Objective To investigate the expression of serum exosomal long non-coding RNA X chromo-some inactivation specific transcript(LncRNA XIST)and microRNA(miR)-130a-3p in gestational diabetes mellitus(GDM)patients and its relationship with pregnancy outcome.Methods A total of 149 GDM patients(GDM group)and 149 healthy pregnant women(control group)admitted to the hospital from January 2021 to January 2024 were selected.Serum exosomal LncRNA XIST,miR-130a-3p and glucose and lipid metabolism indexes of the two groups were detected and compared.The correlation of LncRNA XIST and miR-130a-3p levels with glycolipid metabolism indexes was analyzed by Pearson method.Univariate and multivariate Logis-tic regression models were used to analyze the influencing factors of pregnancy outcomes in GDM patients.Re-ceiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of serum exosomal Ln-cRNA XIST and miR-130a-3p levels alone and in combination for pregnancy outcomes in GDM patients.Results Serum exosomal LncRNA XIST levels,fasting insulin(FINS),fasting blood glucose(FBG),insulin resistance index(HOMA-IR),2-hour postprandial glucose(2 hPG),total cholesterol(TC),triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)levels in GDM group were higher than those in control group(P＜0.05),and the levels of miR-130a-3p and high density lipoprotein cholesterol(HDL-C)were lower than those in the control group(P＜0.05).LncRNA XIST was positively correlated with FINS,FBG,HOMA-IR,2 hPG,TC,TG and LDL-C,and negatively correlated with HDL-C(P＜0.05).miR-130a-3p was negatively correlated with FINS,FBG,HOMA-IR,2 hPG,TC,TG and LDL-C,and positively correlated with HDL-C(P＜0.05).Among the 149 GDM patients,43 cases showed adverse pregnancy outcome,accounting for 28.86％.The increase level of FBG,the increase level of LncRNA XIST and the increase of HOMA-IR were risk factors for adverse pregnancy outcome in GDM patients,while the increase of miR-130a-3p was a protec-tive factor.The ROC curve analysis showed that the predictive efficacy of combined detection was superior to that of single indicator detection.Conclusion The serum exosomal LncRNA XIST of GDM patients is highly expressed,and miR-130a-3p is lowly expressed,and the combined detection of the above indexes has a high predictive value for pregnancy outcome.

Colorectal cancer is one of the most common malignant tumors worldwide. Due to the heterogeneity in patient outcomes and treatment responses to standard therapy regimens, personalized diagnostic and therapeutic strategies have remained a focus of sustained interest in research. In recent years, with the rapid progression of artificial intelligence (AI) technology in the medical field, an abundance of phased research results has emerged in the decision-making for preoperative, intraoperative, and postoperative diagnostic and therapeutic plans for colorectal cancer, demonstrating great potential for application. This new and efficient solution provides for the personalized evaluations and auxiliary diagnoses and treatments of patients with colorectal cancer. In the future, AI systems may continue to advance towards multimodal, multi-omics, and real-time directions. This paper aims to explore the current state of research on the multi-faceted auxiliary applications of AI in the diagnosis and treatment of colorectal cancer, as well as to present a prospective view of the innovations that AI technology could bring to personalized colorectal cancer treatment in the future and the challenges it may face.

Colorectal cancer is one of the most common malignant tumors worldwide. Due to the heterogeneity in patient outcomes and treatment responses to standard therapy regimens, personalized diagnostic and therapeutic strategies have remained a focus of sustained interest in research. In recent years, with the rapid progression of artificial intelligence (AI) technology in the medical field, an abundance of phased research results has emerged in the decision-making for preoperative, intraoperative, and postoperative diagnostic and therapeutic plans for colorectal cancer, demonstrating great potential for application. This new and efficient solution provides for the personalized evaluations and auxiliary diagnoses and treatments of patients with colorectal cancer. In the future, AI systems may continue to advance towards multimodal, multi-omics, and real-time directions. This paper aims to explore the current state of research on the multi-faceted auxiliary applications of AI in the diagnosis and treatment of colorectal cancer, as well as to present a prospective view of the innovations that AI technology could bring to personalized colorectal cancer treatment in the future and the challenges it may face.

Objective:To investigate the early and mid-term outcomes of aortic endovascular remodeling device (AERD) for Stanford type A aortic dissection (TAAD) in type Ⅱhybrid surgery, and to evaluate its clinical efficacy.Methods:46 patients with TAAD, including 14 females and 32 males, participated in the single-center clinical trial of West China Hospital of Sichuan University and underwent type II hybrid surgery (Bentall / ascending aorta replacement + AERD implantation) from February 2021 to October 2023. The safety and efficacy of AERD in type Ⅱ hybrid surgery for TAAD were estimated by clinical indicators (postoperative mortality, cardiovascular and cerebrovascular accidents, paraplegia, ischemia), and blood flow condition (volume of the true and false lumen, and suprachial branches).Results:Three patients (6.52%) died during the follow-up period, and the operation-related mortality was 4.35% (2/46). The remaining 43 patients were followed up for an average of (25.53±9.60) months. There were two cases (4.35%) of stroke after the operation, and paraplegia, acute renal insufficiency, and other severe complications were not noticed. The blood flow of the superior branch of the aortic arch was unobstructed, and there was no significant difference in the blood flow of the branch before the operation and at each follow-up time point. Compared to the pre-operation, the true lumen volume of the stent part increased by 59.0% and the false lumen volume decreased by 82.4%.Conclusion:AERD is a safe and effective alternative in type II hybrid surgery for acute TAAD, which is helpful in improving perioperative and short- and long-term survival rates and clinical outcomes.

