Objective To evaluate the efficacy of XELOX regimen as neoadjuvant chemotherapy in the treatment of stage Ⅱ and Ⅲ colon cancer.Methods The clinical data of 50 patients with clinical stage Ⅱ(T4)Ⅲ colon cancer who underwent laparoscopic radical resection at general surgery department of our hospital from January 1,2012 to January 1,2021 were retrospectively analyzed.Patients were divided into neoadjuvant chemotherapy group(NACT)and adjuvant chemotherapy group(ACT)according to whether they received neoadjuvant chemotherapy with XELOX regimen.The general clinical data,adverse reactions of chemotherapy,surgical complications,operation time,intraoperative blood loss,hospitalization time,hospitalization cost,negative conversion rate of tumor markers,tumor remission rate,tumor downstaging rate,tumor response grade after chemotherapy,postoperative disease-free survival curve,and overall survival curve were retrospectively analyzed and compared among the groups.Results There were no significant differences in operative complications,postoperative exhaust time and hospital stay between NACT group and ACT group(P＞0.05).The adverse reactions of chemotherapy,the negative conversion rate of postoperative CEA and CA19-9,the duration of operation,the amount of bleeding,and the hospitalization cost in NACT group were significantly better than those in ACT group(P＜0.05).In terms of DFS and OS survival curves,with the extension of time,the decline of the NACT survival curve was smaller than that of the ACT group,and there was a significant difference in DFS survival curve(P＜0.05),but no significant difference in OS survival curve(P＞0.05).Conclusion XELOX neoadjuvant chemotherapy is safe and effective in the treatment of stage Ⅱ(T4)and stage Ⅲcolon cancer.

BACKGROUND:The researchers noted that upon embedding clinical-grade catgut and polyglycolide-co-lactide threads in the normal human"Zusanli"(ST 36)acupoint,the local area displayed temporal and inflammatory stimulatory effects,resulting in thread differentiation.However,the underlying mechanism behind thread involvement remains to be studied. OBJECTIVE:To investigate the expression levels of calcitonin gene-related peptide,5-hydroxytryptamine,leukotriene B4,and bradykinin at point"Zusanli"(ST 36)in rats after embedding catgut and polyglycolide-co-lactide respectively at different time points. METHODS:110 male SD rats were divided into a blank group(10 rats),a catgut embedding group(50 rats),and a polyglycolide-co-lactide embedding group(50 rats)according to the random number table method.In the blank group,no thread was embedded.In catgut embedding group and the polyglycolide-co-lactide embedding group,the thread was embedded in the left side of the ST36 acupoint once.Tissue was collected from the left side of the ST36 acupoint area 8 hours,3,7,14,and 21 days after embedding.The expression levels of calcitonin gene-related peptide and 5-hydroxytryptamine were detected by immunohistochemistry,and the contents of leukotriene B4 and bradykinin were detected by ELISA. RESULTS AND CONCLUSION:(1)Compared with the blank group,the expression of calcitonin gene-related peptide,5-hydroxytryptamine,bradykinin,and leukotriene B4 was significantly increased in the 8 hours,3,7,14,and 21 days of the catgut embedding group(P<0.05);calcitonin gene-related peptide expression was significantly increased in 8 hours,3,7,and 14 days in the polyglycolide-co-lactide embedding group(P<0.05);the expression of bradykinin was significantly increased in 8 hours,3,and 7 days(P<0.05);the expression of leukotriene B4 was significantly increased at 8 hours,3,7,14,and 21 days(P<0.05).(2)Compared with the polyglycolide-co-lactide embedding group,the expression of calcitonin gene-related peptide was increased at 7,14,21 days after thread embedding(P<0.05),and the expression of 5-hydroxytryptamine was increased at 8 hours,3,7,14 and 21 days after thread embedding(P<0.05);contents of leukotriene B4 and bradykinin in tissues were increased at 8 hours,3,14 and 21 days after embedding(P<0.05)in the catgut embedding group.(3)The results show that calcitonin gene-related peptide,5-hydroxytryptamine,leukotriene B4,and bradykinin in the acupoint region alter after catgut embedding in the ST36 of rats,as well as the alteration of calcitonin gene-related peptide,leukotriene B4,and bradykinin is found in the acupoint region after polyglycolide-co-lactide embedding in rats,which may be one of the mechanisms involved in the local time sensitive stimulus effects caused by embedding threads at acupoints.Moreover,there is a discernible difference between the two thread types.

