The 16th International Gastric Cancer Congress (IGCC 2025) highlighted advances in the treatment of esophagogastric junction cancer (EGJC). From a medical oncology perspective, the unique molecular subtypes of EGJC are critical for prognosis and therapeutic decision-making. Key research topics include the optimal time to surgery after neoadjuvant therapy, active survei-llance strategies, comparisons between perioperative chemotherapy and neoadjuvant chemoradio-therapy, and the exploration of immunotherapy and targeted therapy. Recent studies, such as ESOPEC, demonstrated that perioperative chemotherapy with the FLOT regimen is superior to conventional chemoradiotherapy, while immunotherapy shows promise in improving pathological response and survival outcomes. From the surgical perspective, ongoing debates focus on redefining adenocarcinoma of esophagogastric junction (AEG) classification and optimizing surgical strategies, particularly regarding approaches and mediastinal lymphadenectomy for Siewert Ⅱ AEG. Results from the European TIGER study are eagerly awaited, and the CLASS-10 trial led by our institution is expected to provide high-level evidence to guide lymphadenectomy strategies in AEG. The authors provide an in-depth introduction to the diagnosis and treatment strategies of EGJC from a multi-disciplinary perspective, highlighting the challenges posed by the uniqueness of EGJC to research and clinical practice. Future efforts should emphasize controlling heterogeneity and designing precise clinical trials based on molecular and anatomical classifications to promote individualized treatment strategies.

Objective:To investigate the clinical efficacy and prognostic factors of neoadju-vant chemotherapy (NACT) and radical resection on adenocarcinoma of esophagogastric junction (AEG) and gastric adenocarcinoma (GC).Methods:The propensity score matching and retrospec-tive cohort study was conducted. The clinicopathological data of 263 patients with AEG and GC who were admitted to Peking University Cancer Hospital from March 2017 to March 2022 were collected. There were 204 males and 59 females, aged (60±10)years. Of the 263 patients, 81 cases with AEG were set as the AEG group, and 182 cases with GC were set as the GC group. Observation indicators: (1) propensity score matching and comparison of clinicopathological characteristics of patients between the two groups after matching; (2) evaluation of the efficacy of NACT and pathological conditions; (3) intraoperative and postoperative conditions; (4) follow-up; (5) analysis of factors affecting prognosis of patients. 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 rank sum test. Comparison of count data between groups was conducted using the chi-square test. Comparison of ordinal data between groups was conducted using the nonparametric rank sum test. The Cox proportional hazard model was used for univariate and multivariate analyses. The Kaplan-Meier method was used to calculate survival rate and draw survival curve. The Log-rank test was used for survival analysis. Propensity score matching was done by the 1:1 nearest neighbor matching method with a caliper value of 0.02. Results:(1) Propensity score matching and comparison of clinicopathological charac-teristics of patients between the two groups after matching. Of 263 patients, 156 cases were succe-ssfully matched, including 78 cases in the AEG group and 78 cases in the GC group. After propensity score matching, the elimination of age and degree of tumor differentiation confounding bias ensured comparability between the two groups. (2) Evaluation of the efficacy of NACT and pathological condi-tions. After propensity score matching, cases with pathological complete response were 2 in the AEG group, versus 9 in the GC group, showing a significant difference between the two groups ( χ2=4.793, P<0.05). (3) Intraoperative and postoperative conditions. After propensity score matching, the operation time of AEG group was 225(200,283)minutes. The resection range (whole stomach, distal stomach, proximal stomach) were 68, 0, 10, respectively. The digestive tract reconstruction methods (Roux-en-Y, Billroth Ⅰ/Ⅱ/Uncut Roux-en-Y, esophageal residual gastric, double channel) were 68, 0, 5, 5, respectively. Duration of postoperative hospital stay was 12(10,16)days. Total hospi-talization expense was (114 400±4 828)yuan. The above indicators of the GC group were 200(174,234)minutes, 22, 55, 1, 21, 56, 0, 1, 10(9,11)days, (98 790±2 549)yuan, respectively. There were significant differences in the above indicators between the two groups ( Z=-3.813, χ2=85.875, 88.487, Z=-4.060, t=2.524, P<0.05). Cases of complication and cases of serious complication were 32 and 9 in the AEG group, versus 22 and 5 in the GC group, showing no significant difference between the two groups ( χ2=2.832, 1.256, P>0.05). (4) Follow-up. All 156 patients after propensity score matching were followed up after surgery, with a follow-up time of 51(range, 3-84)months. Number of death in the AEG group and GC group were 26 and 25 during the follow-up. The postoperative 3-, 5-year overall survival rate were 70.4%, 58.3% in patients of the AEG group, versus 75.7%, 62.6% in patients of the GC group, showing no significant difference in overall survival between the two groups ( χ2=0.141, P>0.05). (5) Analysis of factors affecting prognosis of patients. Results of multivariate analysis showed that NACT, average tumor diameter after NACT, vascular tumor emboli were independent factors affecting prognosis of patients with AEG and GC after NACT and radical resection before propensity score matching ( hazard ratio=1.864, 1.807, 4.551, 95% confidence interval as 1.137-3.056, 1.124-2.903, 2.709-7.645, P<0.05). Conclusions:Compared with patients of GC, patients of AEG have a lower proportion of pathological complete response after NACT, but there is no signifi-cant difference in the incidence of complication and survival of patients with AEG and GC after NACT and radical resection. NACT, average tumor diameter after NACT, vascular tumor emboli are indepen-dent factors affecting prognosis of patients with AEG and GC after NACT and radical resection.

