Objective To investigate the short-term efficacy and safety of small-incision laparo-scopic radical gastrectomy in patients with advanced gastric cancer.Methods A total of 80 patients with advanced gastric cancer scheduled for radical gastrectomy were enrolled and randomly divided into control group and observation group using a random number table method,with 40 patients in each group.The control group underwent open surgery,while the observation group underwent small-inci-sion laparoscopic surgery.Clinical indicators related to the surgery were recorded in both groups.In-flammatory markers were measured and compared between the two groups before surgery and 72 hours af-ter surgery.Postoperative recovery and the incidence of complications during hospitalization were ob-served and compared between the two groups.Results There were no statistically significant differences in operative time,the number of dissected lymph nodes,distance from the proximal margin to the tumor,and distance from the distal margin to the tumor between the two groups(P＞0.05).The incision length in the observation group was shorter,intraoperative blood loss was less,hospital stay was shorter,and treatment cost was higher than those in the control group[(7.15±1.22)cm versus(14.65±2.64)cm,(177.16±28.46)mL versus(244.16±42.16)mL,(8.11±1.46)d versus(14.15±3.65)d,(5.54±0.31)×10,000 yuan versus(4.38±0.61)×10,000 yuan,P＜0.05].There were no sta-tistically significant differences in preoperative levels of C-reactive protein,interleukin-6,and tumor necrosis factor-α between the two groups(P＞0.05).At 72 hours after surgery,the observation group had lower levels of C-reactive protein[(12.38±4.31)mg/L versus(24.87±4.68)mg/L],tumor necrosis factor-α[(9.64±1.55)μg/L versus(15.65±1.98)μg/L],and interleukin-6[(14.33±3.21)ng/mL versus(30.16±2.98)ng/mL]compared with the control group(P＜0.05).The observation group had shorter time to anal exhaust[(2.61±0.87)d versus(3.98±1.45)d],getting out of bed[(2.91±0.98)d versus(4.78±1.46)d],intake a liquid diet[(3.44±1.45)d versus(4.87±1.64)d],and first defecation[(1.66±0.18)d versus(2.93±0.78)d]compared with the control group(P＜0.05).There were no statistically significant differ-ences in the incidence of anastomotic leakage,incision infection,intra-abdominal hemorrhage,anastomotic bleeding,and reflux gastritis between the two groups(P＞0.05).Conclusion Small-incision laparoscopic radical gastrectomy can effectively reduce postoperative stress and inflammatory responses,promote postoperative recovery,and has good short-term efficacy and safety.

Objective To investigate the association between preoperative N-terminal pro-brain natriuretic peptide(NT-proBNP)and acute kidney injury(AKI)after liver transplantation(LT),to clarify the influencing factors for AKI after liver transplantation,and to provide diagnostic reference indicators for the early prevention of AKI after LT.Methods A retrospective analysis was performed for the medical records of the adult patients who underwent LT in The First Hospital of Jilin University from September 13,2020 to June 30,2022,and according to the presence or absence of AKI after LT,the patients were divided into AKI group and non-AKI group.The propensity score matching(PSM)method was used to match the basic information of the two groups at a ratio of 1∶4.The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups,and the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups.The multivariate Logistic regression analysis was used to investigate the independent risk factors for AKI after LT.Results A total of 144 patients were included in this study,among whom 22(15.3%)developed AKI after surgery and 122(84.7%)did not develop postoperative AKI.A total of 93 patients were included after PSM,with 19 patients in the AKI group and 74 patients in the non-AKI group.The multivariate Logistic regression analysis showed that preoperative NT-proBNP(odds ratio[OR]=7.692,95%confidence interval[CI]:1.473-40.159,P=0.016),preoperative fibrinogen level(OR=5.520,95%CI:1.160-26.267,P=0.032),time of operation(OR=15.802,95%CI:2.418-103.268,P=0.004),and intraoperative blood loss(OR=13.246,95%CI:2.291-76.594,P=0.004)were independent risk factors for AKI after LT.Conclusion Preoperative NT-proBNP level may be used as a predictive factor for AKI after LT and can provide a certain reference for establishing a risk predictive model for AKI after LT.

