The benefit of postoperative adjuvant therapy for patients with resectable esophageal squamous cell carcinoma (ESCC) is not yet supported by high-level evidence. This review analyzes the role of adjuvant therapy by examining the discrepancy between clinical needs and guidelines, its historical evolution, recent advances in high-risk factors, and future outlooks. We provide a detailed discussion of high-risk factors used for patient selection, including lymph node positivity, and for node-negative patients, features such as tumor length, location, T stage, extent of lymph node dissection, differentiation, vascular and neural invasion, laboratory indices, and molecular markers. The goal is to inform the development of individualized precision treatment strategies for resectable ESCC.

Objective:To explore optimal timing and surgical approaches for bile duct repair in patients with bile duct injuries associated with laparoscopic cholecystectomy (LC-BDI).Methods:A retrospective analysis was conducted on the clinical data of 13 patients with LC-BDI treated at Chuxiong Yi Autonomous Prefecture People's Hospital from October 2012 to October 2023. The cohort included 6 males and 7 females, aged (51.2±7.6) years. Clinical parameters such as gender, age, Strasberg classification, timing of surgery, surgical techniques, and complications were recorded. Postoperative follow-up was conducted via telephone to assess complications and reoperation status.Results:Among the 13 LC-BDI patients, 4 cases were diagnosed intraoperatively during LC, while 9 cases were diagnosed postoperatively. The Strasberg classification was as follows: 5 cases of E2, 6 cases of E3, and 2 cases of E4. Except for 2 patients who underwent immediate repair during LC, the remaining 11 patients initially received proximal bile duct or subhepatic space drainage, followed by definitive biliary reconstruction after 6-8 weeks. All 13 patients underwent repair via side-to-side hepaticojejunostomy (SSHJ). Over a mean follow-up period of (68.5±30.8) months, only 1 patient with Strasberg E4 LC-BDI was judged as repair failure at 21 months postoperatively; the remaining 12 cases achieved successful repair.Conclusion:For LC-BDI patients with Strasberg E2 or higher classifications, in the absence of intra-abdominal infection, biliary reconstruction via SSHJ at 6-8 weeks postoperatively demonstrated superior therapeutic efficacy.

Objective To investigate the correlation between changes in the inner retinal irregularity index(IRII)af-ter macular epiretinal membrane(ERM)stripping and visual function in patients with idiopathic macular epiretinal mem-brane(IMEM).Methods A retrospective analysis was conducted on the clinical data of 134 patients(162 eyes)with IMEM who visited our hospital from March 2022 to December 2024.Based on fundus color photography and OCT findings,the patients were divided into the cellophane macular reflex(CMR)group and the preretinal macular fibrosis(PMF)group.Differences in central macular thickness(CMT),best-corrected visual acuity(BCVA),inner retinal thickness(IRT),and IRII were analyzed between the two groups.The diagnostic efficacy of these indicators for IMEM at admission was analyzed using receiver operating characteristic(ROC)curves.The differences in visual function indicators and IRII before and 3 months after ERM stripping were compared in IMEM patients.The correlation between IRII levels and visual function parameters at 3 months postoperatively was analyzed using Pearson correlation analysis.Results Among the 134 patients(162 eyes)with IMEM,93 patients(103 eyes)were in the CMR group and 41 patients(59 eyes)were in the PMF group.The CMT,IRT,and IRII were significantly lower in the CMR group than in the PMF group(all P＜0.05).The areas under the curve(AUC)for CMT,IRT,and IRII were 0.616,0.609,and 0.862,respectively(all P＜0.05).Among the 134 patients(162 eyes)with IMEM,79 patients(86 eyes,53.86％)underwent surgical treatment,and 55 patients(76 eyes,46.91％)received non-surgical treatment.Three months after surgery,the CMT,IRT,and IRII in IMEM patients were sig-nificantly lower than those before surgery(all P＜0.05).At 3 months postoperatively,CMT and IRT were significantly pos-itively correlated with IRII in IMEM patients(all P＜0.05).Conclusion CMT,IRT,and IRII all have good diagnostic ef-ficacy for IMEM staging.Moreover,IRII changes in IMEM patients who underwent macular ERM stripping are positively correlated with visual function.

Background: Gestational diabetes mellitus (GDM) is a metabolic disorder posing significant risks to maternal and infant health, with a lack of effective early screening markers. Therefore, identifying early screening biomarkers for GDM with higher sensitivity and specificity is urgently needed. Methods: High-throughput sequencing was employed to screen for key circular RNAs (circRNAs), which were then evaluated using reverse transcription quantitative polymerase chain reaction. Logistic regression analysis was conducted to examine the relationship between clinical characteristics, circRNA expression, and adverse pregnancy outcomes. The diagnostic accuracy of circRNAs for early and mid-pregnancy GDM was assessed using receiver operating characteristic curves. Pearson correlation analysis was utilized to explore the relationship between circRNA levels and oral glucose tolerance test results. A predictive model for early GDM was established using logistic regression. Results: Significant alterations in circRNA expression profiles were detected in GDM patients, with hsa_circ_0031560 and hsa_ circ_0000793 notably upregulated during the first and second trimesters. These circRNAs were associated with adverse pregnancy outcomes and effectively differentiated GDM patients, with second trimester cohorts achieving an area under the curve (AUC) of 0.836. In first trimester cohorts, these circRNAs identified potential GDM patients with AUCs of 0.832 and 0.765, respectively. The early GDM prediction model achieved an AUC of 0.904, validated in two independent cohorts. Conclusion Hsa_circ_0031560, hsa_circ_0000793, and the developed model serve as biomarkers for early prediction or midterm diagnosis of GDM, offering clinical tools for early GDM screening.

