Laparoscopic repair of gastroduodenal perforation has been widely used in clinical practice. With the advent of barbed sutures, the position of traditional absorbable sutures has been challenged, but the superiority of one over the other in terms of clinical outcomes remains unclear. To evaluate the efficacy and safety of laparoscopic barbed sutures in the repair of gastroduodenal perforations through a meta-analysis. A systematic review, including randomized controlled trials (RCTs) and case‒control studies, was conducted following PRISMA guidelines. From the PubMed, Web of Science, Embase, Cochrane, CNKI, CDDB, and CSTJ databases up to August 23, 2024, relevant studies comparing laparoscopic barbed sutures to conventional sutures were identified. The primary outcomes were suturing time and operative duration, whereas the secondary outcomes included hospital stay and postoperative complications. Sensitivity analysis was conducted to evaluate the robustness of the findings, and publication bias was examined via Egger’s test complemented by the trim-and-fill method. The study was registered on the platform Prospero with the ID CRD42024591576. Five studies with 436 patients were included. Barbed sutures significantly reduced the operative time [standard mean difference (SMD: -0.89; 95

As the volume of medical literature accelerates, necessitating efficient tools to synthesize evidence for clinical practice and research, the interest in leveraging large language models (LLMs) for generating clinical reviews has surged. However, there are significant concerns regarding the reliability associated with integrating LLMs into the clinical review process. This study presents a systematic comparison between LLM-generated and human-authored clinical reviews, revealing that while AI can quickly produce reviews, it often has fewer references, less comprehensive insights, and lower logical consistency while exhibiting lower authenticity and accuracy in their citations. Additionally, a higher proportion of its references are from lower-tier journals. Moreover, the study uncovers a concerning inefficiency in current detection systems for identifying AI-generated content, suggesting a need for more advanced checking systems and a stronger ethical framework to ensure academic transparency. Addressing these challenges is vital for the responsible integration of LLMs into clinical research.

The incidence of obesity is increasing annually worldwide. A high-fat diet (HFD) causes intestinal barrier damage, but effective interventions are currently unavailable. Our previous work demonstrated the therapeutic effect of nobiletin on obese mice; thus, we hypothesized that nobiletin could reverse HFD-induced damage to the intestinal barrier. Male C57BL/6 J mice were orally administered nobiletin for 14 d. After identification, the obese mice were equally divided into three groups: the HFD group, the low-dose (NOL, 100 mg/kg/d) group and the high-dose nobiletin (NOH, 200 mg/kg/d) group. A normal control group (CON) was also included. Hematoxylin and eosin (HE) staining and immunofluorescence were used to observe the intestinal barrier. RT-qPCR was used to determine the transcriptomic levels of genes involved in intestinal barrier integrity and lipid metabolism. The results revealed that intestinal tight proteins, including ZO-1 and Occludin, were significantly reduced in HFD-fed mice but markedly restored after nobiletin intervention, particularly in NOH mice. Improvements in the intestinal barrier and lipid metabolism associated with major histocompatibility complex class II (MHC-II) and relevant elements were revealed after nobiletin intervention. Enrichment analysis revealed that MHC-II plays an important role in the restoration of the intestinal barrier. Taken together, nobiletin restored intestinal barrier integrity and lipid metabolism by regulating MHC-II expression.

Background:A diet low in whole grains may be a significant risk factor for colorectal cancer (CRC). Therefore, analyzing the latest global burden of disease (GBD) data to understand the burden of CRC attributable to low whole-grain diets is crucial for informing public health policies aimed at reducing CRC-related burdens. Methods:This study utilized data from the GBD 2021 to analyze global trends in mortality and disability-adjusted life years (DALYs) attributable to low whole-grain diets from 1990-2021. A Bayesian age-period-cohort (BAPC) model was employed to project the future burden of CRC attributable to low whole-grain diets up to 2050. Results:In 2021, the global number of deaths attributable to low whole-grain diets was 186,256.80, representing an 82.94% increase from 1990. The number of global DALYs attributable to low whole-grain diets in 2021 was 4,327,218.86, a 70.30% increase from 1990. The burden of CRC in males attributable to low whole-grain diets was greater than that in females aged 50-74 years. Nationally, Monaco recorded the highest mortality rate (13.23/100,000), China had peak deaths/DALYs. Projections to 2050, the global number of deaths attributable to low whole-grain diets will continue to rise, reaching 199,565.06. Conclusions:Low whole-grain diets pose a significant threat to public health, contributing to an increasing burden of CRC. To reduce the burden of CRC attributable to low whole-grain diets, enhancing public education and awareness of whole-grain diets, implementing policies to promote the consumption of whole grains, and conducting early screening among high-risk populations are recommended.

