BackgroundPatients undergoing colorectal cancer surgery are at risk of postoperative nutritional deterioration due to perioperative metabolic stress, inflammation, and transient gastrointestinal dysfunction. Evidence-based, nursing-led nutritional pathways may improve perioperative nutritional surveillance and timely nutrition support.MethodsThis retrospective study included 214 adults who underwent elective curative-intent colorectal cancer resection between January 2023 and December 2024. Patients receiving routine perioperative nursing care in 2023 were assigned to the control group (n = 106), whereas those receiving the nutrition-focused evidence-based nursing protocol in 2024 were assigned to the observation group (n = 108). The primary outcomes were change in Nutritional Risk Screening 2002 (NRS-2002) score and postoperative nutritional risk, defined as NRS-2002 ≥ 3 at postoperative day 7 or immediately before discharge.ResultsBaseline characteristics were comparable between groups. The observation group had lower postoperative NRS-2002 scores and smaller ΔNRS-2002 than the control group (both P < 0.001). Postoperative nutritional risk was also lower in the observation group (44.4% vs. 67.0%, P = 0.001). After multivariable adjustment, the observation group remained associated with lower odds of postoperative nutritional risk (adjusted odds ratio = 0.17, 95% confidence interval: 0.08–0.36; P < 0.001). Secondary findings showed less weight loss, smaller declines in albumin and prealbumin, lower discharge C-reactive protein, earlier feeding recovery, shorter postoperative hospital stay, fewer overall complications, and fewer nutrition-support–related safety events.ConclusionsA nutrition-focused evidence-based nursing protocol was associated with more favorable postoperative nutritional risk status assessed by NRS-2002, as well as selected short-term recovery- and safety-related outcomes after colorectal cancer surgery. These findings should be interpreted as associative and require confirmation in prospective studies.

Anastomotic stricture (AS) is a common complication following low-level anastomosis of the colon and rectum in rectal cancer (RC) surgery. The aim of this study is to evaluate whether intraoperative stay sutures combined with postoperative anal dilatation reduce the incidence of AS after low anterior resection with defunctioning stoma. A total of 240 patients with low RC who underwent treatment at the Ninth Medical Center of the PLA General Hospital between February 2019 and May 2024 were randomly assigned to four groups (n = 60 each): one experimental group and three control groups (A, B, and C). The experimental group underwent intraoperative placement of stay sutures at the anastomotic site under anoscopic guidance during low anterior resection with defunctioning stoma, with 3 to 4 radial transanastomotic sutures placed across the anastomotic line. Postoperative anal dilatation was initiated two weeks after surgery. Control group A received only intraoperative stay sutures; control group B received only postoperative anal dilatation; control group C received neither intervention. The incidence of AS was evaluated 1 to 2 months postoperatively, with follow-up continuing from 2 months to 1 year. The incidence of AS was 0

Hepatic macrophages are a complex population of cells that play an important role in the normal functioning of the liver and in liver diseases. Autophagy, as a maintainer of cellular homeostasis, is closely connected to many liver diseases. And its roles are not always beneficial, but manifesting as a double-edged sword. The polarization of macrophages and the activation of inflammasomes are mediated by intracellular and extracellular signals, respectively, and are important ways for macrophages to take part in a variety of liver diseases. More attention should be paid to autophagy of hepatic macrophages in liver diseases. In this review, we focus on the regulatory role of hepatic macrophages' autophagy in a variety of liver diseases; especially on the upstream regulator of polarization and inflammasomes activation of the hepatic macrophages. We believe that the autophagy of hepatic macrophages can become a potential therapeutic target for management of liver diseases.

