Objective To systematically evaluate the efficacy and safety of proximal gastrectomy (PG) versus total gastrectomy (TG) for the treatment of Siewert type Ⅱ/Ⅲ adenocarcinoma of the esophagogastric junction (AEG). Methods PubMed, The Cochrane Library, Web of Science, EMbase, CNKI, Wanfang, and VIP databases were searched for literature comparing the efficacy and safety of PG and TG for the treatment of Siewert type Ⅱ/Ⅲ AEG. The search period was from database inception to March 2023. Meta-analysis was performed using Review Manager 5.4 software. Results A total of 23 articles were included, including 16 retrospective cohort studies, 5 prospective cohort studies, and 2 randomized controlled trials. The total sample size was 2 826 patients, with 1 389 patients undergoing PG and 1 437 patients undergoing TG. Meta-analysis results showed that compared with TG, PG had less intraoperative blood loss [MD=−19.85, 95%CI (−37.20, −2.51), P=0.02] and shorter postoperative hospital stay [MD=−1.23, 95%CI (−2.38, −0.08), P=0.04]. TG had a greater number of lymph nodes dissected [MD=−6.20, 95%CI (−7.68, −4.71), P<0.001] and a lower incidence of reflux esophagitis [MD=3.02, 95%CI (1.24, 7.34), P=0.01]. There were no statistically significant differences between the two surgical approaches in terms of operative time, postoperative survival rate (1-year, 3-year, 5-year), and postoperative overall complications (P>0.05). Conclusion PG has advantages in terms of intraoperative blood loss and postoperative hospital stay, while TG has advantages in terms of the number of lymph nodes dissected and the incidence of reflux esophagitis. There is no significant difference in long-term survival between the two surgical approaches.

Hydration status refers to the balance between the intake and discharge of water in the body. When the ingested and discharged water are roughly equal and the body is in water balance, it is the normal hydration status, and when the water intake is too little or too much, it is the "dehydration" or "overhydration status". The hydration status of the body not only affects metabolism, but also affects the functions of the urinary system, cardiovascular system, nervous system, etc. In order to further clarify the relationship between body hydration status and decompression sickness (DCS), this paper reviewed relevant studies and analyzed the interaction between hydration and decompression safety during diving. The primary causes of dehydration in diving are "hyperbaric diuresis", "immersion diuresis", breathing dry gas, heat, and cold. Dehydration not only promotes the occurrence of DCS but also reduces the aerobic work efficiency and athletic performance of divers, as well as affects cognition and mood. A study found that appropriate rehydration before and during diving can reduce the risk of DCS, which possibly associates with the increase of blood volume, plasma surface tension, and vasoconstriction. Fluid therapy is also important for those who already have DCS. This paper analyzed the amount, nature, timing, and effect of rehydration involved in the above links, comprehensively sorted out the relationship between hydration and diving safety, summarized the existing problems, and provided reference for practical application and future research.

Objective To observe the effect of deglycerolized red blood cells suspended in MAP on preservation and ex-plore the most effective preservation method.Methods Concentrated red blood cells were prepared by centrifuging 400 mL of whole blood on the third day after collection.40%compound glycerol solution was added using the ACP 215 automatic blood cell analyzer,and the resulting mixture was stored in an ultra-low temperature refrigerator at-65℃for 30 days.After thawing and washing,it was equally separated into two bags.The control group received 0.9%sodium chloride solution,while the experimental group received MAP.Both groups were stored at 2-6℃.Hematological parameters,hemolysis inde-xes and cell metabolism indexes were measured on day 0,1,3,5,7 and 14 after storage.The quality changes of both groups were observed during the 14-day storage period.Results The quality of red blood cells in both groups was assessed through a panel of quality tests,including volume,hemoglobin content,free hemoglobin content,white blood cell residue,glycerin residue and sterility.These results met the Quality Requirements outlined in the"Quality Requirements of Whole Blood and Component Blood"(GB18469-2012),Hematocrit,red blood cell count,Hb recovery rate after washing and MCV meet the detection limit outlined in the"Expert Consensus on Quality Evaluation Indicators for Frozen Red Blood Cells",and the residual amount of platelets exceeds the detection limit(≤1%).There were no significant differences in RBC,Hct,MCV and hemoglobin between the two groups during the 14 day storage period.The level of free hemoglobin,hemolysis rate and K+value increased in both groups over time.Significant differences in free hemoglobin were found on day 3,5,7 and 14 between the two groups(P<0.05).Hemolysis rate was significantly different on days 3,5,7 and 14,while K+value was significantly different only on day 14(P<0.05).On day 14,the osmotic fragility of red blood cells was higher in the control group than in the experimental group(P<0.05);The ATP and pH values of both groups decreased as storage time in-creased,and significant differences in ATP and pH value were found on day 3,5,7 and on day 1,3,5,7 and 14,respec-tively(P<0.05).Conclusion Deglycerolized red blood cells suspended in MAP additive solution can extend the storage period of blood to 7 days.This study provides a reference for the formulation of relevant standards.