Background:Colorectal cancer (CRC) is a major global and Chinese public health issue, and dietary factors are controllable risk factors. However, China's CRC epidemiological trends and diet-attributable analyses based on the latest global burden of disease (GBD) data remain incomplete. This study systematically assessed China's CRC disease burden (1990-2021) and temporal trends in diet-related risk factors via GBD 2021 data to inform precision prevention. Methods:GBD 2021 data were used to analyze age/sex differences in the incidence, prevalence, mortality, disability-adjusted life years (DALYs) and diet-related risk factors for CRC. Temporal trends in CRC burden were evaluated via joinpoint regression analysis. To enable comparisons across populations with differing age structures, we calculated age-standardized rates (ASRs) via the GBD world standard population. The estimated annual percentage change (EAPC) trends were assessed. Results:In 2021, China had 658321.36 new CRC cases (315.63% increase vs. 1990) and 275129.23 deaths (130.61% increase), with males showing greater burden increases. The 15-49-year-old had the fastest incidence growth (EAPC = 3.40%); those ≥75 years of age had the highest incidence (255.34/100000 people). Among the dietary risk factors, low milk intake caused the most deaths in 2021 (51030.32 cases), followed by low whole grain intake (49990.79 cases). From 1990 to 2021, processed meat-related deaths rose the most (274.71%), with higher proportions of young adults; low-calcium diet deaths significantly declined (EAPC = -0.48%). Females had the highest share of low-milk deaths, whereas males had the most low-whole-grain deaths. Conclusion:China's CRC burden is increasing overall, with increasing sex differences and coexisting youth and later life trends, driven by dietary shifts. Urgent promotion of increased milk and whole-grain intake, alongside reduced processed meat consumption, is needed, with tailored strategies for different populations.

BACKGROUND:The effective management of acute left-sided obstructive colon cancer (LSOCC) remains challenging. This meta-analysis compared the short-term and long-term outcomes between two prevalent treatment approaches: selective surgery following colonic stenting (CS) and colonic stenting combined with neoadjuvant chemotherapy (CS-NAC). METHODS:We conducted a comprehensive literature search of databases, including PubMed and Web of Science, covering the period from January 2000 to May 2025. Relevant studies comparing CS with CS-NAC were identified and analyzed. Both the short-term and long-term outcomes of the two treatment strategies were evaluated. The meta-analysis calculated pooled odds ratios (ORs), mean differences (MDs), and 95% confidence intervals (95% CIs). This study is registered with PROSPERO (registration number: CRD42024580176). RESULTS:Seven studies were included in the meta-analysis. Compared with the CS strategy, the CS-NAC strategy demonstrated significantly better short-term outcomes, including higher rates of laparoscopic surgery, lower intraoperative stoma rates, fewer overall postoperative adverse events, shorter operative times, and shorter postoperative hospital stays. However, no significant differences were observed between the two strategies in terms of stent-related complications or specific short-term adverse events, including postoperative incision infection rates, anastomotic leakage rates, and pulmonary infection rates. Furthermore, compared with the CS strategy, the CS-NAC strategy significantly improved both 3-year disease-free survival and overall survival. CONCLUSION:Compared with CS alone, the CS-NAC treatment strategy improves laparoscopic surgery rates and 3-year survival outcomes without increasing the risk of certain postoperative adverse events.

This study investigated the potential causal relationship between chronic obstructive pulmonary disease (COPD) and diabetes mellitus in European and East Asian populations using Mendelian randomization (MR) analysis. Single nucleotide polymorphisms associated with COPD, type 1 diabetes mellitus (T1DM), and type 2 diabetes mellitus (T2DM) were obtained from large-scale genome-wide association studies and used as instrumental variables. Three MR methods were applied: inverse variance weighting, MR-Egger regression, and the weighted median approach. Our analysis found a marginal causal association between genetically predicted T1DM and an increased risk of COPD in the European population (odds ratio = 1.9109, 95% confidence interval 1.0003–3.0016, P = .005). However, no significant causal relationship was observed between COPD and T2DM in either direction. Sensitivity analyses suggested no evidence of directional pleiotropy or heterogeneity, thus supporting the robustness of the findings. Nonetheless, the P -value for the simple mode method was above .05, indicating some uncertainty in the results. While a potential causal effect of T1DM on COPD in European populations, the weak statistical signals and marginal odds ratios warrant caution in interpreting these findings. Furthermore, no causal link between COPD and T2DM was observed. The study’s findings should be considered preliminary, and further research with larger, more diverse cohorts and additional mechanistic insights are necessary to validate and extend these results.

Objective: We explored the value of a standardized patient -based situational simulation teaching method in general surgery internships. Methods: A prospective, single-blind, randomized controlled trial was conducted with clinical medicine undergraduates from the 2020 cohort of our university as subjects. These students were randomly divided into a traditional teaching (TT) group and a combined teaching (CT) group based on their internship schedules. The TT group followed the conventional teaching model, while the CT group engaged in the standardized patient -based situational simulation teaching method. The study compared differences in preinternship theoretical scores, post -internship theoretical scores, medical record writing quality, and student satisfaction between the two groups. Results: The CT group (n=108) significantly outperformed the TT group (n=104) in post -internship theoretical scores and medical record writing quality (all P <0.05) and showed marked improvement in stimulating students' interest in learning ( P =0.015), enhancing clinical diagnostic and treatment abilities ( P <0.001), improving doctor -patient communication skills ( P <0.001), strengthening medical mission sense ( P <0.001), reinforcing physicians' sense of responsibility ( P <0.001), and facilitating the application of learned knowledge ( P <0.001). These differences were statistically significant. Conclusion: The standardized patient -based situational simulation teaching method (CT) in general surgery internships has been highly recognized by students and can enhance their clinical competency, offering considerable value for broader.