Exposure to microgravity can adversely affect the fitness of astronauts. The integrity of the skin plays a crucial role in protecting against mechanical forces and infections, fluid imbalance, and thermal dysregulation. In brief, the skin wound may cause unknown challenges to the implementation of space missions. Wound healing is a physiological process that relies on the synergistic action of inflammatory cells, extracellular matrix (ECM), and various growth factors to maintain the integrity of skin after trauma. Fibroblasts are present almost throughout the entire process of wound repair, especially in the scar formation at the endpoint of wound healing. However, there is limited knowledge about the extent to which fibroblasts are affected by the lack of gravity during wound healing. In this study, we utilized the rotary cell culture system, a ground‐based facility that mimics the weightless condition, to study the alterations of L929 fibroblast cells under simulated microgravity (SMG). Our results demonstrated that the SM condition exerted negative influences on the proliferation and ECM formation of the L929 fibroblast. Whereas, the apoptosis of fibroblast was significantly upregulated upon exposure to SMG conditions. Moreover, the transforming growth factor‐β1/Smad3 (TGF‐β1/smad3) signaling pathway of L929 fibroblast related to wound repair was also altered significantly under a weightless environment. Overall, our study provided evidence that fibroblasts are strongly sensitive to SMG and elucidated the potential value of the TGF‐β1/Smad3 signaling pathway modulating wound healing in the future practice of space medicine.

Microgravity is an ecological factor that affects the environment of the body. In this study, quantitative isobaric labeling (tandem mass tag) method was used to study the changes in human gastric mucosal cells under simulated microgravity for the first time. Comparative proteomic analysis identified 394 (202 upregulated and 192 downregulated) and 542 (286 upregulated and 256 downregulated) proteins differentially regulated by simulated microgravity after 3 and 7 days, respectively. Then the identified proteins were subjected to Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses for further exploration. The results of the analysis showed that the ribosomes of gastric mucosal cells were significantly impacted after exposure to simulated microgravity for 3 days, and the cells appeared to be in a state of stress and inflammation. Exposure to simulated microgravity for 7 days significantly affected the mitochondria of the cells, oxidative stress became more evident, while inflammation and weakened connections were observed in the cells. The results of this study highlighted the temporal response trend of gastric mucosal cells to the stressor of microgravity at the two time points of 3 and 7 days. These findings will provide insights into the development of methods to protect the gastric mucosa during space flight.

Background: Intussusception is a rare clinical condition in adults. The majority of patients present with symptoms of bowel obstruction. Intussusception is often misdiagnosed and the majority of cases are diagnosed intraoperatively. In this paper, we present a rare case of adult jejunojejunal intussusception with chronic bleeding caused by a gastrointestinal stromal tumor (GIST). We emphasize the role of contrast enhanced computed tomography (CT) and enteroscopy in the presurgical diagnosis and the good prognosis in the high-risk GIST patient after surgery and targeted therapy. Case Description: Herein, we present the case of a 63-year-old female patient with small bowel intussusception with chronic bleeding caused by a GIST. Her main symptoms were intermittent melena and progressive anemia. She had a 20-year history of hypertension and had never undergone previous abdominal surgery. After failure of an esophagogastroduodenoscopy and colonoscopy to locate the hemorrhagic foci in the gastrointestinal tract, contrast-enhanced CT and enteroscopy were used and a small bowel intussusception and an intraluminal mass with a bleeding ulcer was identified. The patient underwent laparoscopic partial small bowel resection, and postoperative pathological examinations showed a small intestinal GIST with a high risk of recurrence. It was suggested that the patient take imatinib regularly for at least 3 years. At the time of writing, she has remained in good health without relapse for 24 months after discharge. We also review 20 published cases of intussusception caused by small bowel GIST in the PubMed database. Conclusions: Obscure gastrointestinal hemorrhage needs meticulous examinations to promptly determine the cause and location of bleeding. This case and literature review revealed that comprehensive surgical resection-centered treatment was the standard treatment for primary localized GISTs in patients at significant risk of relapse.