Objective:To explore the remodeling of brain function 2 years after anterior cruciate ligament reconstruction (ACLR) and its relationship with functioning and behavior.Methods:Forty-eight volunteers who had received ACLR from the same surgeon were divided into a coping and a non-coping group, each of 17. Another 14 health volunteers formed the control group. Resting-state functional magnetic resonance imaging was used to record blood oxygen level-dependent signals from the members of all three groups in the 0.01 to 0.08Hz band. One-way analysis of variance was applied to the differences in low frequency amplitude (ALFF) observed.Results:The results of multiple comparisons with Gaussian random field theory correction showed that the differences in bilateral putamen ALFF values among the three groups were statistically significant. The signals from the right cerebellar area 8 and the bilateral putamen were significantly stronger among the non-coping group on average. Pearson correlation analysis showed that the ALFF values from the right cerebellar 8 region were positively and significantly more correlated with the symmetry of a subject′s Y balance function test results in the coping group compared with the non-coping group.Conclusions:Subcortical brain function remodeling occurs in ACLR patients returning to exercise after surgery, and a Y-balance function test can indirectly reflect such remodeling. That can provide a basis for designing programs for rehabilitating advanced brain functions.

Studies have shown that vertebral artery hypoplasia(VAH)is associated with posterior circulation ischemic stroke,but it is difficult to distinguish VAH from atherosclerotic stenosis in cerebrovascular angiography and other imaging examinations,and there is currently no unified diagnostic standard for intracranial VAH.The authors reviewed the definition and incidence of intracranial VAH from the aspects of autopsy and imaging,and summarized its relationship with posterior circulation ischemic stroke,in order to improve the clinicians'understanding of intracranial VAH.

Animals ; Mice ; Spinal Neoplasms/pathology* ; Disease Models, Animal

Objective To explore the difference of brain function remodeling in patients with differ-ent motor ability and record the brain function index of patients returning to exercise 2 years after an-terior cruciate ligament reconstruction(ACLR).Methods Patients undergoing ACLR in year 2017 and 2018(2 years after ACLR)were selected and randomly divided into a return-to-exercise(CP,n=7)group,a non-return-to-exercise(NP,n=7)group.Moreover,8 healthy counterparts of the CP group were chosen into a healthy control(HC)group.Resting state functional magnetic resonance imaging(rs-fMRI)was used to obtain the blood oxygen level dependent signals,and the amplitude of low-frequen-cy fluctuation(ALFF)was computed across the typical band(0.01～0.08 Hz),sub-band Slow-4(0.027～0.073 Hz)and Slow-5(0.01～0.027 Hz).Meanwhile,brain maps were obtained and two-sample t-tests were performed among different groups(P<0.005).Results In the typical frequency band,the average ALFF value was higher in the CP and HC groups than the NP group for the Cerebelum_Crus1,but lower in the CP group than the NP group for the Occipital_Mid,higher in the CP group than the HC group for the Putamen and higher in the NP group than the HC group for the Frontal_Mid_Orb.More-over,in the Slow-4 band,the ALEF level was lower in the CP group than the NP group for the Oc-cipital_Mid,higher in the CP group than the HC group for the Putamen,and higher in the NP group than the HC group for the Frontal_Mid_Orb and cerebellum_Crus2.However,in the Slow-5 band,the ALEF values were higher in the CP group than the NP group for the Occipital_Inf and Precen-tral,but lower for the caudate.In the same band,those values were higher in the CP group than in the HC group for the Cerebellum_Crus1,but lower in the NP group than the HC group for the Cere-bellum_Crus1 and Supp_Motor_Area,and higher in the NP group than the HC group for the Fron-tal_Mid_Orb.Conclusion The patients returning to exercise after ACLR have higher cerebellar remodel-ing and lower visual compensation than those not,and display higher basal ganglia and cerebellar nerve remodeling than healthy controls,suggesting that functional compensation occurs in the former pa-tients.Moreover,Slow-4,Slow-5 and other sub-bands can complement the classical frequency bands and are worthy of further study.

