Objective To systematically evaluate the risk prediction models for anastomotic leakage (AL) in patients with esophageal cancer after surgery. Methods A computer-based search of PubMed, EMbase, Web of Science, Cochrane Library, Chinese Medical Journal Full-text Database, VIP, Wanfang, SinoMed and CNKI was conducted to collect studies on postoperative AL risk prediction model for esophageal cancer from their inception to October 1st, 2023. PROBAST tool was employed to evaluate the bias risk and applicability of the model, and Stata 15 software was utilized for meta-analysis. Results A total of 19 literatures were included covering 25 AL risk prediction models and 7373 patients. The area under the receiver operating characteristic curve (AUC) was 0.670-0.960. Among them, 23 prediction models had a good prediction performance (AUC>0.7); 13 models were tested for calibration of the model; 1 model was externally validated, and 10 models were internally validated. Meta-analysis showed that hypoproteinemia (OR=9.362), postoperative pulmonary complications (OR=7.427), poor incision healing (OR=5.330), anastomosis type (OR=2.965), preoperative history of thoracoabdominal surgery (OR=3.181), preoperative diabetes mellitus (OR=2.445), preoperative cardiovascular disease (OR=3.260), preoperative neoadjuvant therapy (OR=2.977), preoperative respiratory disease (OR=4.744), surgery method (OR=4.312), American Society of Anesthesiologists score (OR=2.424) were predictors for AL after esophageal cancer surgery. Conclusion At present, the prediction model of AL risk in patients with esophageal cancer after surgery is in the development stage, and the overall research quality needs to be improved.