胰腺癌作为一种消化系统高度恶性的肿瘤性疾病,其发生和进展的分子机制仍不确定.为寻找与胰腺癌发生和进展有关的新的有效治疗靶点和潜在的生物标志物.利用GEO数据库中的GEO2R在线工具对胰腺癌组织和正常对照组织的基因表达进行差异分析并对差异表达基因(DEGs)进行GO功能和KEGG通路富集分析.然后通过GEPIA数据库中胰腺癌的转录数据对候选基因的表达进行验证.Kaplan?Meier法分析各候选基因的预后价值.利用starBase数据库中的7个预测程序对候选基因上游潜在的miRNAs进行预测.此外,还使用miRNet和starBase预测了hsa?miR?20b?5p的上游lncRNAs并利用lncATLAS数据库对潜在的lncRNAs进行亚细胞定位.在本研究中,我们发现胰腺癌组织中LAMA3基因的转录水平明显高于健康对照组织.同时,LAMA3的过表达与胰腺癌患者较差的临床预后相关.随后,预测了21个可能靶向LAMA3的潜在上游miRNAs.在预测到的miRNA?mRNA调控轴中,has?miR?20b?5p?LAMA3轴在胰腺癌的发生和进展中具有较高的潜力.进一步研究发现,FGD5?AS1潜在的抑制has?miR?20b?5p?LAMA3调控轴的作用可能能够在胰腺癌中作为诊断和治疗的有效靶点.FGD5?AS1?has?miR?20b?5p?LAMA3调控网络在胰腺癌发生和发展中的具有关键作用,可作为胰腺癌临床诊断和治疗的潜在靶点和生物标志物.

Torsion of an epiploic appendage may result in epiploic appendagitis, which is a rare cause of acute abdominal pain. However, no previous reports have described an asymptomatic twisted epiploic appendage found during laparoscopic surgery to the best of our knowledge. This case describes a 66-year-old man who was admitted to our medical center with yellowness of the skin and eyes that had lasted over two months. Physical examination showed slight yellow staining of the skin and sdera. Blood analysis indicated liver dysfunction and jaundice. Routine blood, C-reactive protein (CRP), and levels of tumor markers were normal. The contrast-enhanced abdominal and pelvic computed tomography, magnetic resonance imaging, and magnetic resonance cholangiopancreatography revealed gallbladder atrophy and choledocholithiasis. The patient underwent laparoscopic surgery for the removal of the choledocholithiasis. The laparoscopic exploration unexpectedly revealed a twisted and ischemic epiploic appendage, which was surgically removed. The postoperative pathological examination uncovered necrosis of adipocytes and vascular obstruction, but there was no inflammation of the epiploic appendage. The patient had a satisfactory recovery during the 16-month follow-up period. This case describes and provides a feasible management approach for an asymptomatic twisted epiploic appendage discovered during surgery and highlights its pathological characteristics, reflecting the early stage of epiploic appendagitis.

The composition and function of intestinal microbial communities are important for human health. However, these intestinal floras are sensitive to changes in the environment. Adverse changes to intestinal flora can affect the health of astronauts, resulting in difficulties in implementing space missions. We randomly divided mice into three groups and placed each group in either a normal environment, simulated microgravity environment or a combined effects environment, which included simulated microgravity, low pressure and noise. Fecal samples of the mice were collected for follow-up analysis based on metagenomics technology. With the influence of different space environmental factors, the species composition at the phylum and genus levels were significantly affected by the combined effects environment, especially the abundance of the Firmicutes and Bacteroidetes . Furthermore, screening was conducted to identify biomarkers that could be regarded as environmental markers. And there have also been some noticeable changes in the function of intestinal floras. Moreover, the abundance of antibiotic resistance genes (ARGs) was also found to be changed under different environmental conditions, such as bacitracin and vancomycin. The combined effects environment could significantly affect the species composition, function, and the expression of ARGs of intestinal flora of mice which may provide a theoretical basis for space medical supervision and healthcare.

门静脉海绵样变性（cavernous transformation of portal vein,CTPV）是指门静脉主干或其分支受阻后,机体为维持肝脏血流灌注,在肝门区代偿性形成的大量海绵样侧支血管丛.该病较罕见,临床实践中缺乏对其病因及诊疗原则的认识.对于出现门静脉高压相关症状的患者需要采取积极治疗措施.治疗的主要目的是防治门静脉高压引起的上消化道出血和脾功能亢进,以及恢复肝脏门静脉血流灌注.需要在充分了解患者病情及每种治疗方式最佳适应症的基础上,采用个体化综合治疗策略.本文就CTPV的病因、诊断、分型、治疗方面的最新进展作一综述.