Objectives:To investigate the association between social determinants of health(SDOH)and incident stroke and analyze the main risk factors for stroke among resident with different SDOH levels. Methods:From 2012 to 2015,30 036 residents(≥35 years old)from 30 districts in 14 provincial-level administrative divisions in China were enrolled this study based on stratified multi-stage-random-sampling method.The prevalence of cardiovascular diseases and related risk factors were investigated,and stroke events were followed up in 2018 to 2019.Principal component analysis was performed to establish SDOH scores based on 9 indicators related to socioeconomic and healthcare resources,participants were divided into low SDOH group(n=8 343)when it was≥-2.01 to<-1.14,middle SDOH group(n=7 257)when it was≥-1.14 to<0.10,and high SDOH group(n=8 457)when it was≥0.10 to≤5.79.Multivariate Cox regression was applied to estimate the association of SDOH levels with incident stroke.The random survival forest method was used to analyze the major risk factors in different SDOH levels. Results:A total of 24 057 participants were finally included,669(2.8%)participants developed stroke during a mean of(4.7±0.8)years follow-up.The incidence densities of stroke in the low,medium,and high SDOH groups were 468.39,628.85,and 700.39/100 000 person-years,respectively(Pdifference<0.05,Ptrend=0.01).Compared with individuals with low SDOH level group,fully HR for incident stroke among those with medium and high were 1.91(95%CI:1.54-2.36)and 1.59(95%CI:1.30-1.95),respectively(Ptrend<0.001).Advanced age is the primary risk factor for stroke in the population,especially in districts with high SDOH level.In districts with medium SDOH level,diabetes is an important risk factor for stroke.High blood pressure and alcohol consumption are important modifiable risk factors in low SDOH level districts. Conclusions:Present study shows that higher levels of SDOH are associated with increased risk of stroke.The main risk factors for stroke differ among participants with different SDOH level districts.Targeted interventions should be implemented to improve the prevention and treatment of stroke in populations with different levels of SDOH.

Ginger mainly contains two main categories of volatile and non-volatile components,of which the non-volatile gingerol is a general term for pungent substances in ginger,mainly containing gingerols,shogaols and other components,with a wide range of pharmacological effects.By reviewing the 2020 edition of the Pharmacopoeia of the People's Republic of China and related literature in Chinese databases such as CNKI and Wanfang,it was found that the use of the Chinese names of gingerols and shogaols was confusing,which caused certain troubles to readers and obstacles to academic exchanges.According to the naming principles of Chinese medicinal extracts,it is suggested that gingersols,6-gingerol,8-gingerol and 10-gingerol should be uniformly named as gingerols(姜酚类),6-gingerol(6-姜酚),8-gingerol(8-姜酚)and 10-gingerol(10-姜酚),respectively,and shogaols and 6-shogaol should be uniformly named as shogaols(姜烯酚类)and 6-shogaols(6-姜烯酚).The standardized use of the Chinese names of gingerols and shogaols will facilitate in-depth research and academic exchange on ginger,dried ginger,baked ginger and other ginger herbal medicines.

