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 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 explore the effects of astaxanthin on pressure injury wounds.Methods In vitro experiment:Fibroblasts were treated with different concentrations of astaxanthin and their proliferation activity was detected by CCK-8 assay.Subsequently,fibroblasts were induced by hypoxia/reoxygenation,and the optimal concentration of astaxanthin was administered.Then the intracellular reactive oxygen species(ROS)level was detected by DHE fluorescent probes and the mRNA expression level of TNF-α,IL-1β,IL-6,IL-10,TGF-β was evaluated by RT qPCR.In vivo experiment:to construct a pressure injury model,two circular magnets were symmetrically adsorbed on both sides of the mouse skin for 5 hours everyday.Subsequently,equal amounts of physiological saline,low-dose astaxanthin(10 mg/kg),and high-dose astaxanthin(20 mg/kg)were administered by gavage in groups.Wound images were taken regularly.After 7-day treatment,wound healing rates were counted and wound tissues were collected for histopathological staining.Results In vitro,the fluorescence intensity of DHE in the astaxanthin groups were reduced dramatically.The relative mRNA expression level of TNF-α,IL-1β,IL-6 in the astaxanthin group declined,and the level of TGF-β and IL-10 mRNA increased significantly(P<0.05).In vivo,the wound healing rate and the level of TGF-β,IL-10 in high-dose astaxanthin group increased significantly.The ROS content and the level of TNF-α,IL-1β and IL-6 dropped markedly in astaxanthin groups(P<0.05).Conclusions Astaxanthin can significanlty alleviate oxidative stress,mitigate inflammation,thus exerting a protective effect on pressure injury wounds.

Objective To construct evaluation indicators for the construction of key specialties in traditional Chinese medicine nursing at the provincial and municipal levels and conduct preliminary verification,providing references for evaluating the level of construction of key specialties in traditional Chinese medicine nursing.Methods From December 2022 to March 2023,based on the Wuli-Shili-Renli system methodology,the content and weight of the evaluation indicators for the construction of key specialties in traditional Chinese medicine nursing at the provincial and municipal levels were determined through literature review,semi-structured interviews,Delphi method,and analytic hierarchy process.Opinion consultation and satisfaction survey were conducted on 46 nursing managers of secondary and above traditional Chinese medicine hospitals in Chongqing in April 2023 to preliminarily verify the application effect of the indicators.Results After 2 rounds of consultation with 16 experts,the questionnaire response rates were 100％and 100％,respectively.The expert authority coefficients were 0.963 and 0.950,respectively,and the coordination coefficients were 0.216～0.307,0.134～0.144,respectively(P＜0.05).Ultimately,an evaluation index for the construction of key specialties in traditional Chinese medicine nursing at the provincial and municipal levels was formed,which includes 3 primary indicators,17 secondary indicators,and 76 tertiary indicators.97.83％nursing managers of hospitals are satisfied with the constructed indicators,believing that the indicator content is clear,comprehensive,professional,and has good practicality.Conclusion The evaluation indicators for the construction of key specialties in traditional Chinese medicine nursing at the provincial and municipal levels are scientific,reliable,which can provide references for the construction of key specialties in traditional Chinese medicine nursing and promote the development of traditional Chinese medicine nursing.

Objective To construct evaluation indicators for the construction of key specialties in traditional Chinese medicine nursing at the provincial and municipal levels and conduct preliminary verification,providing references for evaluating the level of construction of key specialties in traditional Chinese medicine nursing.Methods From December 2022 to March 2023,based on the Wuli-Shili-Renli system methodology,the content and weight of the evaluation indicators for the construction of key specialties in traditional Chinese medicine nursing at the provincial and municipal levels were determined through literature review,semi-structured interviews,Delphi method,and analytic hierarchy process.Opinion consultation and satisfaction survey were conducted on 46 nursing managers of secondary and above traditional Chinese medicine hospitals in Chongqing in April 2023 to preliminarily verify the application effect of the indicators.Results After 2 rounds of consultation with 16 experts,the questionnaire response rates were 100％and 100％,respectively.The expert authority coefficients were 0.963 and 0.950,respectively,and the coordination coefficients were 0.216～0.307,0.134～0.144,respectively(P＜0.05).Ultimately,an evaluation index for the construction of key specialties in traditional Chinese medicine nursing at the provincial and municipal levels was formed,which includes 3 primary indicators,17 secondary indicators,and 76 tertiary indicators.97.83％nursing managers of hospitals are satisfied with the constructed indicators,believing that the indicator content is clear,comprehensive,professional,and has good practicality.Conclusion The evaluation indicators for the construction of key specialties in traditional Chinese medicine nursing at the provincial and municipal levels are scientific,reliable,which can provide references for the construction of key specialties in traditional Chinese medicine nursing and promote the development of traditional Chinese medicine nursing.

