Objective:To investigate the effects of prophylactic analgesia using erector spinae plane block (ESPB) combined with ketorolac tromethamine on postoperative analgesia and early recovery of patients undergoing laparoscopic radical gastrectomy.Methods:A prospective randomized controlled study was conducted. A total of 105 gastric cancer patients who underwent laparoscopic radical gastrectomy in Heji Hospital Affiliated to Changzhi Medical College from June 2022 to October 2023 were selected, and the patients were divided into ESPB+ketorolac tromethamine group (T group), ESPB group (C1 group), and ketorolac tromethamine group (C2 group) by using the random number table method, with 35 cases in each group. The prophylactic analgesia method was preoperative ESPB + ketorolac tromethamine in T group, preoperative ESPB in C1 group and preoperative ketorolac tromethamine in C2 group. The intraoperative sufentanil and remifentanil dosage and the postoperative resting pain visual analogue scale (VAS) score, remedial analgesia, recovery status and complication occurrence were compared among the 3 groups.Results:The baseline characteristics and intraoperative conditions of the patients in the 3 groups were compared, and the differences were not statistically significant (all P > 0.05). The intraoperative sufentanil dosage in T group was less than that in C1 and C2 groups [30 (25, 30) μg vs. 35 (30, 35) μg vs. 40 (35, 45) μg], and the difference was statistically significant ( Z = 33.03, P < 0.001); the intraoperative remifentanil dosage in T group was less than that in C1 and C2 groups [0.34 (0.30, 0.40) mg vs. 0.40 (0.30, 0.50) mg vs. 0.70 (0.60, 0.85) mg], and the difference was statistically significant ( Z = 53.84, P < 0.001). The VAS scores at 1, 6, 12, 24, 48 h after surgery in T group were lower than those in C1 and C2 groups, and the differences were statistically significant (all P < 0.001). The press number of analgesic pump in T group was less than that in C1 and C2 groups [1 (0, 2) times vs. 2 (1, 2) times vs. 4 (3, 5) times], and the difference was statistically significant ( Z = 48.10, P < 0.001). The postoperative first time of exhaust and get out of bed and days of hospital stay in T group were shorter than those in C1 and C2 groups, and the differences were statistically significant (all P < 0.001). The differences in the incidence of postoperative nausea and vomiting, dizziness, pruritus, pneumonia, and anastomotic fistula among the 3 groups were not statistically significant (all P > 0.05). None of the 3 groups experienced postoperative drowsiness, hypotension or respiratory depression. Conclusions:Prophylactic analgesia using ESPB combined with ketorolac tromethamine can effectively reduce the postoperative pain of patients undergoing laparoscopic radical gastrectomy, reduce the use of analgesic drugs, and promote the early recovery of the patients in the postoperative period without increasing the postoperative complications.

Neurodegenerative diseases are a group of disorders characterized by progressive and chronic degeneration of neurons in the central or peripheral nervous system,primarily including conditions such as amyotrophic lateral sclerosis,frontotemporal dementia,Alzheimer's disease,Parkinson's disease,multiple sclerosis,Huntington's disease and age-related macular degeneration.The condition worsens over time,ultimately leading to neuronal loss and synaptic dysfunction.Despite significant advances in medical research,the diagnosis and treatment of neurodegenerative diseases still face major challenges.There is an urgent need for effective and innovative treatment strategies as well as early monitoring methods.This involves not only new drug targets but also research into disease mechanisms.Neuronal pentraxin 2(NPTX2)is a protein expressed in the nervous system,highly expressed in synaptic regions of the brain,where it plays a critical role in synaptic plasticity and the formation and maintenance of neural networks.This paper reviews the role of NPTX2 in neurodegenerative diseases and summarizes recent research progress.

