Objective:To explore the optimal duration of preoperative imatinib therapy in patients with locally advanced gastrointestinal stromal tumors (GIST) in order to optimize surgical timing and long-term survival benefits.Methods:A total of 171 patients with locally advanced GIST who received preoperative imatinib therapy and subsequent surgical resection between November 2012 and October 2024 at Fujian Cancer Hospital and Union Hospital of Fujian Medical University were retrospectively analyzed. Patients were divided into three groups according to the duration of preoperative imatinib treatment: short-term (≤6 months, n=50), intermediate-term (7-12 months, n=87), and long-term (>12 months, n=34). Imaging response, pathological efficacy, recurrence-free survival (RFS), and overall survival (OS) were compared among the groups. Univariate and multivariate Cox regression analyses were used to identify the optimal treatment duration. Results:The median duration of preoperative imatinib therapy was 9 (6, 12) months. After treatment, the average maximum tumor diameter decreased from (10.37±5.74) cm to (6.99±4.34) cm, with an average shrinkage of 31.5%. The objective response rates in the short-, intermediate-, and long-term groups were 50.0% (25/50), 58.6% (51/87), and 52.9% (18/34), respectively; high-grade pathological response rates were 28.0% (14/50), 37.9% (33/87), and 29.4% (10/34), with no statistically significant differences among groups (all P>0.05). With a median follow-up of 46 months, 39 patients experienced recurrence and 20 died. The intermediate-term group had 3- and 5-year RFS rates of 87.1% and 79.6%, respectively, significantly better than those of the short-term group (75.5% and 55.5%, P=0.004). The long-term group had 3- and 5-year RFS rates of 85.3% and 75.5%, which were between the other two groups, but not significantly different (all P>0.05). For OS, the intermediate-term group had 3- and 5-year rates of 97.3% and 92.7%, superior to the short-term group (84.4% and 72.4%, P=0.007), while the long-term group (88.2% and 79.4%) showed no significant advantage (all P>0.05). Stratified analysis revealed that among non-gastric primary tumor patients with c-Kit exon 11 mutations, partial response on imaging, or postoperative imatinib ≤24 months, the intermediate-term group had significantly better RFS and OS than the short-term group (all P<0.05), but had no differences compared to the long-term group ( P>0.05). Multivariate Cox regression analysis indicated that preoperative imatinib duration was not an independent factor for RFS ( P>0.05), but treatment for 7-12 months was an independent protective factor for OS ( HR=0.275, 95% CI: 0.089-0.851, P=0.025), while prolonging therapy beyond 12 months conferred no additional OS benefit ( P>0.05). Conclusions:In patients with locally advanced GIST, preoperative imatinib therapy for 7-12 months yielded the most favorable prognosis, with significantly improved RFS and OS compared to ≤6 months of treatment. Extending preoperative therapy beyond 12 months did not provide additional survival benefit.

Acute symptomatic osteoporotic thoracolumbar compression fracture (ASOTLF) can lead to chronic low back pain, kyphosis deformity, pulmonary dysfunction, loss of mobility, and even life-threatening complications. Vertebral augmentation is currently the mainstream treatment method for this condition. In 2019, the Editorial Board of Chinese Journal of Trauma and the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association collaboratively led the development of Clinical guideline for vertebral augmentation for acute symptomatic osteoporotic thoracolumbar compression fractures. Six years later, with advances in clinical diagnosis and treatment techniques as well as accumulating evidence in related fields, the 2019 guideline requires updating. To this end, the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association, the Spinal Health Professional Committee of China Human Health Science and Technology Promotion Association, and the Minimally Invasive Orthopedics Professional Committee of Shaanxi Medical Doctor Association have organized experts in the field to develop the Clinical guideline for vertebral augmentation of acute symptomatic osteoporotic thoracolumbar compression fractures ( version 2025) , based on the latest evidence-based medical researches. This guideline incorporates 3 recommendations retained from the 2019 version with updated strength of evidence, along with 12 new recommendations. It provides recommendations from six aspects of diagnosis, pain management, treatment option selection, prevention of postoperative complications, anti-osteoporosis therapy, and postoperative rehabilitation, aiming to provide a reference for standard treatment of vertebral augmentation for ASOTLF in hospitals at all levels.