Objective To evaluate total laparoscopic left hemihepatectomy vs open procedures for operable left hepatic lesions.Methods We retrospectively analyzed the clinical data of laparoscopic and open hepatectomy in 40 patients with left hepatic disease in Huanshan People's Hospital between January 2016 and January 2018.Among them,laparoscopic hepatectomy was performed in 24 cases,open liver resection in 16 cases.Results The postoperative fasting time,postoperative analgesic usage and length of postoperative hospital stay were all significantly different in favor of laparoscopic group (t =4.158,x2 =9.184,t =2.174,all P ＜ 0.05),while,the operative time,intraoperative blood loss,incidence of postoperative complications and the total hospitalization expense showed no statistical difference (t =0.752,t =1.186,x2 =0.000,t =0.925,all P ＞ 0.05).Conclusion Laparoscopic left liver resection is a minimally invasive,safe and effective treatment for operable left liver lesions.

Objective To compare the EEG complexity between rats under awaking and differ-ent depth of anesthesia via analyzing sample entropy and fractal dimension.Methods Sixteen SD rats were intraperitoneally injected with urethane twice,first with 500 mg/kg and second with 800 mg/kg one hour later.The scalp EEG was collected in stage of awaking (W),light anesthesia (LA)and heavy anesthesia (HA).The sample entropy (SampEn)and fractal dimension (FD)were computed by MATLAB.The characteristic values were denoised by linear dynamic system method during the whole process.Results The value of SampEn and FD gradually dropped from awaking to heavy anes-thesia.The SampEn and FD in W was significantly higher than the value in LA or in HA (P <0.05). The SampEn and FD in HA was significantly lower than that in LA (P < 0.05 ).Conclusion The SampEn and FD of EEG could be used to monitor the depth of anesthesia.

Objective To investigate the expression of miR-424* in 2 and 4 Gy X-ray irradiated A549 cells in vitro and in vivo,as well as in clinical lung tissues and serum sample of non-small cell lung cancer(NSCLC) patients,and to explore its potential role in the diagnosis and prognosis of lung cancer.Methods A549 cells were irradiated with 2 and 4 Gy X-rays,and some of irradiated cells were injected into nude mice through tail vein.Real time quantitative PCR (RT-qPCR) assay was employed to detect the expression of miR-424 * in 2 and 4 Gy X-ray irradiated A549 cells in vitro and in vivo,as well as in clinical lung tissues and serum sample of lung cancer patients.Results Compared with the control group,the expression of miR-424* was up-regulated significantly in X-ray irradiated A549 cells at 1,2,12,24 and 48 hpost irradiation,respectively (2 Gy:t =-45.886--6.709,P ＜0.05;4 Gy:t =-29.087--7.833,P ＜ 0.05).Furthermore,the expression of miR-424 * was up-regulated in the lung and serum of nude mice with injection of 0,2 and 4 Gy X-ray irradiated A549 cells,compared with control group (fold change was 9.72,8.58 and 4.7 with 2 Gy irradiation and 11.93,9.22 and 8.99 with 4 Gy irradiation,t=-13.243,-12.409,-9.833 in lung andt=-6.436,-3.052,-3.609 in serum,respectively,P ＜ 0.05).Out of 11 tissue samples of NSCLC patients,6 were detected with up-regulated miR-424* expression,and no significant discrepancy of miR-424* expression was detected in two type of NSCLC tissue samples.On the contrary,43 serum samples were detected with up-regulated miR-424* expression out of 84 serum samples (51.20％) of NSCLC patients (fold change range 1.97 to 17.71),and significant discrepancy of miR-424* expression was shown in two subtypes of NSCLC serum samples [adenocarcinoma:39.10％ (18/46) and squamous carcinoma:65.8％ (25/38)],as well as in serum samples of NSCLC patients with radiotherapy [41.5％ (22/53)] and without radiotherapy [67.7％ (21/31)] (t=5.919,5.387,P ＜0.05,respectively).Conclusions 2 and 4 Gy X-ray irradiation could up-regulate the expression of miR-424* in A549 cells,which might be correlated with the enhanced metastasis of A549 cells induced by X-ray in vivo and in vitro.Furthermore,the expression of miR-424* was up-regulated in over 50％ of the tissue and serum samples of NSCLC patients,which might be correlated with the diagnosis of NSCLC subtype and prognosis of radiotherapy.