Neurodegenerative diseases are a group of disorders characterized by progressive and chronic degeneration of neurons in the central or peripheral nervous system,primarily including conditions such as amyotrophic lateral sclerosis,frontotemporal dementia,Alzheimer's disease,Parkinson's disease,multiple sclerosis,Huntington's disease and age-related macular degeneration.The condition worsens over time,ultimately leading to neuronal loss and synaptic dysfunction.Despite significant advances in medical research,the diagnosis and treatment of neurodegenerative diseases still face major challenges.There is an urgent need for effective and innovative treatment strategies as well as early monitoring methods.This involves not only new drug targets but also research into disease mechanisms.Neuronal pentraxin 2(NPTX2)is a protein expressed in the nervous system,highly expressed in synaptic regions of the brain,where it plays a critical role in synaptic plasticity and the formation and maintenance of neural networks.This paper reviews the role of NPTX2 in neurodegenerative diseases and summarizes recent research progress.

Objective:To investigate the effects of prophylactic analgesia using erector spinae plane block (ESPB) combined with ketorolac tromethamine on postoperative analgesia and early recovery of patients undergoing laparoscopic radical gastrectomy.Methods:A prospective randomized controlled study was conducted. A total of 105 gastric cancer patients who underwent laparoscopic radical gastrectomy in Heji Hospital Affiliated to Changzhi Medical College from June 2022 to October 2023 were selected, and the patients were divided into ESPB+ketorolac tromethamine group (T group), ESPB group (C1 group), and ketorolac tromethamine group (C2 group) by using the random number table method, with 35 cases in each group. The prophylactic analgesia method was preoperative ESPB + ketorolac tromethamine in T group, preoperative ESPB in C1 group and preoperative ketorolac tromethamine in C2 group. The intraoperative sufentanil and remifentanil dosage and the postoperative resting pain visual analogue scale (VAS) score, remedial analgesia, recovery status and complication occurrence were compared among the 3 groups.Results:The baseline characteristics and intraoperative conditions of the patients in the 3 groups were compared, and the differences were not statistically significant (all P > 0.05). The intraoperative sufentanil dosage in T group was less than that in C1 and C2 groups [30 (25, 30) μg vs. 35 (30, 35) μg vs. 40 (35, 45) μg], and the difference was statistically significant ( Z = 33.03, P < 0.001); the intraoperative remifentanil dosage in T group was less than that in C1 and C2 groups [0.34 (0.30, 0.40) mg vs. 0.40 (0.30, 0.50) mg vs. 0.70 (0.60, 0.85) mg], and the difference was statistically significant ( Z = 53.84, P < 0.001). The VAS scores at 1, 6, 12, 24, 48 h after surgery in T group were lower than those in C1 and C2 groups, and the differences were statistically significant (all P < 0.001). The press number of analgesic pump in T group was less than that in C1 and C2 groups [1 (0, 2) times vs. 2 (1, 2) times vs. 4 (3, 5) times], and the difference was statistically significant ( Z = 48.10, P < 0.001). The postoperative first time of exhaust and get out of bed and days of hospital stay in T group were shorter than those in C1 and C2 groups, and the differences were statistically significant (all P < 0.001). The differences in the incidence of postoperative nausea and vomiting, dizziness, pruritus, pneumonia, and anastomotic fistula among the 3 groups were not statistically significant (all P > 0.05). None of the 3 groups experienced postoperative drowsiness, hypotension or respiratory depression. Conclusions:Prophylactic analgesia using ESPB combined with ketorolac tromethamine can effectively reduce the postoperative pain of patients undergoing laparoscopic radical gastrectomy, reduce the use of analgesic drugs, and promote the early recovery of the patients in the postoperative period without increasing the postoperative complications.

Concurrent chemoradiotherapy (CCRT) refers to the simultaneous treatment of chemotherapy and radiotherapy, and the effect of radiotherapy is enhanced with low-dose chemotherapy, which can reduce tumor recurrence and metastasis and improve clinical prognosis of patients. At present, the main factors for the increase of radiosensitivity of concurrent chemotherapy is that concurrent chemotherapy prevents the repair of tumor cells, and chemotherapy and radiotherapy act on different cell cycles and have synergistic effects. However, even for patients with locally advanced cervical cancer (LACC) who have undergone CCRT, the 5-year survival rate is only 60%, which is still not ideal. In order to improve the efficacy, researchers have conducted a series of exploratory studies, which consist of the combination of targeted drugs and immunodrugs, and neoadjuvant regimens before CCRT, etc. Although targeted or immunologic drugs are effective treatment of LACC, in view of the lack of large-scale evidence-based medical evidence, multi-center prospective and randomized phase III clinical trials and high-level articles are needed to improve the level of evidence-based medicine. This consensus summarizes several key evidence-based medical studies published recently, especially the clinical research progress in targeted and immunological therapies, providing reference for domestic peers.