Pancreatic ductal adenocarcinoma (PDAC) is a highly malignant solid tumor of the digestive system, characterized by rapid progression and difficulties of early diagnosis. Five-year survival rate of the patients is less than 9%. With the acceleration of global population aging and lifestyle change, the incidence of PDAC has been increasing annually. Currently, surgical treatment and chemotherapy remain the standard treatment options for PDAC patients. Early symptoms of PDAC are so undetectable that most patients miss the optimal opportunity for radical surgical resection. Even among those who undergo surgery, the high recurrence rate remains a major problem. PDAC is known for its unique tumor microenvironment. The cellular and non-cellular components in the tumor microenvironment account for as much as 90% of the tumor stroma, presenting many potential targets for PDAC therapy. Activated pancreatic stellate cells within PDAC tissue express specific proteins and secrete various cytokines and metabolites, which directly contribute to the proliferation, invasion, and metastasis of PDAC cells. These elements are critical in extracellular matrix production, connective tissue hyperplasia, immune tolerance, and drug resistance. Immune cells, such as macrophages and neutrophils, exert immunosuppressive and tumor-promoting roles in PDAC progression. The extracellular matrix, which serve as a natural physical barrier, induces interstitial hypertension and reduces blood supply, thereby hindering the delivery of drugs to the tumor. Additionally, it helps the metastasis and differentiation of PDAC cells, reducing the efficacy of clinical chemotherapy and immunotherapy. Although chemotherapeutic agents like gemcitabine have been used in the clinical treatment of PDAC for more than 20 years, the curative effect is obstructed by their poor stability in the bloodstream, low cellular uptake, and poor targeting. While small-molecule inhibitors targeting mutations such as KRAS^G12C, BRCA, and NTRK fusion have shown great potential for molecular targeted treatments and gene therapies of PDAC, their broader application is limited by side effects and restricted scope of patients. The advancement of nanotechnology brings new strategies for PDAC treatment. By virtue of unique size characteristics and actual versatility, different drug-delivery nanosystems contribute to overcome the dense stromal barrier, prolong the circulation time of therapeutics and realize precise PDAC treatment by targeted drug delivery. Clinical nanodrugs such as albumin-bound paclitaxel (nab-paclitaxel) and irinotecan liposome greatly improve the pharmacokinetics of conventional chemotherapeutics and promote drug accumulation inside the tumor, thereby are applying to the first-line treatment of PDAC. It is noteworthy that none nanodrugs with active targeting design have been approved for clinical treatment yet, though many are in clinical trials. In this review, we discuss promising targeting strategies based on different nanodrug delivery systems for treatment of PDAC. One major nanostrategy focuses on the tumor cell targeting and its applications in chemotherapy, molecular targeting therapy, gene therapy, and immunotherapy of PDAC. Another nanostrategy targets the tumor microenvironment, which highlights the nanosystems specifically regulating pancreatic stellate cells, immune cells and the extracellular matrix. Recent progress of developing new nanotheraputics for breakthrough in the fight of PDAC are elaborated in this review. We also provide our perspectives on the challenges and opportunities in the field.

Objective To investigate the clinical characteristics and influencing factors of moderate-to-severe pulmonary ventilation dysfunction in occupational pneumoconiosis (hereinafter referred to as "pneumoconiosis") patients complicated with pulmonary tuberculosis. Methods A total of 136 male pneumoconiosis patients complicated with pulmonary tuberculosis suffering different degrees of pulmonary ventilation dysfunction were selected as the study subjects using the judgmental sampling method. Patients were divided into mild dysfunction and moderate-to-severe dysfunction groups based on the degrees of pulmonary ventilation dysfunction. Clinical data from patients of these two groups were collected, and influencing factors of pulmonary ventilation dysfunction were analyzed. Results The prevalence of mild dysfunction and moderate-to-severe dysfunction among the study subjects was 39.0% and 61.0%, respectively. The proportion of patients with moderate-to-severe pulmonary ventilation dysfunction increased with the progression of pneumoconiosis (P<0.05). Patients in moderate-to-severe dysfunction group had higher rates of dyspnea, elevated C-reactive protein, coexisting chronic obstructive pulmonary disease (COPD), and a history of lung infections within the past two years compared with those in the mild dysfunction group (all P<0.05). The result of multivariate logistic regression analysis showed that the degree of pneumoconiosis, complicated with COPD, and a history of lung infections within the past two years were risk factors for moderate-to-severe pulmonary ventilation dysfunction (all P<0.05). Specifically, higher degree of pneumoconiosis was associated with a greater proportion of moderate-to-severe dysfunction, and patients complicated with COPD or had a history of lung infections within the past two years were more likely to experience severe pulmonary ventilation dysfunction. Conclusion The degree of pneumoconiosis, complicated with COPD, and a history of lung infections within the past two years are influencing factors of moderate-to-severe pulmonary ventilation dysfunction in patients with pneumoconiosis combined with pulmonary tuberculosis. Early detection of pneumoconiosis progression, timely diagnosis of COPD and lung infections, and appropriate treatment such as antifibrotic agents, inhaled bronchodilators, and anti-infective therapies are recommended.