Objective:To explore the severe complications, such as blindness, brain infarction and even death caused by cosmetic autologous fat filler injection and their underlying mechanisms.Methods:From May 2022 to October 2023, 64 male New Zealand rabbits were selected in the clinical laboratory of Shaanxi University of Chinese Medicine and divided into 8 groups with 8 rabbits in each group. They were divided into grinding fat group, fat granule group, fat lipid group and normal saline group, and each group was further divided into 0.2 ml group and 0.4 ml group. Fat was cut from the rabbit groin, then chopped or treated with collagenase I, and centrifuged to separate fat lipids and fat particles, as well as other tissues. The rabbit facial artery was exposed along the incision below the mandibular angle, and 0.2 or 0.4 ml of chopped fat, fat particles, and lipids were retrogradely injected into the facial artery in each group, and then the incision was closed under the microscope. Ophthalmic and neurological symptoms were observed and recorded after surgery, and visual electrophysiology and fundus microscopy were performed to verify visual acuity and fundus artery obstruction.Results:Two weeks after surgery, the incidence of ophthalmic symptoms in the 0.2 ml injection group was 100% in the grinding fat group, 62.5% in the fat granule group, 0 in the lipid group and 0 in the normal saline group. The complication rates of 0.4 ml embolic injection were 100%, 87.50%, 12.5% and 0, respectively. The incidence of neurological symptoms was 62.5%, 25.0%, 0 and 0, respectively. Mortality rates were 37.5%, 12.5%, 0 and 0 after injection of 0.2 ml, and 100%, 50%, 0 and 0 after injection of 0.4 ml, respectively.Conclusions:Animal models have shown that grinding adipose tissue without collagenase I treatment is more likely to cause serious complications, simple lipid entry into blood vessels does not block relevant arteries, and fat volume is positively correlated with the incidence of postoperative complications.

OBJECTIVE To investigate the improvement mechanism of caudatin on liver injury of rats. METHODS SD rats were randomly divided into blank group， model group， caudatin low-dose and high-dose groups （25， 50 mg/kg）， with 6 rats in each group. Diethylnitrosamine （DEN） was injected intraperitoneally three times per week for eight weeks to establish liver injury model of rats. At 5th week of modeling， the rats received relevant medicine or 0.5% sodium carboxymethylcellulose intragastrically for 4 weeks. The levels of liver function indexes [alanine transaminase （ALT）， aspartate transaminase （AST）， total protein （TP） and total bilirubin （TBI）] and inflammatory factors [interleukin （IL-6）， tumor necrosis factor α （TNF-α）， IL-1β] in serum were detected； the histopathological morphological changes of rat liver were observed； the positive protein expressions of nuclear factor κB （NF-κB） and 78 kDa glucose regulatory protein （Grp78） in liver tissue were also determined； the expressions of endoplasmic reticulum stress-related protein Grp78， C/EBP homologous protein （CHOP）， activating transcription factor 6 （ATF6） and inositol requiring enzyme 1α （IRE1α） and the level of protein kinase R-like endoplasmic reticulum kinase robertluoyi@126.com （PERK） in liver tissue were detected. RESULTS Compared with blank group， serum levels of ALT， AST， TBI， IL-6， TNF-α and IL-1β and positive expressions of NF-κB and Grp78 in liver tissue as well as protein expressions of Grp78， CHOP， ATF6 and IRE1α， PERK protein phosphorylation level were all increased significantly in model group （P＜0.05）， while the serum level of TP was decreased significantly （P＜0.05）. The disordered structure of liver lobule， swollen liver cells， unclear intercellular boundary were observed and accompanied by inflammatory cell infiltration. Compared with model group， most of the above indexes were significantly reversed in caudatin groups （P＜0.05）； the structure of hepatic lobule was relatively complete and clear， the cells were arranged orderly， and the infiltration of inflammatory cells was also reduced. CONCLUSIONS Caudatin has a significant improvement effect against DEN-induced liver injury in rats， the mechanism of which may be associated with inhibiting endoplasmic reticulum stress and inflammatory reaction.