Acute symptomatic osteoporotic thoracolumbar compression fracture (ASOTLF) can lead to chronic low back pain, kyphosis deformity, pulmonary dysfunction, loss of mobility, and even life-threatening complications. Vertebral augmentation is currently the mainstream treatment method for this condition. In 2019, the Editorial Board of Chinese Journal of Trauma and the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association collaboratively led the development of Clinical guideline for vertebral augmentation for acute symptomatic osteoporotic thoracolumbar compression fractures. Six years later, with advances in clinical diagnosis and treatment techniques as well as accumulating evidence in related fields, the 2019 guideline requires updating. To this end, the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association, the Spinal Health Professional Committee of China Human Health Science and Technology Promotion Association, and the Minimally Invasive Orthopedics Professional Committee of Shaanxi Medical Doctor Association have organized experts in the field to develop the Clinical guideline for vertebral augmentation of acute symptomatic osteoporotic thoracolumbar compression fractures ( version 2025) , based on the latest evidence-based medical researches. This guideline incorporates 3 recommendations retained from the 2019 version with updated strength of evidence, along with 12 new recommendations. It provides recommendations from six aspects of diagnosis, pain management, treatment option selection, prevention of postoperative complications, anti-osteoporosis therapy, and postoperative rehabilitation, aiming to provide a reference for standard treatment of vertebral augmentation for ASOTLF in hospitals at all levels.

Objective:To explore the optimal duration of preoperative imatinib therapy in patients with locally advanced gastrointestinal stromal tumors (GIST) in order to optimize surgical timing and long-term survival benefits.Methods:A total of 171 patients with locally advanced GIST who received preoperative imatinib therapy and subsequent surgical resection between November 2012 and October 2024 at Fujian Cancer Hospital and Union Hospital of Fujian Medical University were retrospectively analyzed. Patients were divided into three groups according to the duration of preoperative imatinib treatment: short-term (≤6 months, n=50), intermediate-term (7-12 months, n=87), and long-term (>12 months, n=34). Imaging response, pathological efficacy, recurrence-free survival (RFS), and overall survival (OS) were compared among the groups. Univariate and multivariate Cox regression analyses were used to identify the optimal treatment duration. Results:The median duration of preoperative imatinib therapy was 9 (6, 12) months. After treatment, the average maximum tumor diameter decreased from (10.37±5.74) cm to (6.99±4.34) cm, with an average shrinkage of 31.5%. The objective response rates in the short-, intermediate-, and long-term groups were 50.0% (25/50), 58.6% (51/87), and 52.9% (18/34), respectively; high-grade pathological response rates were 28.0% (14/50), 37.9% (33/87), and 29.4% (10/34), with no statistically significant differences among groups (all P>0.05). With a median follow-up of 46 months, 39 patients experienced recurrence and 20 died. The intermediate-term group had 3- and 5-year RFS rates of 87.1% and 79.6%, respectively, significantly better than those of the short-term group (75.5% and 55.5%, P=0.004). The long-term group had 3- and 5-year RFS rates of 85.3% and 75.5%, which were between the other two groups, but not significantly different (all P>0.05). For OS, the intermediate-term group had 3- and 5-year rates of 97.3% and 92.7%, superior to the short-term group (84.4% and 72.4%, P=0.007), while the long-term group (88.2% and 79.4%) showed no significant advantage (all P>0.05). Stratified analysis revealed that among non-gastric primary tumor patients with c-Kit exon 11 mutations, partial response on imaging, or postoperative imatinib ≤24 months, the intermediate-term group had significantly better RFS and OS than the short-term group (all P<0.05), but had no differences compared to the long-term group ( P>0.05). Multivariate Cox regression analysis indicated that preoperative imatinib duration was not an independent factor for RFS ( P>0.05), but treatment for 7-12 months was an independent protective factor for OS ( HR=0.275, 95% CI: 0.089-0.851, P=0.025), while prolonging therapy beyond 12 months conferred no additional OS benefit ( P>0.05). Conclusions:In patients with locally advanced GIST, preoperative imatinib therapy for 7-12 months yielded the most favorable prognosis, with significantly improved RFS and OS compared to ≤6 months of treatment. Extending preoperative therapy beyond 12 months did not provide additional survival benefit.