Objectives:To analyze the disease burden and changing trends of non-rheumatic valvular heart disease(NRVHD)from 1990 to 2019 in China. Methods:Based on the Global Burden of Disease 2019 database,we collected data related to NRVHD in China from 1990 to 2019,analyzed the crude incidence rate,crude prevalence rate,crude disability-adjusted life year(DALY),and age-scaled rate of NRVHD during this period,and analyzed the corresponding trends.The grey prediction model GM(1,1)was used to predict the disease burden of NRVHD in China from 2020 to 2029. Results:The crude incidence,crude prevalence,and crude DALY rates of NRVHD increased in China from 7.87/100 000,123.21/100 000,and 9.83/100 000 in 1990 to 22.85/100 000,374.16/100 000,and 11.95/100 000 in 2019;the age-standardized incidence rate and the age-standardized prevalence rate increased from 9.22/100 000 and 169.04/100 000 in 1990 to 15.30/100000 and 262.85/100 000 in 2019 respectively,with females being higher than males;the age-standardized DALY rate declined from 13.43/100 000 in 1990 to 9.07/100 000 in 2019,with females being higher than males.Joinpoint regression model analysis showed an increasing trend in the age-standardized incidence rate and age-standardized prevalence rate,and a decreasing trend in the age-standardized DALY rate(annual average percentage change[AAPC]values of 1.86%,1.72%and-1.66%,respectively),trend of change was statistically significant(all P<0.05).The burden of disease for all age groups from 1990 to 2019 showed an overall increasing trend,and the crude incidence rate,crude prevalence rate and crude DALY rate all increased with age,and the elderly group over 60 years old was the main group of disease burden.The results of the grey prediction model showed that by 2029,the age-standardized incidence rate and age-standardized prevalence rate would increase to 18.51/100 000 and 303.26/100 000,respectively,and the age-standardized DALY rate would decrease to 7.42/100 000. Conclusions:From 1990 to 2019,the age-standardized incidence rate and age-standardized prevalence rate of NRVHD in China showed an increasing trend,and the age-standardized DALY rate all showed a decreasing trend.The disease burden of NRVHD in China remains high.Women and the senior population are the main target groups needing special attention in China,and more targeted prevention and treatment strategies are needed for high-risk population.

新冠病毒感染疫情严重威胁着世界各国人民的生命健康。目前，对病毒感染的防治研究主要集中在抑制病毒与分子受体的结合上。AXL作为新发现的严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）受体，在协助病毒感染人体呼吸系统中发挥着重要作用，是未来临床干预的潜在靶点。本研究对已发表的单细胞测序数据进行整理和分析，发现AXL在年轻人肺细胞中的表达水平明显高于老年人。人胚肺二倍体成纤维细胞（2BS）是衰老研究的公认细胞株。本文采用2BS细胞构建复制性细胞衰老模型，发现年轻细胞中AXL的蛋白水平明显高于衰老细胞，据此推测年轻人感染的风险可能更高，需要注意防护。我们发现一种羊栖菜褐藻多糖硫酸酯组分（SFW-3）可显著下调年轻2BS细胞中AXL的表达水平，表明SFW-3具有一定的抗SARS-CoV-2感染的研究价值，同时表明2BS细胞株也可作为潜在的SARS-CoV-2体外感染模型。
Humans ; SARS-CoV-2 ; Sargassum/metabolism* ; Diploidy ; Sulfates/metabolism* ; COVID-19 ; Polysaccharides/pharmacology* ; Lung

