Objective:To investigate the clinical characteristics, prognosis, and the impact of different secondary prevention strategies on stroke recurrence in patients with carotid web (CaW)-associated acute anterior circulation large vessel occlusion (LVO).Methods:A retrospective analysis was conducted on 401 patients with acute anterior circulation LVO who underwent mechanical thrombectomy at 2 advanced stroke centers, Xingtai Central Hospital and Xingtai People′s Hospital, from January 2018 to June 2024. CaW was identified using digital subtraction angiography (DSA) and other imaging modalities. Based on the presence of CaW, patients were divided into CaW group and non-CaW group. Differences between the 2 groups in baseline characteristics, clinical features, and clinical outcomes were compared, and long-term follow-up was conducted for the CaW group.Results:Among the 401 patients, the CaW group consisted of 16 patients (4.0%), while the non-CaW group included 385 patients (96.0%). Compared to the non-CaW group, patients in the CaW group were younger [53 (46, 58) years vs 65 (56, 76) years, Z=-3.811, P<0.001], had a higher proportion of M1 segment middle cerebral artery occlusion [13/16 vs 54.0% (208/385), χ2=4.602, P=0.032] and a lower proportion of internal carotid artery terminus occlusion [1/16 vs 40.0% (154/385), χ2=6.024, P=0.014]; the 90-day modified Rankin Scale (mRS) score was significantly lower in the CaW group [1.00 (0, 1.75) vs 3.00 (1.00, 4.00), Z=14.210, P<0.001], and the proportion of patients with favorable functional independence (mRS score 0-2) was significantly higher [15/16 vs 45.7% (176/385), χ2=12.350, P<0.001] in the CaW group; the incidence of pneumonia in the CaW group was significantly lower [2/16 vs 42.6% (164/385), χ2=4.562, P=0.033]. Among the 16 CaW patients, 10 received antiplatelet therapy, 4 underwent carotid artery stenting (CAS), and 2 underwent carotid endarterectomy (CEA). During a median follow-up of 29 months, patients who underwent CAS and CEA had no stroke recurrence, while 2 patients who received antiplatelet therapy had stroke recurrence and subsequently underwent CAS and CEA. Conclusions:The proportion of CaW among patients with acute anterior circulation LVO was 4.0%. The patients with CaW were younger and had a higher proportion of M1 segment middle cerebral artery occlusion. Following mechanical thrombectomy, patients in the CaW group had good functional outcomes. Simple drug therapy may be insufficient to prevent stroke recurrence in CaW patients, and CAS and CEA may be effective therapeutic options.

Objective:To compare the diagnostic efficacy of 18F-fibroblast activation protein inhibitor (FAPI) PET/MR and contrast-enhanced CT in detecting metachronous ovarian metastasis after gastric signet-ring cell carcinoma (GSRCC) surgery, and to evaluate its impact on clinical decision-making. Methods:This study employed a diagnostic test design. A retrospective analysis was conducted on 26 female patients with suspected metachronous ovarian metastasis following GSRCC resection between January 2023 and June 2025 in Renji Hospital, Shanghai Jiao Tong University School of Medicine. All patients underwent both 18F-FAPI PET/MR and contrast-enhanced CT within 2 weeks. Using histopathology or clinical imaging follow-up (≥6 months) as the reference standard, the diagnostic performance of both modalities was compared (McNemar test, Fisher exact test and Delong test), and changes in clinical management were analyzed. Results:Metachronous ovarian metastasis was confirmed in 12 patients (22 lesions). 18F-FAPI PET/MR showed significantly higher sensitivity (90.9%(20/22) vs 72.7%(16/22); χ2=4.10, P=0.043), specificity (100%(30/30) vs 50.0%(15/30); χ2=13.01, P<0.001), and accuracy (96.2%(50/52) vs 59.6%(31/52); χ2=15.43, P<0.001), compared to contrast-enhanced CT, with a significantly higher AUC (0.964 vs 0.815; Z=2.85, P=0.015). It also demonstrated superior detection of extraovarian metastases, including anastomotic recurrence, peritoneal spread, and lymph node involvement ( P values: 0.004-0.031), and identified 5 additional rare-site metastases in 3 patients that were missed by contrast-enhanced CT. Based on 18F-FAPI PET/MR findings, clinical management was adjusted in 6 patients with metastasis. Conclusion:18F-FAPI PET/MR outperforms contrast-enhanced CT in diagnosing metachronous ovarian metastasis and performing whole-body restaging in post-surgical GSRCC patients, therapy provides critical evidence for informing decision-making.