OBJECTIVE: To explore the neuroprotective effect and underlying mechanism of Xingnao Kaiqiao acupuncture (acupuncture for regaining consciousness and opening orifices) in the rat models of cerebral ischemia-reperfusion injury (CIRI) based on the p53 protein (p53)/solute carrier family 7 member 11 (SLC7A11)/glutathione peroxidase 4 (GPX4) signaling pathway. METHODS: Of 102 male Wistar rats, 20 rats were randomly collected as a sham-operation group. Using a modified external carotid artery filament insertion method, CIRI models were prepared by occluding the middle cerebral artery in the rest rats. After modeling and excluding 1 non-successfully modeled rat and 1 dead one, the other modeled rats were randomized into a model group, an agonist group, an acupuncture group, and an acupuncture + agonist group, 20 rats in each one. Xingnao Kaiqiao acupuncture therapy was delivered in the rats of the acupuncture group and the acupuncture + agonist group. The acupoints included "Shuigou" (GV26), bilateral "Neiguan" (PC6), and "Sanyinjiao" (SP6) on the affected side. Electroacupuncture was attached to "Neiguan" (PC6) and "Sanyinjiao" (SP6) on the affected side, with dense-disperse wave, a frequency of 2 Hz/15 Hz and intensity of 1 mA. The intervention was delivered twice daily, 20 min each time and for 7 consecutive days. In the agonist group and acupuncture+agonist group, p53 agonist, COTI-2 was intraperitoneally injected (15 mg/kg), once daily for 7 consecutive days. Neurological deficit was evaluated using Zausinger's six-point scale. Cerebral infarction volume was quantified by triphenyl tetrazolium chloride (TTC) staining. Histopathological changes were observed using hematoxylin-eosin (HE) staining. Iron deposition was assessed by Prussian blue staining. Mitochondrial ultrastructure in the ischemic cortex was examined under transmission electron microscopy (TEM). Serum iron (Fe²⁺) was measured with chromometry. Malondialdehyde (MDA) and glutathione (GSH) levels in the ischemic hippocampus were determined using thiobarbituric acid and microplate assays, respectively. The mean fluorescence intensity of reactive oxygen species (ROS) in the ischemic cortex was analyzed by flow cytometry. The mRNA and protein expression of GPX4, SLC7A11, and p53 in the ischemic hippocampus were evaluated using quantitative real-time PCR (qRT-PCR) and Western blotting, respectively. RESULTS: Compared with the sham-operated group, the model group exhibited the decrease in neurological deficit score (P<0.01), and the increase in cerebral infarction volume percentage (P<0.01). The changes of brain tissue were presented in extensive cellular necrosis, pyknotic and deeply-stained nuclei, and vacuolar degeneration. The iron deposition was elevated in cortex and hippocampus (P<0.01), mitochondrial membrane density increased, the cristae was broken or reduced, and the outer membrane ruptured. The levels of Fe²⁺ and MDA, as well as the mean flourscence intensity of ROS were elevated (P<0.01) and the level of GSH was reduced (P<0.01). The mRNA and protein expression of GPX4 and SLC7A11 was reduced (P<0.01), while that of p53 rose (P<0.01). When compared with the model group, in the agonist group, the neurological deficit score was reduced (P<0.05), the percentage of infarction volume was higher (P<0.01), the histopathological damage was further exacerbated, and the percentage of iron deposition increased in the cortex and hippocampus (P<0.01). The mitochondrial quantity decreased, the membrane density increased, the mitochondrial cristae were broken or reduced, and the outer membrane was ruptured. The levels of Fe²⁺ and MDA, as well as the mean flourscence intensity of ROS were higher (P<0.01, P<0.05) and the level of GSH was reduced (P<0.05). The mRNA and protein expression of GPX4 and SLC7A11 decreased (P<0.01, P<0.05), while that of p53 was elevated (P<0.01). Besides, in comparison with the model group, the neurological deficit score was higher in the acupuncture group and the acupuncture + agonist group (P<0.01, P<0.05), the percentage of cerebral infarction volume was lower in the acupuncture group (P<0.01), the pathological damage of brain tissue was alleviated in the acupuncture group and the acupuncture + agonist group, and the percentage of iron depositiondecreased in the cortex and hippocampus (P<0.01). The mitochondrial structure was relatively clear, the mitochondrial cristae were fractured or reduced mildly in the acupuncture group and the acupuncture + agonist group. The levels of Fe²⁺ and MDA, as well as the mean flourscence intensity of ROS were lower (P<0.01) and the level of GSH was higher (P<0.01) in the acupuncture group. The mean fluorescence intensity of ROS were dropped (P<0.01) in the acupuncture + agonist group. The mRNA expression of GPX4 and SLC7A11 was elevated (P<0.01) and that of p53 was reduced (P<0.01, P<0.05) in either the acupuncture group or the acupuncture + agonist group; the protein expression of GPX4 and SLC7A11 rose (P<0.05, P<0.01) and that of p53 was dropped (P<0.01) in the acupuncture group; and the protein expression of p53 was also lower in the acupuncture + agonist group (P<0.05). When compared with the agonist group, in the acupuncture + agonist group, neurological deficit score increased (P<0.01), the percentage of cerebral infarction volume decreased (P<0.01), the pathological brain tissue damage was reduced, the percentage of iron deposition in cortex and hippocampus decreased (P<0.01), the mitochondrial structure was relatively clear and the cristae broken or reduced slightly; the levels of Fe²⁺ and MDA, as well as the mean fluorescence intensity of ROS were dropped (P<0.01), while the level of GSH increased (P<0.05); the mRNA and protein expression of GPX4 and SLC7411 was elevated (P<0.01, P<0.05), and that of p53 reduced (P<0.01). In comparison with the acupuncture + agonist group, in the acupuncture group, the neurological deficit score increased (P<0.05), the percentage of cerebral infarction volume decreased (P<0.05), the pathological brain tissue damage was alleviated, the percentage of iron deposition in cortex and hippocampus decreased (P<0.01), the mitochondrial structure was normal in tendency; the levels of Fe²⁺ and MDA, as well as the mean fluorescence intensity of ROS were reduced (P<0.05), while the level of GSH rose (P<0.01); the mRNA and protein expression of GPX4 and SLC7411 was elevated (P<0.01, P<0.05), and that of p53 reduced (P<0.01, P<0.05). CONCLUSION Xingnao Kaiqiao acupuncture can alleviate neurological damage in CIRI rats, which is obtained probably by inhibiting ferroptosis through p53/SLC7A11/GPX4 pathway.
Animals ; Reperfusion Injury/metabolism* ; Male ; Acupuncture Therapy ; Rats ; Tumor Suppressor Protein p53/genetics* ; Brain Ischemia/metabolism* ; Rats, Wistar ; Signal Transduction ; Humans ; Phospholipid Hydroperoxide Glutathione Peroxidase/genetics* ; Disease Models, Animal ; Acupuncture Points ; Amino Acid Transport System y+/genetics*