Objective:To study the correlation between non-contact anterior cruciate ligament (ACL) injury and functional ankle instability (FAI) in young patients.Methods:A retrospective analysis was conducted of the 102 patients with non-contact ACL injury[61 males and 41 females, with an age of (31.9±6.1) years and a Tegner activity score of (6.1±1.9) points] who had been treated at Department of Orthopedics, Sun Yat-sen Memorial Hospital from January 2017 to March 2020 (injury group). Another 102 citizens without ACL injury from Guangzhou [56 males and 46 females, with an age of (30.3±7.2) years and a Tegner activity score of (6.0±2.1) points] were recruited as a control group. The Cumberland ankle instability tool (CAIT) and the Ankle Joint Functional Assessment Tool (AJFAT) were used to assess whether the subjects had self-conscious FAI or not. A correlation analysis was conducted using the data collected.Results:The 2 groups were comparable because there were no significant differences between them in general data ( P>0.05). By the CAIT score, the incidence of FAI in the injury group [52.9% (54/102)] was significantly higher than that in the control group [32.4% (33/102)] ( P<0.05); by the AJFAT score, the incidence of FAI in the injury group [59.8% (61/102) ] was significantly higher than that in the control group [39.2% (40/102)] ( P<0.05). Pearson correlation analysis showed that diagnoses of FAI by CAIT and by AJFAT were respectively correlated with ACL injury ( r=-0.159, P=0.023; r=-0.215, P=0.002). Conclusions:The incidence of FAI may be high in patients with ACL injury and there is a correlation between FAI and ACL injury.

Objective: To describe the distribution and drug resistance of pathogens at hematology department of Jiangsu Province from 2014 to 2015 to provide reference for empirical anti-infection treatment. Methods: Pathogens were from hematology department of 26 tertiary hospitals in Jiangsu Province from 2014 to 2015. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or agar dilution method. Collection of drug susceptibility results and corresponding patient data were analyzed. Results: The separated pathogens amounted to 4 306. Gram-negative bacteria accounted for 64.26%, while the proportions of gram-positive bacteria and funguses were 26.99% and 8.75% respectively. Common gram-negative bacteria were Escherichia coli (20.48%) , Klebsiella pneumonia (15.40%) , Pseudomonas aeruginosa (8.50%) , Acinetobacter baumannii (5.04%) and Stenotropho-monas maltophilia (3.41%) respectively. CRE amounted to 123 (6.68%) . Common gram-positive bacteria were Staphylococcus aureus (4.92%) , Staphylococcus hominis (4.88%) and Staphylococcus epidermidis (4.71%) respectively. Candida albicans were the main fungus which accounted for 5.43%. The rates of Escherichia coli and Klebsiella pneumonia resistant to carbapenems were 3.5%-6.1% and 5.0%-6.3% respectively. The rates of Pseudomonas aeruginosa resistant to tobramycin and amikacin were 3.2% and 3.3% respectively. The resistant rates of Acinetobacter baumannii towards tobramycin and cefoperazone/sulbactam were both 19.2%. The rates of Stenotrophomonas maltophilia resistant to minocycline and sulfamethoxazole were 3.5% and 9.3% respectively. The rates of Staphylococcus aureus, Enterococcus faecium and Enterococcus faecalis resistant wards vancomycin were 0, 6.4% and 1.4% respectively; also, the rates of them resistant to linezolid were 1.2%, 0 and 1.6% respectively; in addition, the rates of them resistant to teicoplanin were 2.8%, 14.3% and 8.0% respectively. Furthermore, MRSA accounted for 39.15% (83/212) . Conclusions Pathogens were mainly gram-negative bacteria. CRE accounted for 6.68%. The rates of Escherichia coli and Klebsiella pneumonia resistant to carbapenems were lower compared with other antibacterial agents. The rates of gram-positive bacteria resistant to vancomycin, linezolid and teicoplanin were still low. MRSA accounted for 39.15%.

As the development of functional and molecular imaging,PET/CT gradually becomes one of methods in optimizing cancer radiotherapy treatment planning.Currently,numerous hospitals routinely use 18F-FDG PET/CT for the delineation of target volume in esophageal carcinoma (EC).However,the validity of 18F-FDG PET/CT in the delineation of target volume for EC is limited and needs further clinical validation.This review focuses on the value and validity of 18F-FDG PET/CT in the delineation of gross tumor target volume of EC primary lesions and regional lymph nodes.