Objective To evaluate the efficacy and adverse reactions of BRAF inhibitor vermorafenib on the treat-ment of refractory craniopharyngioma carrying BRAF-V600E mutation.Methods Clinical data of two patients with refractory craniopharyngiomas(CP)were recorded and reviewed.The patients were followed up for 3-5 years.Lit-erature on CPs receiving BRAF or BRAF/MEK therapy was reviewed.Results 1)Papillary CP progressed after multiple operations and radiotherapy in two patients.Further treatments were very difficult.2)The presence of BRAF-V600E mutation in the tumor was confirmed,and vermorafenib was administered for 6.5-7.5 months.Tumor volumes remarkably shrank by 95%-99%.No tumor relapse was observed during the follow-up of 3-5 years after discontinuation of vemurafenib.3)The main adverse reaction was rash,which was dose dependent.4)Litera-ture review showed the volume shrank by 50%-100%in 33/34 tumors during BRAF or BRAF/MEK inhibitor therapy.Conclusions BRAF inhibitor vemurafenib is effective in treating refractory craniopharyngioma carrying BRAF-V600E mutation with endurable side effects,which may bring some changes to the management of CP in future.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To investigate the role of PSMA4 in the prognosis,diagnosis and immune infiltration of lung adenocarcinoma(LUAD),and explore its underlying mechanism.Methods The expression profiles and clinical data of LUAD patients were sourced from the Cancer Genome Atlas(TCGA)database.The expression level of PSMA4 in LUAD tissues(n=539)and normal tissues(n=59)were compared using the Wilcoxon rank-sum test.The expression levels of PSMA4 in LUAD tissues and normal tissues were validated by analyzing the GSE40791 and GSE10072 LUAD datasets obtained from the Gene Expression Omnibus(GEO)database.In addition,tumor and adjacent non-cancerous tissues were collected from 10 LU AD undergoing lung biopsy by fiberoptic bronchoscopy in Second Affiliated Hospital of Army Medical University from January to December 2023.The PSMA4 expression in above samples was further verified using RT-qPCR.RT-qPCR was performed to detect the expression of PSMA4 in lung cancer cells and normal lung epithelial cells.Functional enrichment analysis and immune cell infiltration analysis were conducted on the cells with high and low expression of PSMA4.Cox regression analysis and Kaplan-Meier(KM)survival analysis were used to determine the diagnostic and prognostic value of PSMA4 for LUAD,and a nomogram was constructed to predict the overall survival rate at different time points.Results The analysis of TCGA datasets,GSE40791,and GSE10072 LUAD data revealed that PSMA4 expression was significantly higher in LUAD tissues than in normal tissues(P＜0.01).RT-qPCR further confirmed that the expression of PSMA4 was obviously elevated in LUAD tissues and lung cancer cells than adjacent non-cancerous tissues and normal lung epithelial cells(P＜0.01).High PSMA4 expression could be regarded as a marker for LUAD diagnosis and poor prognosis,and was associated with reduced proportions of Tem cells,TFH cells,B cells,NK cells,Tcm cells,and mast cells in the tumor microenvironment.Conclusion PSMA4 presents significant diagnostic performance for LUAD,and is closely associated with the prognosis and immune infiltration of this malignancy.

Objective To prepare paclitaxel-natural borneol complex,and to explore the prescription and preparation process of paclitaxel-natural borneol complex drug-loaded submicroemulsion,and its in vitro anti-tumor effect.Methods The Paclitaxel-natural borneol complex was prepared by grinding method and identified by Fourier Transform infrared spectroscopy(FT-IR)and differential scanning calorimetry(DSC).The compound drug-loaded submicroemulsion was prepared using a two-step high-pressure emulsification method.The single-factor investigation and the orthogonal experimental design were applied to optimize the formulation and preparation process.MTT assay,cell cloning assay,and cell scratch assay were used to evaluate the effect of this preparation on HCT-116 cells.Results The infrared spectral absorption peaks of taxol-natural borneol complex at 3 312.76 cm-1 and 3 513.92 cm-1 disappeared,and DSC analysis showed that a new absorption peak of taxol-natural borneol complex appeared at 154.56 ℃,indicating that taxol be coupled with natural borneol to form a new complex.The optimal prescription was 0.44％active pharmaceutical ingredient[paclitaxel-natural borneol(1∶3)],10％medium chain triglyceride,3％emulsifier[egg yolk lecithin-Poloxam 188(1∶2)],2％glycerol,0.3％oleate.The optimal process was emulsification at 80 ℃,60 MPa high pressure homogenization 10 times.The half inhibitory concentration(IC50)was 0.75 μg·mL-1 by MTT asssy in cell.In the cell cloning assay,the scratch healing area of blank control group,paclitaxel raw material and paclitaxel/natural borneol submicroemulsion were(36.44±3.35)％,(13.59±9.28)％,(8.30±4.09)％,respectively.The results were statistically significant(P＜0.05).In the plate cloning experiment,the cell cloning rates of blank control group,paclitaxel bulk drug group and submicroemulsion group were(37.92±0.729)％,(9.16±1.335)％and(3.36±1.065)％,respectively,the differents were statistically significant(P＜0.05).Conclusion This submicroemulsion has reasonable prescription,feasible process and good stability.Cell experiments showed that the submicronemulision effectively inhibits the proliferation and migration of HCT-116 cells,suggesting its potential as a promising antitumor agent.