The 16th International Gastric Cancer Congress (IGCC 2025) highlighted advances in the treatment of esophagogastric junction cancer (EGJC). From a medical oncology perspective, the unique molecular subtypes of EGJC are critical for prognosis and therapeutic decision-making. Key research topics include the optimal time to surgery after neoadjuvant therapy, active survei-llance strategies, comparisons between perioperative chemotherapy and neoadjuvant chemoradio-therapy, and the exploration of immunotherapy and targeted therapy. Recent studies, such as ESOPEC, demonstrated that perioperative chemotherapy with the FLOT regimen is superior to conventional chemoradiotherapy, while immunotherapy shows promise in improving pathological response and survival outcomes. From the surgical perspective, ongoing debates focus on redefining adenocarcinoma of esophagogastric junction (AEG) classification and optimizing surgical strategies, particularly regarding approaches and mediastinal lymphadenectomy for Siewert Ⅱ AEG. Results from the European TIGER study are eagerly awaited, and the CLASS-10 trial led by our institution is expected to provide high-level evidence to guide lymphadenectomy strategies in AEG. The authors provide an in-depth introduction to the diagnosis and treatment strategies of EGJC from a multi-disciplinary perspective, highlighting the challenges posed by the uniqueness of EGJC to research and clinical practice. Future efforts should emphasize controlling heterogeneity and designing precise clinical trials based on molecular and anatomical classifications to promote individualized treatment strategies.

Objective:To explore the specificity of mediating effects of maladaptive cognition about self and maladaptive cognition about others in the context of childhood maltreatment and internalizing and externalizing problems in middle school students.Methods:A total of 788 middle school students from Hebei province were en-rolled in the study.The first data collection utilized the Childhood Trauma Questionnaire-Short Form(CTQ-SF)and the Posttraumatic Maladaptive Beliefs Scale(PMBS).After a 7-month interval,the second data collection was con-ducted with the Youth Self Report(YSR).The specificity of the mediating effects was examined by using Mplus 7.0 software.Results:Totally 72.3％of middle school students had experienced childhood abuse.Maladaptive cog-nition about self fully mediated the relationship between childhood maltreatment and adolescent internalizing prob-lems,with a mediation effect size of 0.22(95％CI:0.16-0.27).It partially mediated the relationship between childhood maltreatment and adolescent externalizing problems,with a mediation effect size of 0.13(95％CI:0.09-0.19).Maladaptive cognition about others only mediated the relationship between childhood maltreatment and adolescent externalizing problems,with a mediation effect size of-0.07(95％CI:-0.12--0.02),indicating a masking effect.Conclusion:Childhood maltreatment increases the likelihood of internalizing and externalizing prob-lems in middle school students.Childhood maltreatment increases internalizing and externalizing problems by in-creasing their maladaptive cognition of self,and childhood maltreatment increases their externalizing problems by increasing their maladaptive cognition of others.