Aim To investigate whether adipose differentiation-related proteins promote macrophage lipid accu-mulation by upregulating acyl-CoA synthetase long-chain family member 3(ACSL3)expression through PI3K/Akt.Methods The experiments were divided into 24 h group,different PLIN2 expression groups,HA-PLIN2+SC97 group and HA-PLIN2+LY294002 group.Western blot was used to detect the protein expression of PLIN2,Akt,p-Akt and ACSL3 in cells,RT-qPCR was used to detect the mRNA level of PLIN2 in cells,and oil red O was used to observe the degree of lipid accumulation in cells.Results The protein expression levels of Akt,p-Akt and ACSL3 in macrophages overex-pressing PLIN2 were significantly increased(P＜0.05),and p-Akt nuclear translocation was increased,with fluorescence labeling of PLIN2 and Akt overlapping.After adding the PI3K/Akt agonist SC97 to macrophages overexpressing PLIN2,the expression level of ACSL3 significantly increased(P＜0.05),and the degree of intracellular lipid accumulation in-creased;After adding the PI3K/Akt inhibitor LY294002 to macrophages overexpressing PLIN2,the expression level of AC-SL3 significantly decreased(P＜0.05),and the degree of intracellular lipid accumulation decreased.Conclusion PLIN2 upregulates ACSL3 expression through PI3K/Akt,thereby promoting macrophage lipid accumulation.

Aim To investigate whether adipose differentiation-related proteins promote macrophage lipid accu-mulation by upregulating acyl-CoA synthetase long-chain family member 3(ACSL3)expression through PI3K/Akt.Methods The experiments were divided into 24 h group,different PLIN2 expression groups,HA-PLIN2+SC97 group and HA-PLIN2+LY294002 group.Western blot was used to detect the protein expression of PLIN2,Akt,p-Akt and ACSL3 in cells,RT-qPCR was used to detect the mRNA level of PLIN2 in cells,and oil red O was used to observe the degree of lipid accumulation in cells.Results The protein expression levels of Akt,p-Akt and ACSL3 in macrophages overex-pressing PLIN2 were significantly increased(P＜0.05),and p-Akt nuclear translocation was increased,with fluorescence labeling of PLIN2 and Akt overlapping.After adding the PI3K/Akt agonist SC97 to macrophages overexpressing PLIN2,the expression level of ACSL3 significantly increased(P＜0.05),and the degree of intracellular lipid accumulation in-creased;After adding the PI3K/Akt inhibitor LY294002 to macrophages overexpressing PLIN2,the expression level of AC-SL3 significantly decreased(P＜0.05),and the degree of intracellular lipid accumulation decreased.Conclusion PLIN2 upregulates ACSL3 expression through PI3K/Akt,thereby promoting macrophage lipid accumulation.

Objective To investigate the efficacy of single-use flexible ureteroscopes combined with flexible tip negative pressure suction sheath in the primary treatment of upper urinary tract stones. Methods A total of 236 patients with upper urinary tract stones were selected as study subjects. Through retrospective analysis, the patients were divided into study group (n=118) and control group (n=118). The study group was treated with single-use flexible ureteroscopes combined with flexible tip negative pressure suction sheath, while the control group received treatment with single-use flexible ureter oscopes combined with conventional sheath. The postoperative pain level [Visual Analogue Scale (VAS)], inflammatory markers, stress indicators, renal function parameters, complication rates and stone clearance rates were compared between the two groups. Results On the first, second, and third postoperative day, the VAS scores in the control group were significantly higher than those in the study group (P < 0.05). At 1 d after surgery, the levels of C-reactive protein, interleukin-6, procalcitonin, norepinephrine and cortisol in the study group were significantly lower than those in the control group (P < 0.05). Additionally, on the first postoperative day, the levels of urea nitrogen, serum creatinine, uric acid and cystatin C in the study group were significantly higher than those in the control group (P < 0.05). The overall complication rate in the study group was 14.4%, which was significantly lower than 27.1% in the control group (P < 0.05). The postoperative stone clearance rate in the study group was 98.3%, which was significantly higher than 88.1% in the control group (P < 0.05). Conclusion The combination of single-use flexible ureteroscopes and flexible tip negative pressure suction sheath exhibits superior efficacy in the primary treatment of upper urinary tract stones. This approach can enhance stone clearance rates, reduces complication rates, alleviate postoperative pain and inflammatory responses, and promotes renal function recovery.