Objective To explore the relationship between non-high density lipoprotein cholesterol(non-HDL-C)level and leptomeningeal collateral circulation in patients with acute middle cerebral artery occlusion.Methods A total of 85 patients with first-onset acute cerebral infarction with middle cerebral artery M1 segment occlusion were enrolled.According to the results of DSA,LMC circulation was assessed by American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology Collateral Circulation Assess-ment System.All patients were assigned to better LMC circulation group(score 2～4,n = 30)and worse LMC circulation group(score 0～1,n = 55),and the levels of non-HDL-C were compared between the two groups.Results The levels of LDL-C and non-HDL-C in worse LMC circulation group were significantly higher than those of the better LMC circulation group(P = 0.026,P = 0.010).non-HDL-C was an independent risk factor for the worse LMC circulation(OR = 3.019,95%CI:1.053～8.658,P = 0.04).LMC circulatory score of patients was negatively correlated with the levels of non-HDL-C level(r =-0.228,P = 0.036).The AUC of non-HDL-C predicted for the worse LMC circulation was 0.638(95%CI:0.521～0.755,P = 0.036).Conclusions non-HDL-C in patients with acute cerebral infarction was significantly related to worse LMC circulation,and was a risk factor for worse LMC circulation.It is suggested that the higher expression of non-HDL-C could be used to predict worse LMC circulation as a serological indicator.

Objective: To understand the current situation of breakfast consumption and its influencing factors in primary and middle school students in a poor rural area in a city in Guizhou Province, and to provide scientific basis for child nutrition education and intervention. Methods: A stratified cluster sampling method was used to conduct a questionnaire survey of breakfast behavior and influencing factors among 2 833 students from 3 primary schools and 3 middle schools in a area of Guizhou Province from April to June 2019. Results: The most frequently consumed breakfast was rice noodle products(71.66%), followed by fresh vegetables(45.89%), milk(35.55%), meat/egg/fish(29.33%), beans(19.52%), and fresh fruits(18.74%). The proportion of having breakfast everyday among elementary and middle school students who was 62.97%, and having breakfast 4-6 days peer week was 22.80%, and 14.23% with ≤3 days peer week, and the proportion of boys who ate breakfast every day(65.07%) was higher than girls(61.00%)(χ2=10.01, P<0.05). The proportion of low quality breakfast was 71.87%, and girls(73.68%) were higher than boys(69.94%)(χ2=9.29, P<0.05). Logistic regression analysis showed that grade of school, boarding school, and sleep quality are all influencing factors for whether to eat breakfast every day; grade of school, whether to stay at school were factors that affect breakfast quality(P<0.05). Conclusion The frequency and quality of breakfast need more improvement among middle and primary school students in a poor rural area of a city in Guizhou Province. Students, parents, and teachers should be educated on nutrition to promote healthy eating and sleeping habits and improve student health.