Objective:To compare the effectiveness and safety of all-suture anchors and single-row suture anchors for rotator cuff repair.Methods:A prospective randomized controlled study was conducted to analyze the clinical data of 50 patients with rotator cuff tear admitted to Second Affiliated Hospital of Zhejiang University School of Medicine between July 2019 and September 2021. They were divided into two groups according to the random table: 25 patients to receive repair with single-row suture anchors (control group) and the other 25 with all-suture anchors (trial group). Visual Analogue Scale (VAS), University of California, Los Angeles (UCLA) shoulder score, American Shoulder and Elbow Surgeons (ASES) score and shoulder range of motion were compared between the two groups before surgery, at 3 months after surgery and at the last follow-up. The rotator cuff retear rate of the two groups was evaluated according to Sugaya classification at 6 months after surgery. Breakage or anchor loosening during surgery, healing of incision and presence of infections or neurological complications after surgery, and change of the anchor position and periosteal reaction at the insertion site at 3 and 6 months after surgery were observed in the two groups.Results:A total of 50 patients with rotator cuff tear were involved in this study, including 17 males and 33 females, aged 40-73 years [(59.1±10.3)years]. All patients were followed up for 6-9 months [(6.7±1.0)months]. The differences in VAS, UCLA shoulder score, ASES score, and shoulder range of motion between the two groups were statistically insignificant before surgery (all P>0.05). The VAS at 3 months after surgery and at the last follow-up in the control group was 2.0 (2.0, 4.0)points and 2.0 (0.0, 2.0)points, respectively, with no statistical differences from 2.0 (2.0, 2.0)points and 2.0 (0.0, 2.0)points in the trial group (all P>0.05). In the control group, the UCLA shoulder score and ASES score at 3 months after surgery and the ASES score at the last follow-up were (25.1±4.5)points, 78.8 (71.6, 85.8)points and 85.8 (85.8, 93.0)points, respectively, with no statistical differences from (26.8±4.7)points, 85.8 (82.3, 85.8)points, and 92.8 (85.8, 100.0)points in the trial group (all P>0.05). At the last follow-up, the UCLA shoulder score of the control group was (29.2±3.9)points, which was lower than that of the trial group [(31.6±2.4)points] ( P<0.05). The differences in shoulder motion between the two groups at 3 months after surgery and at the last follow-up were not statistically significant (all P>0.05). The VAS, UCLA shoulder score, and ASES score at 3 months after surgery and at the last followup in both groups were significantly improved compared to their preoperative values (all P<0.05); further improvements were observed at the last follow-up compared with those at 3 months after surgery (all P<0.05). The rotator cuff retear rate at 6 months after surgery was 16.7% (4/24) in the control group, not statistically different from 4.3% (1/23) in the trial group ( P>0.05). There were no incidences of anchor loosening or breakage during surgery. All incisions were healed after surgery, with no infections or neurological complications. No grades II to III periosteal reactions at the anchor insertion sites were observed in either group at 3, 6 months after surgery. The percentage of patients with grade 0 periosteal reaction at the anchor insertion site at 3 months after surgery was 4.2% (1/24) in the control group, significantly lower than 30.4% (7/23) in the trial group ( P<0.05). Conclusion:All-suture anchors and single-row suture anchors are effective in rotator cuff repair, but the former results in better shoulder function and fewer periosteal reactions in the anchor insertion site in the early stage.

