Objective:To investigate the impact of coronary angiography-derived index of microcirculatory resistance (caIMR) on the long-term prognosis of patients with coronary heart disease (CHD) undergoing elective percutaneous coronary intervention (PCI).Methods:The study was a retrospective cohort study conducted at a single centre. Patients who successfully underwent elective PCI with pre-and post-PCI caIMR measurements in Peking University First Hospital between August 2013 and December 2020 were included. Then patients were categorised into three groups based on pre-and post-PCI caIMR: post-PCI caIMR<25 U group, pre-PCI caIMR<25 U and post-PCI caIMR≥25 U group, and both pre-and post-PCI caIMR≥25 U group. Collected clinical data of patients, including comorbid diabetes mellitus.The primary endpoint was a composite endpoint, defined as a composite of all-cause death, non-fatal myocardial infarction, and any revascularisation. The association between caIMR-based groupings and clinical outcomes was analysed using Cox proportional hazards regression models.Results:A total of 625 patients who underwent successful elective PCI were included in the study, among whom 294 (47.0%) had stable angina. The age was (64.5±10.1) years, and 440 (70.4%) patients were male. Over a median follow-up of 3.69 (1.80, 5.80) years, 122 patients (19.5%) experienced composite endpoint events. Post-PCI caIMR≥25 U in combination with diabetes mellitus was associated with an increased risk of the composite endpoint compared to those with post-PCI caIMR<25 U and without diabetes mellitus (adjusted HR=2.13, 95% CI 1.17-3.88, P=0.014). In the combined analysis, compared with post-PCI caIMR<25 U group, those with both pre-and post-PCI caIMR≥25 U had higher risks of composite endpoint (adjusted HR=2.01, 95% CI 1.18-3.43, P=0.010) and any revascularisation (adjusted HR=2.12, 95% CI 1.17-3.84, P=0.013). The pre-PCI caIMR<25 U and post-PCI caIMR≥25 U group showed no statistically significant differences in any of the endpoints compared to post-PCI caIMR<25 U group. Conclusions:Integrated pre-and post-procedural assessment of caIMR may enhance risk stratification in patients with coronary heart disease. Persistent coronary microvascular dysfunction present both before and after PCI, as measured by caIMR, serves as an independent risk factor for adverse events in patients with coronary heart disease undergoing elective PCI.

The liver is one of the important metabolic organs in the body, and liver diseases are also one of the major public health issues globally. Currently, the lack of models that accurately simulating human physiology and pathology is the key challenge in liver disease research, and the emerging of organoid technology is an excellent solution to this challenge. Organoids are three-dimensional cellular structures cultured in vitro that can mimic the structure and function of real organs while maintaining genetic stability. The development of organoids has provided possibilities for personalized medicine and precision therapy and has become a key tool in the research and treatment of liver diseases. The authors focuse on the application and development of organoids in liver disease research, while also emphasizing their limitations and future prospects.

The liver is one of the important metabolic organs in the body, and liver diseases are also one of the major public health issues globally. Currently, the lack of models that accurately simulating human physiology and pathology is the key challenge in liver disease research, and the emerging of organoid technology is an excellent solution to this challenge. Organoids are three-dimensional cellular structures cultured in vitro that can mimic the structure and function of real organs while maintaining genetic stability. The development of organoids has provided possibilities for personalized medicine and precision therapy and has become a key tool in the research and treatment of liver diseases. The authors focuse on the application and development of organoids in liver disease research, while also emphasizing their limitations and future prospects.