Objective: To investigate the efficacy and incidence of adverse reactions of therapeutic erythrocytapheresis in high altitude polycythemia (HAPC) population. Methods: A retrospective study was conducted on 243 HAPC patients who were either native residents or long-term workers in Xizang and underwent therapeutic erythrocytapheresis in the Chengdu Office Hospital of the People's Government of Xizang Autonomous Region from 2021 to 2023. A comparative study was carried out on the changes in blood routine, vital signs, skin color, serum iron metabolism data, and the incidence of adverse reactions before and after the procedure. Results: After erythrocytapheresis, significant decreases were observed in red blood cell (RBC) count (7.06±0.89×10 vs 6.08±0.93×10 /L, P<0.001], hemoglobin (HGB, 211.59±17.99 vs 182.76±19.83 g/L, P<0.001), hematocrit (Hct) [(65.30±6.45)% vs (55.56±8.12)%, P<0.001], serum iron (14.46±4.38 vs 11.77±3.78 μmol/L, P=0.003), total iron-binding capacity (126.62±4.47 vs 123.73±3.77 μmol/L, P=0.002), transferrin (1.88±0.41 vs 1.77±0.12 g/L, P=0.023), transferrin saturation [(11.32±3.11)% vs (9.43±2.78)%, P=0.004], serum ferritin (832.4±295.6 vs 665.3±249.2 ng/mL, P<0.001), systolic blood pressure (123.86±14.43 vs 118.51±13.68 mmHg, P<0.001) and diastolic blood pressure (81.68±9.54 vs 74.28±7.61 mmHg, P<0.001). In contrast, platelet count (Plt, 137.21±46.21 ×10 vs 147.94±50.66 ×10 /L, P<0.001) and oxygen saturation [(93.97±3.29)% vs (95.84±2.27)%, P<0.001] increased. No significant differences were found in white blood cell (WBC) count [5.35 (4.59, 6.44)×10 /L vs 5.43 (4.54, 6.53) ×10 /L, P=0.690], unsaturated iron-binding capacity (112.15±0.50 vs 111.96±0.25 μmol/L, P=0.074) and pulse rate (73.42±11.28 vs 73.19±7.18 beats/min, P=0.750). Furthermore, skin color of the face (conjunctiva, lips) and palms mitigated after therapeutic erythrocytapheresis, changing from purplish-red to red. The total incidence of adverse reactions during erythrocytapheresis was 13.98% (34/243), including citrate toxicity 12.75% (31/243), puncture site hematoma 0.82% (2/243) and blood volume imbalance 0.41% (1/243). Conclusion: Therapeutic erythrocytapheresis could rapidly decrease HCT, Hb, serum iron, transferrin and transferrin saturation levels in HAPC patients, with a low incidence of adverse reactions. Therefore, therapeutic erythrocytapheresis has broad clinical application prospects in Xizang Autonomous Region.

Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

Objective:To compare the diagnostic efficacy of 18F-fibroblast activation protein inhibitor (FAPI) PET/MR and contrast-enhanced CT in detecting metachronous ovarian metastasis after gastric signet-ring cell carcinoma (GSRCC) surgery, and to evaluate its impact on clinical decision-making. Methods:This study employed a diagnostic test design. A retrospective analysis was conducted on 26 female patients with suspected metachronous ovarian metastasis following GSRCC resection between January 2023 and June 2025 in Renji Hospital, Shanghai Jiao Tong University School of Medicine. All patients underwent both 18F-FAPI PET/MR and contrast-enhanced CT within 2 weeks. Using histopathology or clinical imaging follow-up (≥6 months) as the reference standard, the diagnostic performance of both modalities was compared (McNemar test, Fisher exact test and Delong test), and changes in clinical management were analyzed. Results:Metachronous ovarian metastasis was confirmed in 12 patients (22 lesions). 18F-FAPI PET/MR showed significantly higher sensitivity (90.9%(20/22) vs 72.7%(16/22); χ2=4.10, P=0.043), specificity (100%(30/30) vs 50.0%(15/30); χ2=13.01, P<0.001), and accuracy (96.2%(50/52) vs 59.6%(31/52); χ2=15.43, P<0.001), compared to contrast-enhanced CT, with a significantly higher AUC (0.964 vs 0.815; Z=2.85, P=0.015). It also demonstrated superior detection of extraovarian metastases, including anastomotic recurrence, peritoneal spread, and lymph node involvement ( P values: 0.004-0.031), and identified 5 additional rare-site metastases in 3 patients that were missed by contrast-enhanced CT. Based on 18F-FAPI PET/MR findings, clinical management was adjusted in 6 patients with metastasis. Conclusion:18F-FAPI PET/MR outperforms contrast-enhanced CT in diagnosing metachronous ovarian metastasis and performing whole-body restaging in post-surgical GSRCC patients, therapy provides critical evidence for informing decision-making.

Objective:To investigate the clinical characteristics, prognosis, and the impact of different secondary prevention strategies on stroke recurrence in patients with carotid web (CaW)-associated acute anterior circulation large vessel occlusion (LVO).Methods:A retrospective analysis was conducted on 401 patients with acute anterior circulation LVO who underwent mechanical thrombectomy at 2 advanced stroke centers, Xingtai Central Hospital and Xingtai People′s Hospital, from January 2018 to June 2024. CaW was identified using digital subtraction angiography (DSA) and other imaging modalities. Based on the presence of CaW, patients were divided into CaW group and non-CaW group. Differences between the 2 groups in baseline characteristics, clinical features, and clinical outcomes were compared, and long-term follow-up was conducted for the CaW group.Results:Among the 401 patients, the CaW group consisted of 16 patients (4.0%), while the non-CaW group included 385 patients (96.0%). Compared to the non-CaW group, patients in the CaW group were younger [53 (46, 58) years vs 65 (56, 76) years, Z=-3.811, P<0.001], had a higher proportion of M1 segment middle cerebral artery occlusion [13/16 vs 54.0% (208/385), χ2=4.602, P=0.032] and a lower proportion of internal carotid artery terminus occlusion [1/16 vs 40.0% (154/385), χ2=6.024, P=0.014]; the 90-day modified Rankin Scale (mRS) score was significantly lower in the CaW group [1.00 (0, 1.75) vs 3.00 (1.00, 4.00), Z=14.210, P<0.001], and the proportion of patients with favorable functional independence (mRS score 0-2) was significantly higher [15/16 vs 45.7% (176/385), χ2=12.350, P<0.001] in the CaW group; the incidence of pneumonia in the CaW group was significantly lower [2/16 vs 42.6% (164/385), χ2=4.562, P=0.033]. Among the 16 CaW patients, 10 received antiplatelet therapy, 4 underwent carotid artery stenting (CAS), and 2 underwent carotid endarterectomy (CEA). During a median follow-up of 29 months, patients who underwent CAS and CEA had no stroke recurrence, while 2 patients who received antiplatelet therapy had stroke recurrence and subsequently underwent CAS and CEA. Conclusions:The proportion of CaW among patients with acute anterior circulation LVO was 4.0%. The patients with CaW were younger and had a higher proportion of M1 segment middle cerebral artery occlusion. Following mechanical thrombectomy, patients in the CaW group had good functional outcomes. Simple drug therapy may be insufficient to prevent stroke recurrence in CaW patients, and CAS and CEA may be effective therapeutic options.

