Objective To investigate the application effect of a refined early diet plan in patients with distal gastric cancer after laparoscopic radical surgery.Methods By convenience sampling method,46 patients with laparoscopic radical gastrectomy for distal gastric cancer admitted to a tertiary hospital in Zhejiang Province from July to December 2023 were selected as an experimental group,while 49 patients admitted from January to June 2023 as a control group.The experimental group was administered with the refined early diet plan,and the control group was administered with conventional methods.The intervention period was from the first day after surgery to discharge.The differences of the first postoperative defecation time,perioperative thirst and hunger score,postoperative hospitalization time,hospitalization cost,postoperative complications and the incidence of readmission 30 days after surgery were compared between the 2 groups.Results 42 patients in the experimental group and 49 patients in the control group completed the study.First postoperative exhaust time(t=4.922,P＜0.001),first postopera-tive defecation time(Z=-2.440,P=0.015),perioperative thirst score(Z=-8.024,P＜0.001),perioperative hunger score(Z=-8.192,P＜0.00 1),postoperative hospitalization time(Z=-7.622,P＜0.001)and hospitalization cost(Z=-4.522,P＜0.001)were lower than those of the control group,and the difference was statistically significant.There was no significant difference in complication rate and 30-day readmission rate between the experimental group and the control group(P＞0.05).Conclusion The refined early diet plan is safe and effective for early recovery of patients after laparoscopic radical gastrectomy for distal gastric cancer,promoting intestinal function recovery,shortening hospital stay,reducing hospital costs,and improving patients'subjective comfort.

Hepatocellular carcinoma(HCC)is one of the leading causes of cancer-related mortality worldwide.As a typical immunogenic tumor,HCC has a complex immune microenvironment that plays a crucial role in its initiation and progression.In recent years,the interactive network between immunosuppressive cells and circulating tumor cells(CTCs)has drawn increasing attention for its role in promoting HCC immune evasion and metastasis.However,how CTCs escape immune surveillance and clearance by immune cells remains unclear.This article focuses on the regulatory networks between CTCs and immunosuppressive cells as well as the key pathways of immune evasion,introduces exosome-mediated regulation and single-cell multi-omics technologies to dissect mechanisms of cellular interactions,systematically discusses the clinical translational challenges of targeting pathways such as PD-L1 and CCL5,and proposes future prospects for personalized therapy driven by artificial intelligence.

Objective To investigate the regulatory effect of miR-372 on Runx2 expression and its impact on osteoblast mineralization.Methods Bioinformatic software(Target Scan,miRanda,RNAhybrid)was used to predict microRNAs(miRNAs)that target Runx2,the binding ability of miR-372 to Runx2 was confirmed by dual-luciferase reporter gene experiments.Western blotting analysis was performed to evaluate the regulatory effects of miR-372 on Runx2 protein expression.Osteoblast mineralization was induced using ascorbic acid andβ-glycerophosphate treatment.The functional impact of miR-372 mediated Runx2 regulation on osteoblast mineralization was assessed by measuring Alkaline Phosphatase(ALP)activity and mineralized nodules formation.Results Dual-luciferase reporter gene experiments confirmed direct binding of miR-372 to the Runx2.Western blotting indicated that overexpression of miR-372 in transfected osteoblasts signficantly suppressed Runx2 protein expression,while silencing miR-372 led to elevated Runx2 protein levels.After mineralization induction,ALP activity and mineralization quantitative detection showed miR-372 reuced ALP activity(P＜0.05)and inhibited minerali-zation(P＜0.05)by suppressing Runx2 expression,which was more obvious especially after Runx2 silencing.Conclusion miR-372 can inhibits osteoblast mineralization by downregulating Runx2 expression.

Hepatocellular carcinoma(HCC)is one of the leading causes of cancer-related mortality worldwide.As a typical immunogenic tumor,HCC has a complex immune microenvironment that plays a crucial role in its initiation and progression.In recent years,the interactive network between immunosuppressive cells and circulating tumor cells(CTCs)has drawn increasing attention for its role in promoting HCC immune evasion and metastasis.However,how CTCs escape immune surveillance and clearance by immune cells remains unclear.This article focuses on the regulatory networks between CTCs and immunosuppressive cells as well as the key pathways of immune evasion,introduces exosome-mediated regulation and single-cell multi-omics technologies to dissect mechanisms of cellular interactions,systematically discusses the clinical translational challenges of targeting pathways such as PD-L1 and CCL5,and proposes future prospects for personalized therapy driven by artificial intelligence.