Objective:To investigate the impact of coronary angiography-derived index of microcirculatory resistance (caIMR) on the long-term prognosis of patients with coronary heart disease (CHD) undergoing elective percutaneous coronary intervention (PCI).Methods:The study was a retrospective cohort study conducted at a single centre. Patients who successfully underwent elective PCI with pre-and post-PCI caIMR measurements in Peking University First Hospital between August 2013 and December 2020 were included. Then patients were categorised into three groups based on pre-and post-PCI caIMR: post-PCI caIMR<25 U group, pre-PCI caIMR<25 U and post-PCI caIMR≥25 U group, and both pre-and post-PCI caIMR≥25 U group. Collected clinical data of patients, including comorbid diabetes mellitus.The primary endpoint was a composite endpoint, defined as a composite of all-cause death, non-fatal myocardial infarction, and any revascularisation. The association between caIMR-based groupings and clinical outcomes was analysed using Cox proportional hazards regression models.Results:A total of 625 patients who underwent successful elective PCI were included in the study, among whom 294 (47.0%) had stable angina. The age was (64.5±10.1) years, and 440 (70.4%) patients were male. Over a median follow-up of 3.69 (1.80, 5.80) years, 122 patients (19.5%) experienced composite endpoint events. Post-PCI caIMR≥25 U in combination with diabetes mellitus was associated with an increased risk of the composite endpoint compared to those with post-PCI caIMR<25 U and without diabetes mellitus (adjusted HR=2.13, 95% CI 1.17-3.88, P=0.014). In the combined analysis, compared with post-PCI caIMR<25 U group, those with both pre-and post-PCI caIMR≥25 U had higher risks of composite endpoint (adjusted HR=2.01, 95% CI 1.18-3.43, P=0.010) and any revascularisation (adjusted HR=2.12, 95% CI 1.17-3.84, P=0.013). The pre-PCI caIMR<25 U and post-PCI caIMR≥25 U group showed no statistically significant differences in any of the endpoints compared to post-PCI caIMR<25 U group. Conclusions:Integrated pre-and post-procedural assessment of caIMR may enhance risk stratification in patients with coronary heart disease. Persistent coronary microvascular dysfunction present both before and after PCI, as measured by caIMR, serves as an independent risk factor for adverse events in patients with coronary heart disease undergoing elective PCI.

The liver's remarkable regenerative capacity is crucial to restore its function, which can be compromised in cases of severe or chronic liver injury. Thus, the search of new methods to promote liver regeneration is of great clinical importance. In recent years, the gut microbiota is an emerging field of research that attracts the scientific community. The gut microbiota not only affects the integrity of digestive system but also exerts a significant impact on liver function via the so-called " gut-liver axis". Increasing evidence suggests that an imbalance in gut microbiota is associated with the development of various liver diseases, and modulation of gut microbiota might be a potential cure for liver diseases. Research into the role of gut microbiota in liver regeneration not only help us understand the pathogenesis of liver diseases but also facilitate the development of new therapeutic strategies.

Background::Gastric cancer (GC), a malignant tumor with poor prognosis, is one of the leading causes of cancer-related deaths worldwide; consequently, identifying novel therapeutic targets is crucial for its corresponding treatment. NUF2, a component of the NDC80 kinetochore complex, promotes cancer progression in multiple malignancies. Therefore, this study aimed to explore the potential of NUF2 as a therapeutic target to inhibit GC progression. Methods::Clinical samples were obtained from patients who underwent radical resection of GC at Lanzhou University Second Hospital from 2016 to 2021. Cell count assays, colony formation assays, and cell-derived xenotransplantation (CDX) models were used to determine the effects of NUF2 on GC progression. Flow cytometry was used to detect the effect of NUF2 or quercetin on cell cycle progression and apoptosis. A live-cell time-lapse imaging assay was performed to determine the effect of NUF2 on the regulation of mitotic progression. Transcriptomics was used to investigate the NUF2-associated molecular mechanisms. Virtual docking and microscale thermophoresis were used to identify NUF2 inhibitors. Finally, CDX, organoid, and patient-derived xenograft (PDX) models were used to examine the efficacy of the NUF2 inhibitor in GC. Results::NUF2 expression was significantly increased in GC and was negatively correlated with prognosis. The deletion of NUF2 suppressed GC progression both in vivo and in vitro. NUF2 significantly regulated the mitogen-activated protein kinase (MAPK) pathway, promoted G2/M phase transition, and inhibited apoptosis in GC cells. Additionally, quercetin was identified as a selective NUF2 inhibitor with low toxicity that significantly suppressed tumor growth in GC cells, organoids, CDX, and PDX models. Conclusions::Collectively, NUF2-mediated G2/M phase transition and apoptosis inhibition promoted GC progression; additionally, NUF2 inhibitors exhibited potent anti-GC activity. This study provides a new strategy for targeting NUF2 to suppress GC progression in clinical settings.