OBJECTIVE To investigate the mechanism of anti-colorectal cancer growth and metastasis-related effects of Astraga-lus mongholicus Bunge-Curcuma aromatica-Paridis Rhizoma(Qi-Zhu-Zao)pairing through PERK/eIF2α/ATF4 signaling pathway mediating endoplasmic reticulum stress.METHODS Twenty-four BALB/c male mice were randomly divided into sham-operated group,model group,5-FU(5-fluorouracil)group(25 mg·kg-1),and Qi-Zhu-Zao high dose group(5.85 g·kg-1),Qi-Zhu-Zao low dose group(2.925 g·kg-1)(n=6)to construct a mouse model of colorectal cancer in situ transplantation tumor,and the inter-vention effect of Qi-Zhu-Zao combination on tumor growth was assessed by the change of tumor volume size after 15 days of administra-tion;the intervention effect of Qi-Zhu-Zao combination on tumor growth was assessed by H&E.Pathological staining was used to eval-uate the effect of Qi-Zhu-Zao combination on the liver and tumor tissues of mice.The changes of MDA,SOD and GSH-Px levels were detected by enzyme-linked immunosorbent assay(ELISA);the expression of PERK/eIF2α/ATF4 signaling pathway and EMT-related proteins were detected by protein immunoblotting(Western blot).RESULTS Compared with the model group,the tumor volume was significantly reduced(P＜0.000 1),liver and spleen metastases were less pronounced in the Qi-Zhu-Zao high-dose group,and his-topathological staining results of liver tissue and tumor produced changes in oxidative stress indicators SOD,MDA,and GSH-Px,up-regulation of ER stress-related proteins p-PERK,p-IF2α,and ATF4,etc.,upregulated the protein expression levels of E-Cadherin,downregulated N-Cadherin,Vimentin,and Snail,and inhibited the EMT process(P＜0.01 or P＜0.05).CONCLUSION In this paper,we investigated the regulatory mechanism related to the inhibition of colorectal cancer growth and metastasis by the combination of Qi-Zhu-Zao trigonal medicine,and demonstrated that it may inhibit the growth and metastasis of colorectal cancer by activating the PERK/eIF2α/ATF4 pathway to induce sustained ER stress and affect the EMT process of colorectal cancer.

Objective:To explore whether the food additive sodium benzoate(NAB) induces pancreatic inflammation and β cell apoptosis through the benzoylation(Kbz) modification pathway.Methods:In vivo experiments: C57BL/6J male mice(8 weeks old, 18-20 g) were randomly divided into normal control group(double distilled water feeding) and NAB feeding group(1 g/kg NAB feeding). Blood glucose were measured. After 20 weeks, fasting serum insulin, interleukin(IL)-18, IL-1β, and benzoyl-CoA levels were detected by ELISA method. Bax, IL-18, Pan-Kbz and Pan-Kac were detected by immunohistochemistry staining. In vitro experiments: β-TC-6 cells were cultured with NAB(6 mmol/L) or benzoyl-CoA(100 μmol/L) as stimulator and acyltransferase P300 inhibitor A485(10 μmol/L) as intervention factor. 24 hours later, inflammation, apoptosis, insulin secretion and Pan-Kbz level were detected by qRT-PCR, ELISA and Western blotting.Results:In the in vivo experiments, compared to the NC group, mice in the NAB group exhibited impaired glucose tolerance, decreased fasting insulin levels, significantly increased serum benzoyl coenzyme A concentrations, relatively elevated pancreatic IL-1β, IL-18, and Bax protein expressions, increased levels of Pan-Kbz, while Pan-Kac levels were downregulated(all P<0.05); In vitro experiments, NAB dose-dependently inhibited insulin secretion, promoted the release of Pan-Kbz and inflammatory factors IL-18 and TNF- α, inhibited Bcl-2 expression and up-regulated Bax expression, A485 reversed NAB-induced Pan-Kbz modification, improved NAB-induced inflammation and apoptosis, and promoted insulin secretion(all P<0.05). Conclusion:NAB may induce pancreatic inflammation, β-cell apoptosis, and impair insulin secretion through Kbz modification pathway.