SOCS3, a feedback inhibitor of the JAK/STAT signal pathway, negatively regulates axonal regrowth and inflammation in the central nervous system (CNS). Here, we demonstrated a distinct role of SOCS3 in the injured spinal cord of the gecko following tail amputation. Severing the gecko spinal cord did not evoke an inflammatory cascade except for an injury-stimulated elevation of the granulocyte/macrophage colony-stimulating factor (GM-CSF) and interferon gamma (IFN-γ) cytokines. Simultaneously, the expression of SOCS3 was upregulated in microglia, and unexpectedly not in neurons. Enforced expression of SOCS3 was sufficient to suppress the GM-CSF/IFN-γ-driven inflammatory responses through its KIR domain by attenuating the activities of JAK1 and JAK2. SOCS3 was also linked to GM-CSF/IFN-γ-induced cross-tolerance. Transfection of adenovirus overexpressing SOCS3 in the injured cord resulted in a significant decrease of inflammatory cytokines. These results reveal a distinct role of SOCS3 in the regenerating spinal cord, and provide new hints for CNS repair in mammals.

Objective:To evaluate the mechanism of α7 nicotinic acetylcholine receptor (α7nAChR) agonist-induced protection of the intestine in rats undergoing cardiopulmonary bypass (CPB) and the relationship with the activity of enteric glial cells (EGCs).Methods:Seventy-two clean-grade adult male Sprague-Dawley rats, aged 400-500 g, were divided into 3 groups ( n=24 each) using a random number table method: sham operation group (group S), CPB group (group C) and α7nAChR agonist PHA568487 plus CPB group (group P). In group P, PHA568487 0.8 mg/kg was intraperitoneally injected, and 30 min later CPB model was established.At the beginning of CPB (T 0), at 1 h of CPB (T 1), and at 2 and 6 h after termination of CPB (T 2, 3), the rats were sacrificed, and intestinal tissues were obtained for examination of the pathological changes and for determination of the expression of ZO-1, occludin, glial fibrillary acidic protein (GFAP), and calcium-binding protein (S-100β protein) by Western blot.The immunohistochemical method was used to observe the positive expression of GFAP at T 2. Results:Compared with group S, the expression of GFAP and S-100β protein was significantly up-regulated, and the expression of ZO-1 and occludin was down-regulated at T 1-3( P<0.05), the positive expression of GFAP was increased, and the intestinal tissue injury was accentuated in C and P groups.Compared with group C, the expression of GFAP, ZO-1 and occludin was significantly up-regulated, and the expression of S-100β protein was down-regulated at T 1-3( P<0.05), the positive expression of GFAP was increased, and the intestinal tissue injury was reduced in group P. Conclusion:The mechanism by which α7nAChR agonist attenuates intestinal injury may be related to activating EGCs and improving intestinal barrier function in rats undergoing CPB.

Objective:To explore the expressions of estrogen receptor α (ERα) and estrogen receptor β (ERβ) in Chinese female esophageal squamous cell carcinoma (ESCC) and their relationship with clinical pathological characteristics, marriage and childbearing factors and their prognostic impact.Methods:A total of 110 female patients with primary ESCC in Nanyang Center Hospital from January 2001 to December 2016 were selected. The expression levels of ERα and ERβ proteins were examined by immunohistochemistry (IHC). Logistic regression was used to analyze the correlations of ERα and ERβ expressions with marriage and childbearing factors (menstrual status, age of menarche, age of first birth and the number of pregnancy) and clinical pathological parameters (tumor location, tumor invasion depth, lymph node metastasis and tumor stage). Kaplan-Meier method was used for survival analysis and log-rank test was used. Cox proportional hazard model was used for survival multivariate analysis.Results:The expression rates of ERα and ERβ proteins were 37.3% (41/110) and 64.5% (71/110) in tissues of female ESCC patients, respectively. ERβ expression was closely correlated with tumor location ( χ2 = 0.999, P = 0.030), tumor stage ( χ2 = 11.097, P < 0.01) and the number of pregnancy ( χ2 = 6.304, P = 0.012). The number of pregnancy ( HR = 2.553, 95% CI 1.051-6.203, P = 0.039) and ERβ expression ( HR = 2.580, 95% CI 1.966-3.386, P < 0.01) were independent protective factors for the survival of patients. Furthermore, ERα expression ( HR = 0.530, 95% CI 0.384-0.739, P < 0.01) and lymph node metastasis ( HR = 0.663, 95% CI 0.512-0.858, P = 0.002) were independent risk factors for survival. Conclusion:ERα and ERβ expressions can predict the prognosis of female ESCC patients.