With the deepening research of comprehensive treatment for gastric cancer, the FLOT regimen has begun to be used for the treatment of gastric cancer patients. FLOT neoadjuvant regimen can significantly improve the R 0 resection rate and prolong the overall survival time of locally advanced gastric cancer patients. FLOT regimen combined with immune-checkpoint inhibi-tors, targeted therapy and hyperthermic intraperitoneal chemotherapy have great potential in neo-adjuvant therapy for gastric cancer. The authors systematically analyse the development history and latest clinical research progress of FLOT neoadjuvant regimen for gastric cancer based on their clinical practice experience.

Objective The aim to assess the methodology and feasibility of ultrasound guided percutaneous thrombin injection(UGTI) for the treatment of Iarogenic Femoral Arterial Complexity Pseudoaneurysms(IFACP).Methods Thirty two iarogenic femoral arterial complexity pseudoaneurysms patients following femoral arerial puncture for arterial angiography were treated with UGTI.Twenty-three IFACP with 2 lobes,8 IFACP with 3 lobes,1 IFACP with 4 lobes.Under local anesthesia the lobe was pene trated by artery needle successively and thrombin jection was performed slowely into distal lobe with US guide precise localization.Dynamical observation was performed for the status of thrombogenesis and cavity plugging.US follow-up examination were performed after 24 h and 7 d.Results Reperfusion occurred in IFACP with 3 lobes after 24 h and UGTI failure.IFACPs with 4 lobes failure.Nothromboembolic,infectious,allergic complication soccurred.Conclusion UGTI is the first mothed for the treatment of IFACP.Precise localization and percutaneous can enhance the ratio of treatment of IFACPs and avoid the severe complications.

OBJECTIVE: To explore the prognosis and surgical method for diffuse-type advanced gastric cancer (AGC).
 METHODS: The clinicopathological data of patient, who underwent curative gastrectomy in the Second Hospital Affiliated to Lanzhou University from 2005 to 2010, were analyzed retrospectively. The prognostic factors of diffuse-type AGC were analyzed by Cox regression models. The patients were divided into a total gastrectomy group (n=120) and a subtotal gastrectomy group (n=167) according to the surgical approach. Survival rates were established by the Kaplan-Meier method and compared by the Log-rank test between the total gastrectomy group and the subtotal gastrectomy group.
 RESULTS: A total of 287 patients with diffuse-type AGC were enrolled in this study, including 120 patients in the total gastrectomy group and 167 patients in the subtotal gastrectomy group. Univariate analysis showed that the prognosis of diffuse-type AGC was associated with body mass index, number of retrieved lymph nodes, Borrmann type, tumor size, T stage, N stage, tumor-node-metastasis (TNM) stage, extent of resection, surgical margin, postoperative complication, perineural and vascular invasion (all P<0.01). Multivariate analysis showed that normal body mass index, tumor size, T stage, N stage, total gastrectomy, surgical margin, postoperative complication were the independent predictors for diffuse-type AGC (all P<0.05). The 5-year overall survival rate and progression-free survival rate for diffuse-type AGC after curative gastrectomy were 17.8% and 13.6%, respectively. The median survival time and progression-free survival of them were 22 and 18 months, respectively. The overall survival rate and progression-free survival rate in the total gastrectomy group was significantly higher than that in the subtotal gastrectomy (P<0.01); the extended extent of lymph node dissection, the lower rate of positive surgical margin and postoperative complications were present in the total gastrectomy group (all P<0.05 or P<0.01).
 CONCLUSION The patients with diffuse-type AGC have a poor prognosis. The great tumor diameter, advanced T stage, advanced N stage, subtotal gastrectomy, high rate of positive surgical margin and postoperative complication are independent risky factors for the diffuse-type AGC. However, the total gastrectomy may be beneficial to patients.
Disease-Free Survival ; Gastrectomy ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; Multivariate Analysis ; Neoplasm Staging ; Postoperative Complications ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms ; diagnosis ; surgery ; Survival Rate