Objective To explore the influencing factors of autoimmune thyroid disease in Xindu region and provide a basis for preventing the occurrence of autoimmune thyroiditis.Methods Using case-control study, 581 autoimmune thyroid patients treated in 2016-2020 in Chengdu Xindu District Hospital of 2020, and 450 healthy patients were selected as the control group. Relevant data were obtained and the influencing factors of adult autoimmune thyroid disease were analyzed by univariate and multivariate logistic regression model. Results Univariate results showed that the observed BMI of 30.0 kg/m², hyperlipidemia, metabolic syndrome and urinary iodine (<100 μg/L and> 200 μg/L) were higher than control group, with thyroid function [free triiodinated thyrigenine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH)), autothyroid antibody [thyroglobulin antibody (TGAb), antithyroid peroxidase antibody (TPOAb),] greater than control group (P <0.05).According to logistic regression analysis, body mass index 30.0, TGAb positive, TPOAb positive, hyperlipidemia, and metabolic syndrome were independent risk factors for adult autoimmune thyroiditis [OR (95% CI): 1.965 (1.340), 3.1262 (1.568-8.243), 3.089 (1.753-7.166), 2.507 (1.164 -4.956), 2.218 (1.207 -3.362), P <0.05]. Conclusion Body mass index of 30.0 kg/m2, hyperlipidemia and metabolic syndrome are the risk factors for adult autoimmune thyroiditis in Xindu region.Controlling weight, controlling autoimmune thyroiditis and metabolic syndrome are the key to reducing adult autoimmune thyroiditis in Xindu region.

OBJECTIVE To provide a reference for the safety of guselkumab in clinical use. METHODS The reporting odds ratio and the Bayesian confidence propagation neural network were used to mine the data of adverse drug events （ADE） related to guselkumab in FAERS database from the fourth quarter of 2017 to the second quarter of 2022. RESULTS & CONCLUSIONS A total of 29 951 ADE reports related to guselkumab were screened， involving 197 （3 871 cases） ADE signals and 21 system organs. The major ADE signals of guselkumab manifested as infectious and invasive diseases， systemic disease and various reactions at the site of administration， and skin and subcutaneous tissue　diseases， which were basically consistent with the instructions. The new ADE signals were found， such as neoplasm of orbit， gallbladder adenocarcinoma， sweat gland disorder， decreased blood uric acid， eyelid retraction， angioimmunoblastic T-cell lymphoma， nonalcoholic fatty liver disease， hyperplastic cholecystopathy， tracheomalacia， inner ear disorder， etc. And the severe ADE signals included severe infections in various parts of the body， liver and gallbladder diseases， tumor， etc.

ObjectiveTo investigate effect of conducting training of autism spectrum disorder （ASD） early screening skill on improving the ability to early identify ASD of medical staffs in primary care hospitals. MethodsIn September 2021， the training of ASD early screening skills was carried out for medical staffs from 20 primary care hospitals in Chengdu. After training， the training effect was evaluated. The numbers of referrals from primary care hospitals to superior hospitals， confirmed ASD as well as their average diagnostic age of children with ASD before and after training were used as evaluation indicators. ResultsAfter training， the number of children with suspected ASD referred by primary care hospitals was more than that before training ［（16.65±11.60） vs. （3.40±2.23）， t=5.431， P<0.01］， the number of children diagnosed with ASD was more than that before training［（6.85±4.93） vs. （2.45±1.67）， t=4.171， P<0.01］， and the differences were statistically significant. As for the diagnosed age of ASD children， after training， the average age was lower than that before training ［（34.95±11.67） vs. （42.2±14.64）， t=-2.553， P=0.019］. ConclusionTraining of ASD early screening skills for medical staffs in primary care hospitals may help to improve their ability to early screening ASD children.

Hydrodynamic chromatography(HDC) and slalom chromatography(SC) called as dynamic liquid chromatography(DLC) were introduced and reviewed, mainly for the recent development of separation principle, theoretical model, and applications. Fifty two