OBJECTIVE: To explore the diagnosis, treatment and surgical approaches of parapharyngeal space tumors. METHOD: This retrospective study consisted of 112 patients with parapharyngeal space tumors underwent surgeries. The data included clinical symptoms and signs, pathological types, imaging examinations, surgical approaches and postoperative complications. RESULT: Computerized tomography (CT), magnetic resonance imaging (MRD and digital subtraction angiography (DSA) made clear the tumor size, localization and its relation to adjacent structures. The postoperative histopathology varied and showed benign in 98 cases consisting of salivary gland tumors (52 cases), neurogenic tumors(33 cases) and other types (13 cases). During the 3 years follow-up period, local recurrence appeared in 3 patients with salivary pleomorphic adenoma and 1 patient with neurofibromatosis. These recurrent tumor cases were cured with second surgery. In 14 patients with malignant tumors reported, 8 cases survived for 5 years, 2 cases (1 adenoid cystic carcinoma and 1 carcinoma in pleornorphic adenoma) recurred in the two and a half years cured with second surgery affiliated radiation therapy through 3 years follow-up time and the rest were followed up 1 to 3 years without recurrence. Peripheral facial paralysis was observed in 25 patients, and 3 patients experienced hypoglossal nerve palsy. Only 1 patient encountered vagus nerve injury, and 2 patients appeared Horner's syndrome, and 4 patients endured Frey syndrome. Gills leakage was discovered in 3 cases and cavity infection was noted in 1 patient. CONCLUSION CT, MRI and DSA were important in the diagnosis and differential diagnosis of parapharyngeal space tumors. The key to successful treatment is knowing the anatomy of the parapharyngeal space, preoperative assessment and appropriate surgical approach.
Adenoma, Pleomorphic ; complications ; Carcinoma, Adenoid Cystic ; complications ; Diagnosis, Differential ; Facial Paralysis ; complications ; Horner Syndrome ; complications ; Humans ; Magnetic Resonance Imaging ; Neoplasm Recurrence, Local ; Pharyngeal Neoplasms ; diagnosis ; therapy ; Pharynx ; pathology ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Salivary Gland Neoplasms ; complications ; Tomography, X-Ray Computed

Objective To investigate the impact of enteral nutrition (EN) through jejunal feeding tube on the nutritional status and immunologic function of patients during chemotherapy after total gastrectomy.Methods Totally 86 patients with gastric cancer who had undergone total gastrectomy with radical resection and jejunostomy received adjuvant venous chemotherapy in our department from January 2009 to June 2010.They were divided into EN group ( n =43 ) and control group ( n =43 ) according to the hospitalization number.The EN group maintained the jejunostomy tube until the end of 6 courses of chemotherapy,and was given EN support for 7 days through jejunal tube during each course of chemotherapy; the control group removed the tube before chemotherapy without further dietary restriction or nutrition support.The nutritional and immunologic indicators on the 1 st day before chemotherapy and the 1st day after 6 chemotherapy courses were measured.ResultsThree patients in the EN group withdrew from the study because of catheter blockage or catheter loss and 2 patients in the control group failed to complete the trial because of chemotherapy side effects or economic reasons; 81 patients entered the final analysis.After 6 courses of chemotherapy,both groups experienced body weight loss,but the percentage is significantly lower in EN group than in control group (6.9％ ± 0.95％ vs.11.2％ ± 1.32％,P =0.0000).Compared with the nutritional status before the first chemotherapy,the prognosis nutritional index (PNI) in both groups declined after the 6th chemotherapy.Such decline was not statistically significant in EN group ( P =0.1534) but was significant in control group (P =0.0000).The PNI in EN group after chemotherapy was significantly higher than that in control group (P =0.0040).The levels of IgG,NK,CD4 +,and CD4 +/CD8 + were significantly higher in EN group than in control group ( P =0.0083,0.0143,0.0000,and 0.0000,respectively) after chemotherapy.ConclusionEN during postoperative chemotherapy may improve the nutritional status and immunologic function in gastric cancer patients after total gastrectomy.

Objective To improve the quality of life in gastric cancer patients after total gastrectomy by exogenous trypsin supplement.Method In this study 106 patients were divided into two groups,with 53 patients in each group,oral pancreatic enzyme capsule was given in comparison without in control group.Patients were asked to fill in EORTC QLQ-C30 questionnaire and Korenaga questionnaire at half a year postoperation,stool sample was collected at the same time for fecal fat assay.Results A total of 86 patients completed this test at postoperation half a year.With a comprehensive assessment of quality of life in patients by the scoring system of EORTC QLQ-C30 and Korenaga and the fecal fat contents measurement.Exogenous trypsin plays a positive role in preventing weight loss,improving emotional function,alleviating loss of appetite,insomnia,fatigue,postprandial fullness,nausea,vomiting and diarrhea,and improving intestinal tolerance to fat and the overall health status of patients.Conclusions Total gastrectomy causes exocrine pancreatic dysfunction,exogenous supplement of the enzyme improves postoperative quality of life in these patients.