In recent years, the incidence of multiple primary lung cancer (MPLC) has been increasing, and it cannot be ignored in clinical practice. The treatment of MPLC is still controversial, but surgical treatment is recognized as the most important treatment. However, current studies have shown that the treatment of MPLC needs to develop multimodal treatment according to different patients. This review summarizes multiple treatment method for MPLC, including surgery, ablation, chemotherapy, radiotherapy, targeted therapy, and immunotherapy in order to enhance understanding of MPLC treatment.
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Humans ; Lung Neoplasms/surgery* ; Immunotherapy ; Combined Modality Therapy

Background: Gestational diabetes mellitus (GDM) is a metabolic disorder posing significant risks to maternal and infant health, with a lack of effective early screening markers. Therefore, identifying early screening biomarkers for GDM with higher sensitivity and specificity is urgently needed. Methods: High-throughput sequencing was employed to screen for key circular RNAs (circRNAs), which were then evaluated using reverse transcription quantitative polymerase chain reaction. Logistic regression analysis was conducted to examine the relationship between clinical characteristics, circRNA expression, and adverse pregnancy outcomes. The diagnostic accuracy of circRNAs for early and mid-pregnancy GDM was assessed using receiver operating characteristic curves. Pearson correlation analysis was utilized to explore the relationship between circRNA levels and oral glucose tolerance test results. A predictive model for early GDM was established using logistic regression. Results: Significant alterations in circRNA expression profiles were detected in GDM patients, with hsa_circ_0031560 and hsa_ circ_0000793 notably upregulated during the first and second trimesters. These circRNAs were associated with adverse pregnancy outcomes and effectively differentiated GDM patients, with second trimester cohorts achieving an area under the curve (AUC) of 0.836. In first trimester cohorts, these circRNAs identified potential GDM patients with AUCs of 0.832 and 0.765, respectively. The early GDM prediction model achieved an AUC of 0.904, validated in two independent cohorts. Conclusion Hsa_circ_0031560, hsa_circ_0000793, and the developed model serve as biomarkers for early prediction or midterm diagnosis of GDM, offering clinical tools for early GDM screening.

Background: Gestational diabetes mellitus (GDM) is a metabolic disorder posing significant risks to maternal and infant health, with a lack of effective early screening markers. Therefore, identifying early screening biomarkers for GDM with higher sensitivity and specificity is urgently needed. Methods: High-throughput sequencing was employed to screen for key circular RNAs (circRNAs), which were then evaluated using reverse transcription quantitative polymerase chain reaction. Logistic regression analysis was conducted to examine the relationship between clinical characteristics, circRNA expression, and adverse pregnancy outcomes. The diagnostic accuracy of circRNAs for early and mid-pregnancy GDM was assessed using receiver operating characteristic curves. Pearson correlation analysis was utilized to explore the relationship between circRNA levels and oral glucose tolerance test results. A predictive model for early GDM was established using logistic regression. Results: Significant alterations in circRNA expression profiles were detected in GDM patients, with hsa_circ_0031560 and hsa_ circ_0000793 notably upregulated during the first and second trimesters. These circRNAs were associated with adverse pregnancy outcomes and effectively differentiated GDM patients, with second trimester cohorts achieving an area under the curve (AUC) of 0.836. In first trimester cohorts, these circRNAs identified potential GDM patients with AUCs of 0.832 and 0.765, respectively. The early GDM prediction model achieved an AUC of 0.904, validated in two independent cohorts. Conclusion Hsa_circ_0031560, hsa_circ_0000793, and the developed model serve as biomarkers for early prediction or midterm diagnosis of GDM, offering clinical tools for early GDM screening.

Background: Salvia miltiorrhiza Bunge, commonly known as “Danshen” in China due to the distinctive red color of its roots, is one of the most widely used traditional Chinese medicines. It is cultivated in various regions across China, and environmental differences among these regions can affect the secondary metabolites of plants, thereby influencing the quality of S. miltiorrhiza. In recent years, increasing demand for S. miltiorrhiza has exacerbated the problem of origin fraud. Therefore, ensuring the authenticity of its geographical origin is crucial for the sustainable development of the industry. Objective: The red coloration of S. miltiorrhiza is closely associated with the content of its primary active compounds, particularly tanshinones. Therefore, both its internal chemical composition and external color characteristics serve as key indicators for quality assessment. This study utilized hyperspectral imaging technology to evaluate its potential in classifying the geographical origin of S. miltiorrhiza. Methods: Spectral data reflecting the internal chemical properties of S. miltiorrhiza were integrated with color information representing its external features through 3 levels of data fusion. These fused datasets were then combined with deep learning algorithms to achieve accurate origin classification. Results: The results demonstrated that the Transformer model combined with soft-voting decision-level fusion achieved the highest classification accuracy of 98.72% by integrating image color and short-wave infrared spectral data. Conclusion: This study demonstrates that integrating hyperspectral imaging spectral data with color information provides a reliable and innovative approach for verifying the authenticity and traceability of S. miltiorrhiza.