Objective:To investigate the relationship between body weight and surgical outcome in patients undergoing radical resection of colorectal cancer.Methods:From January 2010 to October 2014, clinical data of 246 patients who underwent radical resection of colorectal cancer were analyzed retrospectively. All enrolled patients received radical resection of colorectal cancer and were followed up for 5 years until November 2019. According to body mass index (BMI), the patients were divided into normal group, super recombination group and obesity group, 96 cases, 80 cases and 70 cases respectively. Statistical analysis were performed by using SPSS 22.0 software. Kaplan-Meier survival analysis method was used for the 5-year disease-free survival rate (DFS) of patients. BMI and clinically relevant data were analyzed by using Cox regression.Results:The 5-year DFS was 78.13% (75/96), 62.05% (50/80) and 55.71% (39/70) in the normal group, the super recombination group and the obese group respectively. Cox regression analysis showed that high BMI, positive preoperative CEA, low differentiation, high pT staging and high pN staging were risk factors for prognosis of colorectal cancer patients after radical resection (P<0.05), and postoperative chemoradiotherapy was a protective factor for prognosis (P<0.05).Conclusion:Obesity is a major risk factor of poor prognosis in patients with colorectal cancer.

门静脉高压性胆病(PHB)是一种由肝外门静脉阻塞引起的胆道继发性改变,临床罕见;患者大多无明显自觉表现,少数病史较长者可出现腹痛、发热、黄疸等症状.目前对其治疗方案尚无统一意见,有症状的患者往往需要接受综合治疗.该文报告了1例门静脉海绵样变(PVCT)发展为PHB的病例.患者辗转多家医院就诊,因PVCT不宜手术,多次内镜下胆管支架植入及更换,症状反复,最终行腹腔镜下胆囊切除、小切口辅助胆总管切开取石、胆肠Roux-en-Y吻合术,术后黄疸、腹胀、发热等症状得到有效缓解.

Astronauts suffer from inflammatory changes induced by microgravity during space flight. Microgravity can significantly affect the inflammatory response of various cell types and multiple systems of the human body, such as cardiovascular system, skeletal muscle system, and digestive system. The aim of this research was to identify the key genes and pathways of gastric mucosa affected by microgravity. Human gastric mucosal epithelial GES-1 cells were cultured in a rotary cell culture system (RCCS) bioreactor to simulate microgravity. The gene expression profiles of GES-1 cells were obtained using Illumina sequencing platform and differentially expressed genes were identified by DESeq2 software, then Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed. Subsequently, a protein-protein interaction (PPI) network was constructed. Compared with a normal gravity (NG) group, a total of 943 DEGs, including 192 downregulated genes and 751 upregulated genes, were identified. These DEGs were associated with findings that included response to interleukin-1, positive regulation of inflammatory response, and positive regulation of neuroinflammatory response. Furthermore, these DEGs were mainly enriched in herpes simplex virus 1 infection, cytokine-cytokine receptor interaction, and NOD-like receptor signaling pathway. Thus, 21 hub genes were identified from PPI network, including IL6, IL1B, ITGAM, CXCL8, ITGAX, CCL5, SERPINA1, APOE, CSF1R, VWF, GBP1, APOB, CYBB, HLA-DRB1, CD68, FGG, FGA, OASL, NOD2, OAS2 and FCGR2A. These findings suggested that simulated microgravity upregulated inflammation-related genes and pathways of GES-1 cells, which may play important roles in the response to microgravity and provide useful information for preventing mucosal damage in astronauts. In conclusion, this study revealed the key genes and pathways associated with simulated microgravity and indicated that simulated microgravity induced an inflammatory response in gastric mucosal epithelial cells.

哺乳动物的表皮中存在多种不同类型的表皮干细胞(epidermal stem cells,EpSCs),EpSCs拥有自我更新和分化的潜能,在维持表皮组织结构稳定和皮肤创伤愈合及皮肤疾病发生、发展过程中发挥重要作用.本文就EpSCs的特性、信号调节、在创伤愈合过程和抗衰老中的作用以及与皮肤癌的关系做一综述.