Objective:To investigate the effects of 0.1% prednisolone acetate eye drops on the intraoperative pain and expression levels of inflammatory factors in hepatitis B virus (HBV) carriers undergoing cataract surgery.Methods:A randomized single-blind controlled study was adopted.Thirty-six cataract patients diagnosed as HBV carriers in Beijing Tongren Hospital Affiliated to Capital Medical University from November 2021 to August 2023 were enrolled.All patients were scheduled to underwent phacoemulsification combined with intraocular lens implantation.The patients were randomly divided into prednisolone acetate group and control group using the random number table method, with 18 cases in each group.The two groups used 0.1% prednisolone acetate eye drops combined with 0.5% levofloxacin eye drops and 0.3% sodium hyaluronate eye drops combined with 0.5% levofloxacin eye drops for 3 days before the operation according to grouping, respectively.During cataract surgery, aqueous humor samples were collected, and cytokines in the samples were detected using the human cytokine antibody array detection technology.The degree of intraoperative pain of patients was evaluated using the Wong-Baker Scale and the intraoperative pain manifestation record form.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Beijing Tongren Hospital, Capital Medical University (No.TREXKY2017-018).Written informed consent was obtained from each subject.Results:In the aqueous humor samples of patients in the prednisolone acetate group, the expressions of inflammatory factors such as tumor necrosis factor-β, monocyte chemoattractant protein-1, tumor necrosis factor-α, and interleukin-1 receptor antagonist were lower than those in the control group, and the differences were statistically significant ( t=-2.385, -2.286, -2.208, -2.134; all at P<0.05).The proportion of patients with obvious pain in the prednisolone acetate group was 16.7%(1/18), which was significantly lower than 61.1%(11/18) in the control group ( χ2=-2.697, P<0.05).The intraoperative pain score of patients in the prednisolone acetate group was 1(1, 2) points, which was lower than 2(1, 2) points in the control group, and the difference was statistically significant ( Z=-2.902, P<0.05). Conclusions:Preoperative use of prednisolone acetate eye drops for anti-inflammatory intervention can reduce the expression of inflammatory factors in patients' aqueous humor and mitigate the intraoperative pain during cataract surgery in HBV carriers.

Objective:To systematically integrate qualitative research on the real experience and management of cancer pain in adult cancer patients, so as to provide reference for improving the management of cancer pain in adult cancer patients and reducing their cancer pain.Methods:Qualitative research literature on the real experience and management of cancer pain in cancer patients was systematically searched in Cochrane Library, PubMed, Web of Science, CINAHL, Embase, ProQuest, Scopus, China Biomedical Database, China National Knowledge Infrastructure, Wanfang Data, and VIP. The search period was from database establishment to August 2023. The literature was evaluated using the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center. The aggregation Meta-synthesis method was used to integrate and summarize research results.Results:A total of 16 articles were included, and 78 results were extracted to form 11 categories, which were summarized into four integrated results of the cognitive status of adult cancer patients towards cancer pain, the impact of cancer pain on patients, self-management strategies for cancer pain, and medical experiences related to cancer pain.Conclusions:Adult cancer patients face obstacles in alleviating cancer pain, such as lack of awareness of cancer pain, negative impacts, inadequate self-management strategies, and poor medical experience. Patients need to improve their self-management strategies, and the country and medical institutions should provide comprehensive support to enable patients and clinical medical and nursing staff to manage cancer pain.