Nutritional therapy is an important component of enhanced recovery after surgery (ERAS), which runs through the entire patient process, including before admission, during the preoperative, intraoperative, and postoperative periods, and after discharge. As a special group, patients with cancer have particularities in their metabolic processes. Understanding the metabolic characteristics of patients with cancer and then carrying out targeted nutritional therapy is of great clinical significance for accelerating their postoperative recovery. This article briefly summarizes the metabolic characteristics and nutritional therapy strategies for patients with cancer during the perioperative period to provide guidance on the clinical practice of ERAS.

Transarterial radioembolization (TARE) is a widely utilized therapeutic approach for hepatocellular carcinoma (HCC), however, the clinical implementation is constrained by the stringent preparation conditions of radioembolization agents. Herein, we incorporated the superstable homogeneous iodinated formulation technology (SHIFT), simultaneously utilizing an enhanced solvent form in a carbon dioxide supercritical fluid environment, to encapsulate radionuclides (such as ¹³¹I,¹⁷⁷Lu, or ¹⁸F) with lipiodol for the preparation of radiolipiodol. The resulting radiolipiodol exhibited exceptional stability and ultra-high labeling efficiency (≥99%) and displayed notable intratumoral radionuclide retention and in vivo stability more than 2 weeks following locoregional injection in subcutaneous tumors in mice and orthotopic liver tumors in rats and rabbits. Given these encouraging findings, ¹⁸F was authorized as a radiotracer in radiolipiodol for clinical trials in HCC patients, and showed a favorable tumor accumulation, with a tumor-to-liver uptake ratio of ≥50 and minimal radionuclide leakage, confirming the feasibility of SHIFT for TARE applications. In the context of transforming from preclinical to clinical screening, the preparation of radiolipiodol by SHIFT represents an innovative physical strategy for radionuclide encapsulation. Hence, this work offers a reliable and efficient approach for TARE in HCC, showing considerable promise for clinical application (ChiCTR2400087731).

Immune inflammatory response runs through the whole pathological process of liver injury， but its specific regulatory mechanism remains unclear. Recent studies have shown that the Notch signaling pathway plays an important role in liver injury by regulating macrophage polarization， activating neutrophil recruitment， and modulating the differentiation of regulatory immune cells. This article systematically reviews the molecular mechanisms of the Notch signaling pathway in mediating immune inflammatory response in liver injury， in order to provide new perspectives for clarifying the molecular mechanism of immune inflammatory damage in liver diseases， as well as a new reference for future research directions.

Neurosurgery is a vital branch of medicine that deals with the surgical management of brain disorders. The increasing demand for clinical solutions drives technological innovation, and the rapid progress in science and technology enables new discoveries, knowledge, techniques, and instruments in neurosurgery, expanding the scope and accuracy of diagnosis and treatment, and enhancing therapeutic outcomes. The author team combines domestic and international literature and previous clinical and scientific research experience, focusing on practical clinical problems in several subspecialties, including neuroimaging, neuronavigation and surgical robot assistance, central nervous system tumors, surgical treatment of cerebrovascular disease, functional neurosurgery, neuroinjury and neural repair, and digital neurosurgery. The paper summarizes in detail the research hotspots and puts forward the research direction prospects, including the innovative application of imaging technology, the development of fine surgery, the innovation of neuro-oncology diagnosis and treatment, the surgical standardization of cerebrovascular disease, the progress of neuromodulation, the individualized neurological alternative treatment and the digitalization of multi-dimensional information in neurosurgery.

Objective To observe the feasibility and safety of CT-guided fine-needle assisted localization for puncturing difficult lung or liver lesions.Methods Data of 30 patients with single difficult lung or liver lesion,i.e.lesion located at difficult part for puncturing or deep lesion with diameter of 0.5-2.0 cm who underwent CT-guided 22G needle assisted localization before puncturing were retrospectively analyzed.The success rate of fine-needle assisted localization,the success rate of the first-time puncturing and the occurrence of complications were recorded.Results Among 30 difficult lesions,there were 27 lung lesions and 3 hepatic lesions,with a mean diameter of(1.0±0.4)cm.Assisted localization of difficult lesions were successfully performed with 22G needle under CT guidance at the edge of lesion,1 cm adjacent to lesion or at the puncture path,with success rate of fine-needle assisted localization of 100%,and no obvious complication happened.The followed operations included preoperative localization of 14 lung nodules,biopsy of 10 lung nodules and 3 liver nodules,as well as microwave ablation of 3 liver nodules,with the success rate of the first-time puncturing of 100%.Mild pneumothorax was observed in 3 cases(3/27,11.11%)of difficult lung lesions after biopy.No other obvious complication occurred.Conclusion CT-guided fine-needle assisted localization for percutaneous puncturing difficult lung or liver lesions was feasible and safe.