Objective To investigate the occurrence and characteristics of dysphagia and aspiration in the elderly in nursing home in Weifang, Shandong, China.Methods From January to June, 2021, 837 elderly people from 10 nursing homes in Weifang were randomly selected and investigated with general situation questionnaire, Fried Frailty Phenotype, Ohkuma questionnaire and Volume-Viscosity Swallowing Test.Results The prevalence of dysphagia and aspiration was 44.2% and 12.3% respectively. There were significant differences in the prevalence of dysphagia among ages and health condition (χ2 > 8.437, P<0.05). The prevalence of dysphagia and aspiration was higher in men than in women (χ2 > 4.060, P < 0.05). The incidence of oral dysphagia was higher in men than in women, and the incidence of esophageal dysphagia was lower (χ2 > 20.830, P<0.001). Oral dysphagia was predominant in the elderly with stroke, Alzheimer's disease, and Parkinson's disease (χ2=27.579, P<0.001), and esophageal dysphagia and airway protection dysfunction were predominant in the elderly with chronic respiratory disease (χ2 > 20.241, P<0.01).Conclusion The dysphagia and aspiration are prevalent in the elderly in nursing homes, and varies with different genders and basic diseases.

【Objective】 To understand the distribution and gene frequency of main red blood cell blood groups in Lahu ethnic minority and analyze the genetic characteristics of Lahu people. 【Methods】 1) ABO forward and reverse typing had been performed by microplate method; 2) Rh, MN, H, P1Pk and Mur antigen were tested by the tube method. If the ABO forward and reverse typing were incompatible, the tube method was used for confirmation. 【Results】 The distribution characteristics of blood group and gene frequency in Lahu ethnic minority were as follows: B>O>A>AB for ABO, with genotype frequency as p 11.1%, q 27.5% and r 61.4%; the frequency of Rh genotype was CDe 83.3%, cDE 12.0%, cDe 2.42%, CDE 2.32%, CdE 0%, Cde 0%, cdE 0% and cde 0%; M > MN>N for MN blood group, with genotype frequency as M 75.26% and N 24.74%; P1

Indocyanine green (ICG) fluorescence imaging technology has been applied in laparoscopic surgery. It is possible to highly visualize the tumor cutting edge and liver segment boundary during laparoscopic hepatectomy. Although the application of this technique in liver tumor surgery has become more and more mature, the factors affecting the quality of fluorescence imaging are still not completely clear. In this paper, we analyzed and summarized the effects of different factors such as ICG administration scheme, imaging acquisition, tumor characteristics of patients and preoperative liver function indexes on the quality of intraoperative ICG imaging, in order to provide new ideas and practical experience for clinical practice and research.

AIM: To investigate the effect and mechanism of ursolic acid on high glucose and high-fat injury of human aortic endothelial cells. METHODS: MTT method was used to select the appropriate injury concentration of high glucose and sodium palmitate and UA pre incubation concentration. The levels of NO and ROS, the release rate of lactate dehydrogenase and the activities of antioxidant enzymes including total superoxide dismutase, catalase and glutathione peroxidase were detected by kit. The expression of endothelial nitric oxide synthase, intercellular adhesion molecule, vascular cell adhesion molecule caspase-1 and GSDMD were detected by Western blot. The protective effect of UA on HAEC was observed. Hoechst33342 combined with PI fluorescence staining was used to detect the whole state of cell membrane to explore the occurrence of pyroptosis. RESULTS: Pre-incubation with UA (1 and 5 μmol/L) could reduce the damage of HAEC caused by high glucose and high fat (30 mmol/L Glu + 0.1 mmol/L SPA), enhance HAEC activity, increase NO release and eNOS protein expression, alleviate oxidative stress injury, reduce the protein expression of adhesion molecules and reduce the occurrence of pyroptosis. CONCLUSION: UA may reduce the damage of endothelial cells by inhibiting the oxidative stress response and the occurrence of pyroptosis induced by high glucose and high fat.

Purpose: Effective predictors of the response to neoadjuvant chemotherapy (NAC) are still insufficient. This study aimed to investigate the predictive value of serum lipid profiles for the response to NAC in breast cancer patients. Methods: A total of 533 breast cancer patients who had received NAC were retrospectively studied. The pretreatment of serum lipids, including total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and lipoprotein-α, and clinicopathological characteristics were collected to assess their predictive roles. Results: Breast cancer patients had significantly lower TC, TG, HDL-C, and LDL-C levels than normal individuals. Among these indicators, TG and LDL-C levels and HDL-C level increased and decreased significantly after NAC, respectively. In estrogen receptor (ER)-positive patients, increased LDL-C level was associated with better outcomes. Moreover, the receiver operating characteristic curve analyses suggested that TG and HDL-C levels at diagnosis can be used as predictors of the response to NAC only in the ER-positive subgroup.According to univariate analyses, patients with low TG level (< 1.155 mmol/L) or high HDL-C level (≥ 1.305 mmol/L) in the ER-positive subgroup had more favorable clinical responses than the other patients in the subgroup. Furthermore, according to multivariate analyses, a high HDL-C level (≥ 1.305 mmol/L, p = 0.007) was an independent predictor of NAC efficacy. Conclusion High HDL-C level (≥ 1.305 mmol/L) before NAC and increased LDL-C level after NAC were associated with the better treatment response in ER-positive breast cancer patients.These results are potentially considered beneficial in establishing treatment decisions.