Objective: Investigate how miR-7 inhibits epithelial mesenchymal transition (EMT) and the invasion and metastasis of gastric cancer cells by regulating the expression of IGF1R. Methods: Gastric adenocarcinoma cell line gc9811-p was selected to construct four cell models: overexpression of miR-7, overexpression of control, inhibition of miR-7 and inhibition of control. The migration and invasion abilities of each group were observed via Transwell cell migration tests. The expressions of E-cadherin, I3-catenin, vimentin and IGF1R were detected. The expression of snail, slug, ZEB1 and ZEB2 genes were detected via real-time quantitative PCR. Results: The migration ability of gastric cancer cells in the miR-7 overexpression group was significantly lower than that measured in the overexpression control group, and the migration ability of gastric cancer cells in the inhibition group was significantly higher than that measured in the control group (P<0.05). The invasion ability of gastric cancer cells in the miR-7 overexpression group was significantly lower than that measured in the overexpression control group, and the invasion ability of gastric cancer cells in the inhibition of miR-7 group was significantly higher than that measured in the control group (P<0.05). The contact between gc9811-p cells in the miR-7 overexpression group was closer than that measured in the overexpression control group. The expression levels of E-cadherin and I3-catenin in the overexpression group were significantly higher than those measured in the overexpression control group, and the vimentin expression level was significantly lower than that measured in the overexpression control group. The expression levels of E-cadherin and I3-catenin in the inhibition group were significantly lower than those in the overexpression control group, and the vimentin expression level was significantly higher than that measured in the overexpression control group (P<0.05). A Western blot analysis showed that miR-7 could inhibit the overexpression of wild-type IGF1R in gc9811 cells, but could not inhibit the expression of mutant IGF1R. The expression of the snail gene in the miR-7 overexpression group was significantly lower than that measured in the overexpression control group (P<0.05). Conclusion: The overexpression of miR-7 can inhibit the migration and invasion of gastric cancer cells and inhibit the EMT process of gastric cancer cells by regulating EMT related markers such as E-cadherin, I3-catenin and vimentin. The mechanism may be related to the regulation of IGF1R expression by miR-7.

Microgravity is a component of the complex environment in space. Due to its adverse effects on the human body, it poses unknown obstacles to the implementation of space missions. In microgravity, the body often loses the point of force and it is difficult to control itself, which leads to various accidental collisions. As the largest organ of the human body, the skin is often damaged by traumatic injury because of its large contact area with the external environment. In this study, we summarized and discussed the latest research on the impact of weightlessness or simulated microgravity on the skin and the process of wound healing to further understand the changes and mechanisms of wound healing. A series of studies have investigated the effects of weightlessness or simulated microgravity on the human skin and the wound healing process. Under microgravity environment, the skin showed certain changes, such as thinning and altered blood supply; microgravity also affected various cellular functions and their associations with the extracellular matrix during wound healing. Various stages of wound healing and sophisticated interactions between the elements involved in wound healing become disordered in a microgravity environment. However, more studies are needed to further understand the impact and mechanisms of microgravity on the trauma repair process to provide theoretical guidance for wound healing. With the support and help of a lot of good researches and trails, accidental trauma will no longer be an obstacle to human exploration of space.

The incidence of stomach diseases is very high, which has a significant impact on human health. Damaged gastric mucosa is more vulnerable to injury, leading to bleeding and perforation, which eventually aggravates the primary disease. Therefore, the protection of gastric mucosa is crucial. However, existing drugs that protect gastric mucosa can cause nonnegligible side effects, such as hepatic inflammation, nephritis, hypoacidity, impotence, osteoporotic bone fracture, and hypergastrinemia. Autophagy, as a major intracellular lysosome-dependent degradation process, plays a key role in maintaining intracellular homeostasis and resisting environmental pressure, which may be a potential therapeutic target for protecting gastric mucosa. Recent studies have demonstrated that autophagy played a dual role when gastric mucosa exposed to biological and chemical factors. More indepth studies are needed on the protective effect of autophagy in gastric mucosa. In this review, we focus on the mechanisms and the dual role of various biological and chemical factors regulating autophagy, such as Helicobacter pylori, virus, and nonsteroidal anti-inflammatory drugs. And we summarize the pathophysiological properties and pharmacological strategies for the protection of gastric mucosa through autophagy.