OBJECTIVE To explore the role and mechanism of dental pulp stem cells(DPSCs)in repairing hypoxic injury to rats pulmonary microvascular endothelial cells(PMVECs).METHODS ①PMVECs were treated with cobalt chloride at 0,10,25,50 and 100 μmol·L-1 for 72 h.CCK-8 was used to detect the cell viability,and the protein levels of hypoxia-inducible factor 1α(HIF-1α),zona occludens small-band protein 1(ZO-1),and occludin(OCLN)were detected by Western blotting.②There was a cell control group,model group,and model+DPSCs group,and the levels of reactive oxygen species(ROS)was detected by immunofluorescence staining after at 24 and 48 h of action.The levels of ZO-1 and OCLN proteins were detected by Western blotting.③ A cell control group,model group,model+DPSC group and model+DPSC cell knockdown superoxide dismutase 1(SOD1)group were set up.The mRNA level of SOD1 was detected by real-time fluorescence quantitative PCR 24 and 48 h later,while the protein levels of ZO-1 and OCLN were detected by Western blotting.RESULTS ① Com-pared with the cell control group,72 h of cobalt chloride 100 μmol·L-1 treatment of PMVECs resulted in a cell survival rate above 80%,a significant increase in the level of HIF-1α protein(P<0.05),a signifi-cant decrease in the levels of ZO-1 and OCLN proteins(P<0.01),and establishment of a model of hypoxic injury in PMVECs.② Compared with the cell control group,the ROS level was significantly higher in the model group(P<0.01).Compared with the model group,the ROS level was significantly lower in the model+DPSCs group(P<0.01),while the levels of ZO-1 and OCLN proteins were signifi-cantly higher in the model+DPSCs group(P<0.05).③ Compared with the DPSC group,ZO-1 and OCLN expressions were significantly decreased after knockdown of SOD1 in DPSCs(P<0.05,P<0.01).CONCLUSIONS DPSCs can repair hypoxic injury to PMVECs,and the anti-oxidative stress capacity of DPSCs plays an important role in hypoxic injury repair of PMVECs.

Objective To investigate the imaging findings of craniocervical adenoid cystic carcinoma(ACC)with invading adjacent tissues,neural foramen and tube.Methods The CT and MR imaging features of 33 cases of craniocervical ACC with invading adja-cent tissues,neural foramen and tube of the basis cranii were analyzed retrospectively and compared with surgical and pathological results.Results Among 33 cases of ACC,17 cases were located in the nasal cavity,sinuses and nasopharynx(including 3 cases of recur-rence after surgery),8 cases in salivary gland,5 cases in lacrimal gland and lacrimal sac,and 3 cases in external auditory canal.Tumors invaded and destroyed adjacent muscle bundles,spaces,nasal cavity,sinuses,and bone walls in 16 cases,invaded pterygopala-tine fossa in 9 cases,pterygoid canal in 7 cases,foramen rotundum in 6 cases,foramen ovale in 5 cases,nasolacrimal duct in 3 cases,foramina stylomastoideum in 2 cases and external auditory canal in 3 cases(a total of 35 foramen and tubes).When the tumor inva-ded the adjacent muscle bundles,spaces,nasal cavity,sinuses and basis cranii,CT or MR showed the thickening of the surrounding tissues,with the density/signal abnormalities and obvious enhancement.When the tumor invaded the adjacent bone,cartilage,neural foramen and tube,CT displayed the thickening,thinning,or loss of the bone wall,as well as the enlargement of neural foramen and tube,wall thickening,and bone destruction.Conclusion CT and MR can show the imaging features of multiple small vesicles and ethmoid structures in the craniocervical ACC,as well as the invasion of adjacent tissues and the destruction of basis cranii,maxillofa-cial nerve foramen and tube,which are of great significance for the imaging diagnosis and surgical treatment of craniocervical ACC.