Objective:To compare the short-term clinical outcomes associated with longitudinal outside-in capsulotomy and transverse inside-out capsulotomy in arthroscopic surgery for femoral acetabular impingement (FAI).Methods:A retrospective cohort study was conducted encompassing 30 patients who underwent arthroscopic surgery to address FAI from August 2020 to June 2021. This group, comprising an equal distribution of 15 males and 15 females with a mean age of 40.9±10.7 years (range 15-63 years), was subjected to longitudinal outside-in capsulotomy without subsequent capsular closure. Patients of the longitudinal capsulotomy group (Group L) were 1∶1 matched with another 30 patients who underwentarthroscopic surgery for FAI between April 2018 and April 2019 as controls, including 10 males and 20 females, aged 40.6±9.2 years old (range, 25-60 years old). The control group (Group T) underwent transverse inside-out capsulotomy without capsular closure. The subjective functional outcomes within both groups were meticulously evaluated, including the modified Harris hip score (mHHS) and the visual analog scale (VAS). Additionally, the proportions of subjects achieving Grade A or B classifications and the patient acceptable symptomatic state (PASS) based upon the mHHS were scrupulously calculated.Results:The foundational data, encompassing pre-operative subjective functional scores, pre-operative radiological dimensions, and intra-operative discoveries, showed no significant differences between the groups ( P>0.05). At the one-year follow-up, Group L demonstrated a reduced post-operative VAS score of 1.3±1.6, a diminution from the pre-operative mean of 6.3±1.4, alongside a mHHS improvement from 63.8±15.1 pre-operatively to 93.5±5.1 post-operatively. Conversely, Group T revealed a post-operative VAS score of 1.4±1.5, ameliorated from a pre-operative mean of 7.0±1.6, and an mHHS improvement from 64.6±7.8 pre-operatively to 90.4±8.4 post-operatively. The improvements of VAS and the mHHS showed statistical significance in both groups ( P<0.001), yet no significant disparities were observable in the post-operative VAS and mHHS results between the two cohorts ( t=0.03, P=0.735 for VAS; t=1.75, P=0.082 for mHHS). Remarkably, every participant in Group L achieved Grade A or B in mHHS; however, only 83.3% of Group T attained these grades, a discrepancy manifesting statistical significance (χ 2=8.32, P<0.01). Correlatively, the attainment of PASS stood at 100% in Group L versus 90% in Group T, denoting a statistically significant difference (χ 2=6.54, P<0.01). Conclusion:Longitudinal outside-in capsulotomy in the arthroscopic management of FAI is vindicated as an effective technique, exhibiting parallel clinical outcomes to the traditional transverse inside-out technique.

Facial paralysis causes both physical pain and psychological distress to patients. It is difficult for a patient with facial paralysis to engage with a normal social life and at work. Progresses have been made in recent years in the treatment of facial paralysis. More attentions have been caught by masseteric to facial nerve transposition, which has advantages of adjacency in location, abundancy in nerve supply and reliability in the outcome and now has deemed an important option of facial reanimation. It has not been long since the application of the technique of masseteric to facial nerve transposition in China, therefore it still lacks a universal guidance on practice. In order to achieve the aim of better quality control and popularisation of the technique, hereby a consensus with suggestions on facial reanimation with masseteric to facial nerve transposition is proposed as the reference for surgeons specialised in facial reanimation. This consensus is proposed, discussed and drafted by experts from plastic and reconstructive surgery, oral and maxillofacial surgery, head and neck surgery and neurosurgery.

OX40 is a costimulatory receptor that is expressed primarily on activated CD4⁺, CD8⁺, and regulatory T cells. The ligation of OX40 to its sole ligand OX40L potentiates T cell expansion, differentiation, and activation and also promotes dendritic cells to mature to enhance their cytokine production. Therefore, the use of agonistic anti-OX40 antibodies for cancer immunotherapy has gained great interest. However, most of the agonistic anti-OX40 antibodies in the clinic are OX40L-competitive and show limited efficacy. Here, we discovered that BGB-A445, a non-ligand-competitive agonistic anti-OX40 antibody currently under clinical investigation, induced optimal T cell activation without impairing dendritic cell function. In addition, BGB-A445 dose-dependently and significantly depleted regulatory T cells in vitro and in vivo via antibody-dependent cellular cytotoxicity. In the MC38 syngeneic model established in humanized OX40 knock-in mice, BGB-A445 demonstrated robust and dose-dependent antitumor efficacy, whereas the ligand-competitive anti-OX40 antibody showed antitumor efficacy characterized by a hook effect. Furthermore, BGB-A445 demonstrated a strong combination antitumor effect with an anti-PD-1 antibody. Taken together, our findings show that BGB-A445, which does not block OX40-OX40L interaction in contrast to clinical-stage anti-OX40 antibodies, shows superior immune-stimulating effects and antitumor efficacy and thus warrants further clinical investigation.
Mice ; Animals ; Receptors, Tumor Necrosis Factor/physiology* ; Receptors, OX40 ; Membrane Glycoproteins ; Ligands ; Antibodies, Monoclonal/pharmacology* ; Antineoplastic Agents/pharmacology*