Objective To screen and verify a buffer to replace barbiturate solution(BBTS) in immunoelectrophoresis, in order to obtain a safer, environmentally friendly buffer whose electrophoresis effects are equivalent to BBTS.Methods Five types of buffers to be

ObjectiveTo observe the effect of Zuoguiwan on ovarian reserve in the female offspring rat model of prenatal stress （PS） and explore the mechanism based on Toll-like receptor 4/nuclear factor-κB p65 （TLR4/NF-κB p65） signaling pathway. MethodThirty-two pregnant rats were prepared and randomized into four groups （n=8）： control， model， Zuoguiwan （18.9 mg·kg^-1）， and vitamin E （1.44 mg·kg^-1）. Except the control group， the other three groups were subjected to chronic unpredictable mild stress （CUMS） from day 11 of pregnancy， and the modeling was accompanied by gavage with corresponding drugs until delivery. The PS model was evaluated by the sucrose preference test， open field test， and serum corticosterone （CORT） level. The estrous cycle was monitored and the morphological changes in the ovarian tissue were observed. The serum levels of estradiol （E₂）， luteinizing hormone （LH）， follicle-stimulating hormone （FSH）， and anti-Mullerian hormone （AMH） in the 75-day-old offspring rats were measured by enzyme-linked immunosorbent assay （ELISA） to evaluate the ovarian reserve. The ovary and uterus indices were calculated. The serum levels of interleukin-1β （IL-1β） and tumor necrosis factor-α （TNF-α） were measured by enzyme-linked immunosorbent assay （ELISA）. The morphology of the ovarian tissue in the offspring on the day of birth and day 75 after birth was observed by hematoxylin-eosin staining. The transport of NF-κB p65 to the nucleus in the ovaries of the 75-day-old offspring was detected by the immunofluorescence （IF） assay. The expression of TLR4， NF-κB p65 and other related proteins in the ovarian tissue was determined by Western blot. ResultCompared with the control group， the model group showed reduced primordial follicles in the offspring on the day of birth （P<0.01） as well as disturbed estrous cycle， decreased ovary index and uterus index （P<0.01）， reduced corpus luteum， increased atretic follicles （P<0.01）， lowered serum levels of AMH and E₂ （P<0.01）， elevated serum levels of LH， FSH， IL-1β， and TNF-α （P<0.05， P<0.01）， and up-regulated protein levels of TLR4， NF-κB p65， recombinant myeloid differentiation factor 88 （MyD88）， and phosphorylated NF-κB inhibitor （p-IκBα） （P<0.01） in the 75-day-old offspring rats. Compared with the model group， Zuoguiwan and vitamin E increased the primordial follicles in the offspring on the day of birth （P<0.01）. Moreover， they resumed the estrous cycle， increased the ovary and uterine indices （P<0.05， P<0.01） and corpus luteum （P<0.01）， reduced atretic follicles （P<0.01）， elevated the serum levels of AMH and E₂ （P<0.05， P<0.01）， lowered the serum levels of LH， FSH， IL-1β， and TNF-α （P<0.05， P<0.01）， and down-regulated the expression of TLR4， NF-κB p65， MyD88， and p-IκB-α （P<0.05， P<0.01） in the 75-day-old offspring. ConclusionZuoguiwan can improve the ovarian reserve in the offspring rat model of congenital kidney deficiency by regulating the TLR4/NF-κB p65 signaling pathway.