Objective To investigate the regulatory effect of miR-372 on Runx2 expression and its impact on osteoblast mineralization.Methods Bioinformatic software(Target Scan,miRanda,RNAhybrid)was used to predict microRNAs(miRNAs)that target Runx2,the binding ability of miR-372 to Runx2 was confirmed by dual-luciferase reporter gene experiments.Western blotting analysis was performed to evaluate the regulatory effects of miR-372 on Runx2 protein expression.Osteoblast mineralization was induced using ascorbic acid andβ-glycerophosphate treatment.The functional impact of miR-372 mediated Runx2 regulation on osteoblast mineralization was assessed by measuring Alkaline Phosphatase(ALP)activity and mineralized nodules formation.Results Dual-luciferase reporter gene experiments confirmed direct binding of miR-372 to the Runx2.Western blotting indicated that overexpression of miR-372 in transfected osteoblasts signficantly suppressed Runx2 protein expression,while silencing miR-372 led to elevated Runx2 protein levels.After mineralization induction,ALP activity and mineralization quantitative detection showed miR-372 reuced ALP activity(P＜0.05)and inhibited minerali-zation(P＜0.05)by suppressing Runx2 expression,which was more obvious especially after Runx2 silencing.Conclusion miR-372 can inhibits osteoblast mineralization by downregulating Runx2 expression.

Objective To investigate the application effect of a refined early diet plan in patients with distal gastric cancer after laparoscopic radical surgery.Methods By convenience sampling method,46 patients with laparoscopic radical gastrectomy for distal gastric cancer admitted to a tertiary hospital in Zhejiang Province from July to December 2023 were selected as an experimental group,while 49 patients admitted from January to June 2023 as a control group.The experimental group was administered with the refined early diet plan,and the control group was administered with conventional methods.The intervention period was from the first day after surgery to discharge.The differences of the first postoperative defecation time,perioperative thirst and hunger score,postoperative hospitalization time,hospitalization cost,postoperative complications and the incidence of readmission 30 days after surgery were compared between the 2 groups.Results 42 patients in the experimental group and 49 patients in the control group completed the study.First postoperative exhaust time(t=4.922,P＜0.001),first postopera-tive defecation time(Z=-2.440,P=0.015),perioperative thirst score(Z=-8.024,P＜0.001),perioperative hunger score(Z=-8.192,P＜0.00 1),postoperative hospitalization time(Z=-7.622,P＜0.001)and hospitalization cost(Z=-4.522,P＜0.001)were lower than those of the control group,and the difference was statistically significant.There was no significant difference in complication rate and 30-day readmission rate between the experimental group and the control group(P＞0.05).Conclusion The refined early diet plan is safe and effective for early recovery of patients after laparoscopic radical gastrectomy for distal gastric cancer,promoting intestinal function recovery,shortening hospital stay,reducing hospital costs,and improving patients'subjective comfort.

OBJECTIVE To explore the effect and mechanism of the alcoholic extract from Scabiosa comosa against hepatic fibrosis （HF）. METHODS Intragastrical administration of carbon tetrachloride was given to induce HF model. By observing the pathological changes in liver tissue， mRNA and protein expressions of HF indexes [α-smooth muscle actin （α-SMA）， collagen type Ⅰ] and phosphoinositide 3-kinase （PI3K）/protein kinase B （Akt） pathway-related factors were detected， and the improvement effects and possible mechanism of low-dose， medium-dose and high-dose （50， 100， 200 mg/kg） of alcoholic extract from S. comosa on HF model rats were investigated. Drug-containing serum was prepared by intragastrical administration of alcoholic extract from S. comosa at a concentration of 1 800 mg/（kg·d） （calculated by the amount of raw material）. The effects of drug- containing serum of alcoholic extract from S. comosa on the expression of miRNA-21 were observed through the intervention of HSC-T6 cells with low， medium and high concentrations of drug-containing serum of alcoholic extract from S. comosa （diluted to 10%， 15%， 20%）. miRNA-21 mimics or inhibitors were used to transfect HSC-T6 cells， and the mRNA and protein expressions of factors related to the PI3K/Akt signaling pathway were detected. RESULTS The results of in vivo experiments showed that low， medium and high doses of alcoholic extract from S. comosa significantly ameliorated the histopathological changes in liver tissue of HF rats， and the percentage of collagen was significantly reduced （P＜0.01）； mRNA and protein expressions of the indicators related to HF as well as PI3K and Akt were significantly reduced （P＜0.01）， and mRNA and protein expressions of phosphatase and tensin homolog deleted on chromosome ten （PTEN） were increased in liver tissue of rats （P＜0.01）. The results of in vitro experiments showed that drug-containing serum of alcoholic extract from S. comosa significantly inhibited the expression of miRNA-21 at low， medium and high concentrations （P＜0.01）； whereas after transfection with miRNA-21 mimics， it was found that miRNA-21 mimics significantly increased mRNA and protein expressions of PI3K and Akt （P＜0.01）， while significantly decreased mRNA and protein expressions of PTEN （P＜0.01）； after transfection with miRNA-21 inhibitor， the changes of above indexes were opposite to the above results （P＜0.01）. CONCLUSIONS Alcoholic extracts of S. comosa may inhibit the PI3K/Akt signaling pathway by affecting the expression of miRNA-21， so as to achieve the effect of anti-hepatic fibrosis.