Objective To investigate the association between triglyceride glucose index(TyG)combined with waist circumference(WC)and the risk of new-onset coronary heart disease(CHD)in the middle-aged and elderly people in 10 years of non-interventional follow-up in Luzhou area.Methods A total of 8 647 eligible individu-als participated in epidemiological survey in Luzhou area were selected.The subjects were divided into different groups according to the quartiles of the TyG-WC and followed for ten years.The correlation between different TyG-WC quartile group and 10-year new CHD in middle-aged and elderly population was analyzed by using univariate analy-sis and Cox regression analysis.Results Of the 8 647 participants in the study,484 had new CHD,accounting for 5.5%.The comparison of the number of newly diagnosed CHD subjects grouped by TyG-WC quartiles indicated the 4th quartile group>the 3rd quartile group>the 2nd quartile group>the 1st quartile group,showing statistical significance(P<0.001).Cox regression analysis showed that without adjusting for any variables,the risk of new CHD in 10 years increased with the increase of TyG-WC quartile group,and the differences between the second,third and fourth quartile array and the first quartile array were statistically significant(P<0.05).After adjusting for age and sex and further adjusting for the influence of various influencing factors,the risk of new CHD in 10 years increased with the increase of TyG-WC quartile group.The difference between the third and fourth quartile array and the first quartile array was statistically significant(P<0.05).Conclusion TyG-WC is a risk factor for new-onset CHD in the middle-aged and elderly population in Luzhou area in 10 years of non-interventional follow-up,and TyG-WC may be a predictor of the risk of CHD in the middle-aged and elderly population.

Objective To evaluate the protective effect of dental pulp stem cells(DPSCs)against high-altitude pulmonary edema(HAPE)and explore the mechanism.Methods Twenty-one Sprague-Dawley rats were randomly divided into the normal control group(Control),high altitude pulmonary edema group(HAPE)and DPSC prevention group(DPSC).Three days and one day before the hypobaric and hypoxia environment was simulated,DPSCs were administrated via the tail vein in the DPSC group,and phosphate buffered saline(PBS)of the same volume was injected in the control group and HAPE group.After that,rats in the HAPE group and DPSC group were placed in a simulated hypobaric and hypoxic cabin to simulate the environment at an altitude of 6000 m before an HAPE model was established.The rats were sacrificed 3 days later,and the histopathological changes of lung tissue were observed via hematoxylin-eosine(HE)staining.The dry/wet weight of lung tissues was recorded.The concentrations of total protein in lung homogenate were detected using the BCA method.The expression of aquaporin 1(APQ-1)in lung tissue was detected by real-time reverse transcription polymerase chain reaction(RT-PCR)and Western blotting.Colorimetry and enzyme linked immunosorbent assay(ELISA)were used to detect the concentrations of plasma vasoactive substances.The expression of inflammatory factors in serum and lung tissue was detected by ELISA and RT-PCR respectively.Results After three days of treatment in a simulated hypobaric and hypoxic environment,the lung tissue of the HAPE group showed infiltration of inflammatory cells,alveolar wall thickening,alveolar septum thickening and increases of exudation.DPSC prevention could significantly reduce the histopathological damage to the lung.Lung water content(LWC)and total protein content of lung homogenate were significantly increased in the HAPE group but obviously reduced in the DPSC prevention group,and the difference between the two groups was statistically significant(P＜0.01).The protein and mRNA expression levels of AQP-1 in lung tissue of the HAPE group were significantly decreased,but prevention via DPSCs could enhance the expression of AQP-1 in lung tissue.In the HAPE group,the concentrations of nitrous oxide(NO)and prostacyclin(PGI2)in plasma were significantly decreased,but prevention via DPSCs could significantly increase the expression of plasma vasoactive substances.The expressions of inflammatory factors interleukin-1 α(IL-1α)and tumor necrosis factor-α(TNF-α)in serum and lung tissue of the HAPE group increased significantly,but decreased in the DPSC prevention group.Conclusion DPSCs can help prevent high-altitude pulmonary edema in rats by promoting the expression of aquaporin,increasing the content of vasodilators in plasma and reducing the expression of inflammatory factors in serum and lung tissue.

Neurosurgery is a vital branch of medicine that deals with the surgical management of brain disorders. The increasing demand for clinical solutions drives technological innovation, and the rapid progress in science and technology enables new discoveries, knowledge, techniques, and instruments in neurosurgery, expanding the scope and accuracy of diagnosis and treatment, and enhancing therapeutic outcomes. The author team combines domestic and international literature and previous clinical and scientific research experience, focusing on practical clinical problems in several subspecialties, including neuroimaging, neuronavigation and surgical robot assistance, central nervous system tumors, surgical treatment of cerebrovascular disease, functional neurosurgery, neuroinjury and neural repair, and digital neurosurgery. The paper summarizes in detail the research hotspots and puts forward the research direction prospects, including the innovative application of imaging technology, the development of fine surgery, the innovation of neuro-oncology diagnosis and treatment, the surgical standardization of cerebrovascular disease, the progress of neuromodulation, the individualized neurological alternative treatment and the digitalization of multi-dimensional information in neurosurgery.