Objective:To compare the clinical outcomes between percutaneous Kirschner wire leverage plus plaster fixation and elastic intramedullary nailing in the treatment of radial neck fractures in children.Methods:A retrospective study was conducted to analyze the 60 children with radial neck fracture who had been treated by percutaneous Kirschner wire leverage plus plaster fixation at Department of Pediatric Orthopedics, Children's Hospital of Soochow University from January 2016 to July 2023 (set as an internal fixation-free group). They were 30 males and 30 females (34 left and 26 right sides) with an age of (7.7±3.0) years. At the same time, another cohort of 60 patients were chosen as an intramedullary nailing group who had been treated by percutaneous Kirschner wire leverage plus elastic intramedullary nailing and matched in age and gender with those in the internal fixation-free group. The preoperative fracture angulation, operative time, hospitalization time, fracture angulation on the first postoperative day, fracture angulation at 1 month postoperatively, rate of angulation loss after reduction, Mayo elbow performance score (MEPS) at the last follow-up and complications were compared between the 2 groups.Results:There was no significant difference between the 2 groups in their preoperative general data, showing comparability ( P<0.05). The 120 pediatric patients were followed up for (7.5±3.2) months. The operative time [(27.4±15.0) min] and hospitalization time [(3.4±1.9) d] in the internal fixation-free group were significantly shorter than those in the intramedullary nailing group [(45.4±13.5) min and (4.4±1.3) d] ( P<0.05). The preoperative fracture angulation (50.8°±1.9°), fracture angulation on the first postoperative day (11.3°±1.2°), fracture angulation at 1 month postoperatively (12.1°±1.3°), rate of angulation loss after reduction (2.9%±0.5%), and MEPS at the last follow-up [(90.4±2.0) points] in the internal fixation-free group showed no significant differences from those in the intramedullary nailing group [49.5°±1.7°, 11.1°±1.2°, 13.3°±1.5°, 3.9%±1.4%, and (90.2±2.3) points] ( P>0.05). None of the patients in the internal fixation-free group developed pin-tail irritation sign or premature epiphyseal closure after surgery, whereas 3 patients in the intramedullary nailing group developed pin-tail irritation sign and 2 ones premature epiphyseal closure after surgery, showing a significant difference in the complication rate between the 2 groups [0 (0/60) versus 8.3% (5/60)] ( P<0.05). Conclusions:Percutaneous Kirschner wire leverage plus plaster fixation and close elastic intramedullary nailing can both achieve satisfactory outcomes in the treatment of radial neck fractures in children. However, percutaneous Kirschner wire leverage plus plaster fixation needs shorter operative time and hospitalization time, leads to fewer complications, and requires no reoperation to remove internal fixation.

Immune checkpoint inhibitors (ICIs) have been approved for the treatment of urothelial carcinoma(UC). However, the use of antibiotics, proton pump inhibitors, corticosteroids, beta-blockers, metformin, and statin concomitant medications in some patients due to complications during the treatment process may affect the clinical efficacy of ICIs through different pathway, making it difficult for patients to derive clinical benefit or making it more likely to develop drug resistance. In this paper, we present a review of the effects of the above concomitant drugs on ICIs in the treatment of patients with advanced UC, with a view to provide reference for the application of individualized treatment strategies of ICIs in patients with advanced UC.

Biliary tract cancers (BTC), a heterogeneous disease with poor prognosis, including gallbladder cancer (GBC), intrahepatic cholangiocarcinoma (ICC), and extrahepatic cholangiocarcinoma (ECC). Although surgery is currently the primary regimen to treat BTC, most BTC patients are diagnosed at an advanced stage and miss the opportunity of surgical eradication. As a result, non-surgical therapy serves as the main intervention for advanced BTC. In recent years, immunotherapy has emerged as one of the most promising therapies in a number of solid cancers, and it includes immune checkpoint inhibitors (ICIs) monotherapy or combined therapy, tumor vaccines, oncolytic virus immunotherapy, adoptive cell therapy (ACT), and cytokine therapy. However, these therapies have been practiced in limited clinical settings in patients with BTC. In this review, we focus on the discussion of latest advances of immunotherapy in BTC and update the progress of multiple current clinical trials with different immunotherapies.