To investigate the clinical efficacy of laparoscopic-assisted and laparotomy D2 radical total gastrectomy for advanced gastric cancer. From January 2014 to January 2015, 81 patients with advanced gastric cancer were divided into study group A (n=41) for laparoscopic-assisted therapy and study group B (n=40) for laparotomy D2 radical total gastrectomy according to different surgical methods. Postoperative followup was 60 mo. Perioperative period indicators, curative effect and complications were recorded and compared between the two groups. The operation time of study group A was significantly longer than that of study group B. The hospital stay, intraoperative blood loss, incision length and intestinal function recovery of study group A were significantly less than that of study group B and the difference had statistical significance (p<0.05). Compared with study group B, the number of lymph node dissection, the number of positive lymph nodes and the average survival time in study group A were less and the rate of lymph node metastasis, the distance from distal resection margin and the distance from proximal resection margin were large, but the difference had no statistical significance (p>0.05). The difference of complications and recurrence rate between study group A and study group B had no statistical significance (p>0.05). Laparoscopic-assisted treatment for advanced gastric cancer is less invasive, has a shorter recovery time and the outcome and survival time of lymphadenectomy is comparable to those of laparotomy.

BackgroundWeightlessness is a component of the complex space environment. It exerts adverse effects on the human body, and may pose unknown challenges to the implementation of space missions. The regular function of the digestive system is an important checkpoint for astronauts to conduct missions. Simulated microgravity can recreate the changes experienced by the human body in a weightless environment in space to a certain extent, providing technical support for the exploration of its mechanism and a practical method for other scientific research.Methods and materialsIn the present study, we reviewed and discussed the latest research on the effects of weightlessness or simulated microgravity on the digestive system, as well as the current challenges and future expectations for progress in medical science and further space exploration.ResultsA series of studies have investigated the effects of weightlessness on the human digestive system. On one hand, weightlessness and the changing space environment may exert certain adverse effects on the human body. Studies based on cells or animals have demonstrated the complex effects on the human digestive system in response to weightlessness. On the other hand, a microgravity environment also facilitates the ideation of novel concepts for research in the domain of life science.ConclusionThe effects of weightlessness on the digestive system are considerably complicated. The emergence of methods that help simulate a weightless environment provides a more convenient alternative for assessing the impact and the mechanism underlying the effect of weightlessness on the human body. In addition, the simulated microgravity environment facilitates the ideation of novel concepts for application in regenerative medicine and other fields of life science.

Simulated microgravity can significantly affect various cell types and multiple systems of the human body, such as cardiovascular system, skeletal muscle system, and immune system, and is known to cause anemia and loss of electrolyte and fluids. Epidermal stem cells (EpSCs) were cultured in a rotary cell culture system (RCCS) bioreactor to simulate microgravity. The metabolites of EpSCs were identified by liquid chromatography-mass spectrometry (LC-MS). Compared with normal gravity (NG) group, a total of 57 different metabolites of EpSCs were identified ( P < 0.05, VIP > 1), including lipids and lipid-like molecules (51 molecules), amino acids (5 molecules), nucleosides, nucleotides, and analogues (1 molecule). According to the partial least squares discriminant analysis (PLS-DA) score plot, a VIP > 1 and P < 0.05 were obtained for the 57 different metabolites, of which 23 molecules were significantly downregulated and 34 were significantly upregulated in simulated microgravity (SMG) group. These results showed that SMG has a significant impact on different pathways, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis indicated that multiple pathways were involved, mainly the amino acid metabolism pathway, lipid metabolism pathway, membrane transport pathway, and cell growth and death pathways. Thus, the metabolic profile of EpSCs was changed under SMG. Exploring the metabolic profile of EpSCs would be helpful to further understand the growth characteristics of EpSCs under SMG, which will provide a new approach to explore the metabolomics mechanism of stress injury and repair trauma under SMG.