Objective:To analyze and compare the health education efforts of respiratory infectious diseases at home and abroad.Methods:The literature related to health education and popular science of respiratory infectious diseases included in the databases of China National Knowledge Infrastructure (CNKI) and Web of Science (WOS) from January 1, 2003 to December 31, 2023 was searched. A total of 4 686 articles were retrieved in CNKI, 1 540 articles unrelated to the theme were excluded, and 3 146 Chinese articles were obtained. In the WOS database, 7 724 articles were retrieved, 3 685 articles about the clinical mechanism of diseases, pharmacology, and other research topics were excluded, and 4 039 English articles were obtained. The information of annual publications, institutions, authors and keywords was analyzed by using CiteSpace visualization software, and the publication status, research hotspots and development trends of health education related to respiratory infectious diseases at home and abroad were analyzed.Results:Since 2003, the number of publications in health education on respiratory infectious diseases at home and abroad had shown a fluctuating growth trend, and in 2020, the field showed a sharp growth trend at home and abroad. There was no core author group in this field in China, and the network density of domestic authors was 0.006 5, and the network density of foreign authors was 0.009 6. The domestic institutions were mainly the Center for Disease Control and Prevention and medical institutions, including Guangzhou Chest Hospital (29 articles) and the Chinese Center for Disease Control and Prevention (10 articles); Foreign research institutions were mainly higher education institutions, including the University of London (91 articles) and Harvard University (67 articles). The network density of domestic was 0.001 3, and the network density of foreign publishing institutions was 0.026 3, the network density was greater than that of Chinese publishing institutions. The emergence of "COVID-19" "Avian influenza" "Knowledge, Attitude, Practice" and "mental health" in China had strong burst (burst intensity: 46.41, 12.12, 10.33, 8.5); "Coronavirus" "coverage" "Avian influenza" and "COVID-19 vaccine" in foreign countries had strong burst (burst intensity: 14.34, 11.06, 10.73, 10.02).Conclusions:At present, the health education of respiratory infectious diseases at home and abroad has received great attention. But the cooperation between domestic authors and research institutions is loose, and the close collaboration needs to be strengthened. There are differences in the research focus of health education on respiratory infectious diseases at home and abroad.

Objective:To evaluate artificial intelligence constructed by deep convolutional neural network (DCNN) for the site identification in upper gastrointestinal endoscopy.Methods:A total of 21 310 images of esophagogastroduodenoscopy from the Cancer Hospital of Chinese Academy of Medical Sciences from January 2019 to June 2021 were collected. A total of 19 191 images of them were used to construct site identification model, and the remaining 2 119 images were used for verification. The performance differences of two models constructed by DCCN in the identification of 30 sites of the upper digestive tract were compared. One model was the traditional ResNetV2 model constructed by Inception-ResNetV2 (ResNetV2), the other was a hybrid neural network RESENet model constructed by Inception-ResNetV2 and Squeeze-Excitation Networks (RESENet). The main indices were the accuracy, the sensitivity, the specificity, positive predictive value (PPV) and negative predictive value (NPV).Results:The accuracy, the sensitivity, the specificity, PPV and NPV of ResNetV2 model in the identification of 30 sites of the upper digestive tract were 94.62%-99.10%, 30.61%-100.00%, 96.07%-99.56%, 42.26%-86.44% and 97.13%-99.75%, respectively. The corresponding values of RESENet model were 98.08%-99.95%, 92.86%-100.00%, 98.51%-100.00%, 74.51%-100.00% and 98.85%-100.00%, respectively. The mean accuracy, mean sensitivity, mean specificity, mean PPV and mean NPV of ResNetV2 model were 97.60%, 75.58%, 98.75%, 63.44% and 98.76%, respectively. The corresponding values of RESENet model were 99.34% ( P<0.001), 99.57% ( P<0.001), 99.66% ( P<0.001), 90.20% ( P<0.001) and 99.66% ( P<0.001). Conclusion:Compared with the traditional ResNetV2 model, the artificial intelligence-assisted site identification model constructed by RESENNet, a hybrid neural network, shows significantly improved performance. This model can be used to monitor the integrity of the esophagogastroduodenoscopic procedures and is expected to become an important assistant for standardizing and improving quality of the procedures, as well as an significant tool for quality control of esophagogastroduodenoscopy.

Objective:To assess the changes of left ventricular systolic function and global synchronization and myocardial work in patients with left bundle branch pacing (LBBP) by two-dimensional multi-layered speckle tracking imaging.Methods:Forty-two patients with Ⅱ degree Ⅱ type or Ⅲ degree atrioventricular block (AVB) in the Cardiovascular Hospital of Xiamen University from April to December 2019 were selected as pacing group, which were further divided into two groups according to different pacemaker modes: twenty patients with right ventricular septal pacing (RVSP), twenty-two patients with LBBP, and twenty patients with normal ECG and cardiac structure were enrolled as control group. Echocardiography of pacing group and control group was performed and analyzed. The left ventricular subendocardial longitudinal strain peak(LSendo), the middle layer myocardial longitudinal strain peak(LSmid), subepicardial longitudinal strain peak(LSepi), global myocardial longitudinal strain peak(GLS), peak strain dispersion (PSD), global work index (GWI), global constructive work (GCW), global wasted work (GWW) and global work efficiency (GWE) were acquired. The differences among the three groups were analyzed and the high difference indexes were screened by statistical modeling.Results:LSendo in three groups had no difference ( P>0.05). LSmid, LSepi, GLS in the control group, LBBP group and RVSP groups were decreased gradually ( P<0.05). GLS in LBBP group was higher than in RVSP group ( P<0.05). Compared with the control group, the increases of QRS and PSD in LBBP group were not statistically significant ( P>0.05), while the decreases of QRS and PSD in LBBP group were statistically significant compared with the RVSP group ( P<0.05). The values of GCW among three groups had no statistical significance ( P>0.05). Compared with the control group, the decrease of GWI in LBBP group was not statistically significant ( P>0.05), while the increase of GWW and the decrease of GWE were statistically significant ( P<0.05). Compared with the RVSP group, the increases of GWI and GWE and the decrease of GWW in LBBP group were statistically significant ( P<0.05). QRS, LSendo, GLS, LSmid, left ventricular apex rotation to basal rotation peak time(ApexBase period) were the indexes with significant difference among LBBP and RVSP groups and all index characteristics showed better in LBBP than RVSP group. Conclusions:Two-dimensional multi-layered speckle tracking imaging can be used to evaluate the effect of LBBP on left ventricular systolic function and global synchronization and myocardial work. LBBP longitudinal mechanical synchronization is better than right ventricular septal pacing by improving the peak global myocardial longitudinal strain and myocardial work after pacemaker.