Objective:To investigate the impact of early removal of nasogastric tubes on functional recovery after total gastrectomy for gastric cancer patients, to provide scientific evidence for enhanced recovery after surgery strategies in gastric cancer.Methods:A retrospective cohort study was conducted on 102 gastric cancer patients who underwent total gastrectomy at Beijing Friendship Hospital affiliated with the Capital Medical University from March 2018 to July 2022. Patients were divided into two groups based on whether the gastric tube was removed within 24 hours post-operation: the early removal group (within 24 hours, 55 patients) and the non-early removal group (beyond 24 hours, 47 patients). The recovery outcomes, including time to first flatus, time to fluid intake, length of hospital stay, and the incidence of postoperative complications, were compared between the two groups. Non-normally distributed data were expressed as M( Q1, Q3) and compared using the Wilcoxon rank-sum test. Categorical data were expressed as frequencies or percentages and compared using the chi-square test or Fisher′s exact test. To minimize the impact of potential confounders, multivariable linear regression and logistic regression analyses adjusted for propensity scores were further employed to compare quantitative and qualitative data between the groups. Statistical analyses were performed using R software. Results:The exhaust time, water intake time, and hospital stay in the early removal group were 3.0(2.0, 3.5) days, 4.0(3.0, 5.0) days, and 7.0(7.0, 8.0) days, respectively, while those in the non-early removal group were 4.0(3.0, 5.0) days, 6.0(5.0, 7.0) days, and 8.0(7.5, 11.0) days, respectively. Statistically significant differences were observed between the two groups ( P<0.05). However, there was no significant difference in the incidence of postoperative complications between the two groups (5.45% vs 17.02%, P=0.060). Propensity score-adjusted regression analysis suggested that early tube removal might reduce the risk of postoperative complications ( P=0.042). Conclusion:Early removal of nasogastric tubes can significantly accelerate functional recovery after total gastrectomy for gastric cancer patients and may reduce the risk of postoperative complications, providing important clinical guidance for enhanced recovery after surgery management in gastric cancer.

Understanding mechanism of imatinib resistance in gastrointestinal stromal tumors(GIST)and developing new therapeutic tar-gets and schemes to address this resistance exhibit great potential to improve the long-term prognosis of patients with GIST.This review summarizes exiting research into the molecular characteristics of GIST and mechanisms of imatinib resistance acting via non-coding RNA,lysosomes,key protein molecules,fibroblast growth factor-2(FGF-2),and other modulators.Research shows that different drug resistance mechanism networks are closely connected and interrelated.Combining imatinib therapy with multiple drugs that inhibit the resistance mechanism shall present new options treating GIST thereby improving prognosis.Identification and implementation of individualized treat-ment strategies based on drug resistance mechanisms will provide new adjuvant treatment options for patients with GIST resistant to imat-inib,thus delaying progression of GIST.

Reactive oxygen species play a crucial role in maintaining metabolic balance in the body. They are not only important mediators in maintaining a normal physiological environment, but also important triggers for the occurrence and development of many diseases. Osteoarthritis is the most common degenerative joint disease at present. Due to the aging population, extended life expectancy and obesity, the incidence rate and prevalence of osteoarthritis have increased year by year. Recent studies on osteoarthritis show that reactive oxygen species play a crucial role in its occurrence and development, and are key factors leading to extracellular matrix degradation, mitochondrial dysfunction, chondrocyte apoptosis and the progress of osteoarthritis. For osteoarthritis, moderate levels of reactive oxygen species can promote the proliferation of chondrocytes and the formation of cartilage matrix. However, excessive accumulation of reactive oxygen species can induce oxidative stress, leading to degeneration of chondrocytes and breakdown of cartilage matrix, ultimately resulting in the occurrence of osteoarthritis and many other metabolic diseases. In recent years, hydrogels have attracted attention as new biomaterials for the treatment of osteoarthritis. Reactive oxygen scavenging hydrogels are a new type of polymer biomaterials with drug intelligent delivery function that can regulate tissue oxidative stress and inflammatory reaction. They mainly include traditional reactive oxygen scavenging hydrogels with the main function of loading reactive oxygen scavenging drugs and reactive oxygen responsive hydrogels with reactive oxygen responsive groups. The former mainly uses slow-release drugs with reactive oxygen species scavenging properties encapsulated in it to treat osteoarthritis, while the latter can not only clear the reactive oxygen species generated during the occurrence and development of osteoarthritis by breaking the reactive oxygen species responsive groups, but also responsively deliver various drugs for treating osteoarthritis. Reactive oxygen scavenging hydrogels have a good prospect in the treatment of osteoarthritis and repair.