To summarize the nursing experience of a patient with median arcuate ligament compression syndrome.Nursing points:to implement effective measures to relieve local compression and improve gastrointestinal symptoms;to establish a monitoring and evaluation plan focusing on abdominal pain to prevent serious adverse vascular events;to implement pre-rehabilitation care with psychological and nutritional support to reduce surgical risks;to actively provide postoperative gastroparesis care and discharge follow-up care.The patient was discharged from the hospital 22 days after surgery and was followed up for 6 months.His weight increased and his quality of life was high.

Objective To investigate the role and mechanism of action of Scabiosa atropurea in inhibiting the proliferation of hepatic stellate cells using cell experiment. Methods A total of 20 Wistar rats were randomly divided into control group and administration group, with 10 rats in each group. The rats in the control group were given normal saline by gavage, and those in the administration group were given Scabiosa atropurea by gavage to prepare drug-containing serum. HSC-T6 cells were incubated with the serum from the control group (10%) or the low-, middle-, and high-dose serum containing Scabiosa atropurea (10%, 15%, and 20%, respectively). MTT assay was used to observe the effect of different drug concentrations on cells in different periods of time; flow cytometry was used to measure cell apoptosis; qRT-PCR and Western blot were used to measure the mRNA and protein expression levels of fibrosis markers (α-SMA, collagen Ⅰ) and PI3K/Akt signaling pathway-related factors in hepatic stellate cells (HSCs). A one-way analysis of variance was used for comparison between multiple groups, and the least significant difference t - test was used for further comparison between two groups. Results Compared with the control group, the low-, middle-, and high-dose serum containing Scabiosa atropurea groups had a significant reduction in the OD value of cells (all P < 0.05) and a significant increase in the overall apoptosis rate of cells (all P < 0.05). The results of qRT-PCR showed that compared with the control group, the low-, middle-, and high-dose serum containing Scabiosa atropurea groups had significant reductions in the mRNA expression levels of α-SMA, collagen Ⅰ, PI3K, and Akt and a significant increase in the mRNA expression level of PTEN (all P < 0.05); Western blot showed that compared with the control group, the low-, middle-, and high-dose serum containing Scabiosa atropurea groups had significant reductions in the protein expression levels of α-SMA, collagen Ⅰ, PI3K, Akt, and p-Akt and a significant increase in the protein expression level of PTEN (all P < 0.05). Conclusion The Mongolian medicine Scabiosa atropurea can inhibit the proliferation of HSC-T6 cells and promote their apoptosis, possibly by regulating fibrosis markers and the PI3K/Akt signaling pathway to exert an anti-liver fibrosis effect.

Objective To analyze the compliance and influencing factors of patients with mental disorders complicated with diabetes treatment in a third-class general hospital of Nantong City, and to provide theoretical basis for improving the compliance of patients with mental disorders complicated with diabetes treatment. Methods Among of 148 patients with mental disorders combined with diabetes admitted to our hospital from January 2021 to June 2022 were selected and divided into poor compliance group and good compliance group according to the investigation of diabetes treatment compliance. The blood glucose control of the two groups was compared, and clinical data of patients were collected from the medical record system. The independent risk factors affecting the compliance of patients with mental disorders and diabetes were analyzed. Results The levels of FBG, PBG and HbA1c in poor compliance group were significantly lower than those in good compliance group (P<0.05). The results showed that poor cognition of the disease (OR=2.649), paranoid psychosis (OR=0.371), low self-awareness and attitude score (OR=0.618), poor blood glucose control (OR=2.914) were independent risk factors affecting the compliance of patients with mental disorders and diabetes mellitus (P<0.05). Conclusion The compliance of patients with mental disorders combined with diabetes in the treatment of diabetes is not high and the control of blood sugar is not good. Mental health service outlets should be added to actively control the blood sugar of patients, focusing on paranoid mental patients and strengthening the publicity and education of guardians, which can improve the treatment compliance of patients and contribute to the prognosis of patients.