Objective To evaluate the changes of left ventricular hemodynamics and systolic function in patients with apical aneurysm after percutaneous ventricular restoration ( PVR) by echocardiography . Methods Fifty patients with apical aneurysm were divided into PVR group ( 25 cases) and conservative treatment group ( control group ,25 cases ) . Two-dimensional transthoracic echocardiography ( 2D-TTE ) combined with real-time three-dimensional transesophageal echocardiography( RT-3DTEE) were applied for all the subjects in PVR group on preoperative ,one week after operaction ,three months after operaction and in control group on initial stage of prevent ventricular remodeling therapy ,one week after therapy ,three months after therapy to obtain left ventricular end-diastolic diameter( LVEDD) ,left ventricular end-systolic diameter( LVSDD) ,left ventricular end-diastolic volume( EDV ) ,end-systolic volume( ESV ) ,left ventricular ejection fraction( LVEF) ,left ventricular fractional shortening ( LVFS ) ,body surface area ( BSA ) ,stroke volume( SV) ,stroke volume index ( SVI) ,cardiac output ( CO ) ,cardiac output index ( CI) . Results There were significant differences in all parameters( P < 0 .05) especially in LVEF and SVI( P < 0 .01) between PVR group and control group in the following three months after operaction ,while there was no significant difference of the following one week after operaction( P > 0 .05) .Compared with preoperative ,there was no difference in all parameters in the following one week after operaction ( P > 0 .05) ,there was significant increase in SV and significant reduce in LVEDD and EDV ( P < 0 .01) between preoperative and in the following three months after operaction ,while there was no significant difference between preoperative and in the following one week after operaction ( P > 0 .05 ) .For the control group there was no significant difference between initial stage of prevevt ventricular remodeling therapy and in the following one week or three months after operaction .Conclusions PVR has a definite effect on left ventricular hemodynamics and systolic function in patients with apical aneurysm in the short term ,while 2D-TTE and RT-3DTEE provides a reliable basis for clinical to evaluate the effect of the PVR .

Compared with proinflammatory processes in the development of type 2 diabetes,our knowledge on anti-inflammatory cytokines is rather limited.Anti-inflammatory cytokines such as adiponectin,interleukin 1 receptor antagonist(IL-1RA),transforming growth factor-β1 (TGF-β1),growth differentiation factor-15 (GDF-15),omentin,and secreted frizzled-related protein 5 (SFRP5) are strongly associated with increased risk of type 2 diabetes:Adiponectin and omentin levels decreased before type 2 diabetes,in contrast,concentrations of IL-1RA,TGF-β1,GDF-15 are increased.Change of SFRP5 levels in impaired glucose tolerance and type 2 diabetes remains controversial.This paper will summarize and recommend studies that investigated associations between circulating levels of anti-inflammatory cytokines and type 2 diabetes.

The elderly patients with diabetes often have a high prevalence of hypertension.Meanwhile,hypertension is a major vascular risk factor in this population.The benefit of proper management of hypertension in elderly patients with diabetes has been well recognized.According to the IDF Global Guideline for Managing Old People with Type 2 Diabetes,lifestyle interventions are recommended to form the first step in managing hypertension in elderly patients with diabetes.Pharmacological therapy should be initiated in addition to lifestyle interventions after 6 weeks during which non-pharmacological therapy has failed to achieve blood pressure targets.ACE-inhibitors are the first choice for initial medication,especially in the presence of diabetic nephropathy.ARBs can be used in people who cannot tolerate ACE-inhibitors.Diuretics or calcium channel blockers can be used as the first add-on therapy to ACE-inhibitors or ARBs if they fail to achieve target blood pressure.β-blockers should be considered for combination therapy in people with tachycardia or coronary artery disease.The generally recommended blood pressure target for older people with diabetes should be less than 140/90 mmHg(1 mmHg=0.133 kPa).