The pursuit of cosmetic effects in post-surgical wounds has led to the development of ultra-minimally invasive techniques in surgery. Minimal invasive surgery has replaced open surgery and has become the new gold-standard for treating diseases. One such technique is the single incision triangulated umbilicus surgery (SITUS), which offers several advantages over traditional laparoscopic and other scarless surgeries, including reduced trauma, faster recovery, and better cosmetic outcomes. SITUS also has a short learning curve, aligns with conventional instrumentation operating habits, and can be used for whole abdominal surgeries. Chinese scholars have made further improvements to the SITUS technology, including expanding its applicability in intra-abdominal surgery and refining its incision closure methods to achieve superior cosmetic results. Currently, SITUS technology is experiencing rapid development in urology applications and has demonstrated satisfactory results in both domestic and international reports. This review aims to discuss the effectiveness and development of the SITUS technique in urology.

Objective:To explore the attitude of kidney transplant (KT) recipients towards xenotransplantation and explore its related influencing factors to provide auxiliary references for the clinical research of xenotransplantation in China.Methods:The questionnaire data of "Attitude survey of KT recipients towards xenotransplantation" were collected from 194 KT recipients followed up at Organ Transplant Center of Affiliated Tongji Hospital. Nonparametric tests were utilized for comparing score differences and χ2 tests for comparing responses to specific questions. Variables with statistical significance in non-parametric test were included into multifactor linear regression analysis for exploring the influencing factors of recipients' attitudes towards xenotransplantation. Results:KT recipients had a higher score (75 points) on attitude scale of xenotransplantation. "Cognitive preference" dimension scored the highest (85 points); "Fear of risk" dimension scored lowest (50 points). The results of univariate analysis indicated that gender ( P=0.020), medical background ( P=0.006) and knowledge of clinical trial cases ( P<0.001) were the influencing factors of score of cognitive preference. Educational background ( P=0.029) was the factor affecting the score of "risk concern" dimension. Age ( P=0.028) and knowledge of clinical trial cases ( P=0.001) were the factors influencing the score of "psychosocial" dimension. Whether medical background ( P=0.018) and knowledge of clinical trial cases ( P=0.008) were the factors influencing the score of "efficacy expectation" dimension; Gender ( P=0.010), medical background ( P=0.018) and knowledge of clinical trial cases ( P=0.008) were the factors influencing total score. The results of multi-factor analysis revealed that gender ( B=-0.821, 95% CI: -1.419~0.223, P=0.007), medical background ( B=0.938, 95% CI: 0.097~1.779, P=0.029) and knowledge of clinical trials of xenotransplantation in the United States ( B=1.498, 95% CI: 0.887~2.110, P<0.001) was the influencing factor of cognitive preference. Educational background (B=-0.693, 95% CI: -1.353~-0.034, P=0.040) was the influencing factor of score on "risk concern" dimension. Knowledge of clinical trials of xenotransplantation in the United States ( B=1.075, 95% CI: 0.418~1.731, P=0.001) was an influencing factor of score on "social psychological" dimension; Knowledge of clinical trials of xenotransplantation in the United States ( B=0.710, 95% CI: 0.063~1.358, P=0.032) was an influencing factor of score on "efficacy expectation" dimension; Gender ( B=-2.259, 95% CI: -4.094~-0.423, P=0.016), medical background ( B=2.799, 95% CI: 0.219~5.378, P=0.034) and knowledge of clinical trials of xenotransplantation in the United States ( B=3.237, 95% CI: 1.360~5.114, P=0.001) were the influencing factors of total score. Conclusions:KT recipients have a higher awareness rate of xenotransplantation and a better acceptance of xenotransplantation in general. Those males with medical background and knowing clinical cases of xenotransplantation demonstrate a better attitude towards xenotransplantation. More concerned about the risk of infection, respondents expect heterologous pig kidneys to achieve the same long-term survival as allogeneic kidneys.