Abstract Background To explore whether nobiletin has a protective effect on high-fat diet (HFD)-induced enteric nerve injury and its underlying mechanism. Methods An obesity model was induced by a HFD. Nobiletin (100 mg/kg and 200 mg/kg) and vehicle were administered by gastric gavage for 4 weeks. Lee’s index, body weight, OGTT and intestinal propulsion assays were performed before sacrifice. After sampling, lipids were detected using Bodipy 493/503; lipid peroxidation was detected using MDA and SOD kits and the expression of PGP 9.5, Trem2, GFAP, β-tubulin 3, Bax, Bcl2, Nestin, P75 NTR, SOX10 and EDU was detected using immunofluorescence. The GDNF, p-AKT, AKT, p-FOXO3a, FOXO3a and P21 proteins were detected using western blotting. The relative mRNA expression levels of NOS2 were detected via qPCR. Primary enteric neural stem cells (ENSCs) were cultured. After ENSCs were treated with palmitic acid (PA) and nobiletin, CCK-8 and caspase-3/7 activity assays were performed to evaluate proliferation and apoptosis. Results HFD consumption caused colon lipid accumulation and peroxidation, induced enteric nerve damage and caused intestinal motor dysfunction. However, nobiletin reduced lipid accumulation and peroxidation in the colon; promoted Trem2, β-tubulin 3, Nestin, P75NTR, SOX10 and Bcl2 expression; inhibited Bax and GFAP expression; reduced NOS2 mRNA transcription; and regulated the GDNF/AKT/FOXO3a/P21 pathway. Nobiletin also promoted PA-induced impairment of ENSCs. Conclusions Nobiletin restored HFD-induced enteric nerve injury, which may be associated with inhibiting enteric nerve apoptosis, promoting enteric nerve survival and regulating the GDNF/AKT/FOXO3a/P21 pathway.

BackgroundMobile phone addiction (MPA) greatly affects the biological clock and sleep quality and is emerging as a behavioral disorder. The saliva microbiota has been linked to circadian rhythms, and our previous research revealed dysrhythmic saliva metabolites in MPA subjects with sleep disorders (MPASD). In addition, acupuncture had positive effects. However, the dysbiotic saliva microbiota in MPASD patients and the restorative effects of acupuncture are unclear.ObjectivesTo probe the circadian dysrhythmic characteristics of the saliva microbiota and acupunctural restoration in MPASD patients.MethodsMPASD patients and healthy volunteers were recruited by the Mobile Phone Addiction Tendency Scale (MPATS) and the Pittsburgh Sleep Quality Index (PSQI). Saliva samples were collected every 4 h for 72 h. After saliva sampling, six MPDSD subjects (group M) were acupuncturally treated (group T), and subsequent saliva sampling was conducted posttreatment. Finally, all the samples were subjected to 16S rRNA gene sequencing and bioinformatic analysis.ResultsSignificantly increased MPATS and PSQI scores were observed in MPDSD patients (p< 0.01), but these scores decreased (p<0.001) after acupuncture intervention. Compared with those in healthy controls, the diversity and structure of the saliva microbiota in MPASD patients were markedly disrupted. Six genera with circadian rhythms were detected in all groups, including Sulfurovum, Peptostreptococcus, Porphyromonas and Prevotella. There were five genera with circadian rhythmicity in healthy people, of which the rhythmicities of the genera Rothia and Lautropia disappeared in MPASD patients but effectively resumed after acupuncture intervention.ConclusionsThis work revealed dysrhythmic salivary microbes in MPASD patients, and acupuncture, as a potential intervention, could be effective in mitigating this ever-rising behavioral epidemic.

In recent years, the role of nobiletin in neuronal disorders has received extensive attention. However, the study of nobiletin in the peripheral nervous system is limited. Nobiletin, as a compound with high fat solubility, high bioavailability and low toxicity, has been extensively studied. Accumulating scientific evidence has shown that nobiletin has a variety of biological functions in the nervous system, such as inhibiting the expression of inflammatory factors, reducing the neurotoxic response, improving the antioxidant capacity, promoting the survival of nerve cells, promoting axon growth, reducing blood‒brain barrier permeability, reducing brain oedema, promoting cAMP response element binding protein expression, improving memory, and promoting mild depolarization of nerve cell mitochondria to improve antioxidative stress capacity. Accumulating studies have shown that nobiletin also protects enteric nervous system, spinal cord and sciatic nerve. To explore the new therapeutic potential of nobiletin in the nervous system, recent and relevant research progress is reviewed in this article. This will provide a new research idea for nobiletin in the nervous system.

ObjectiveTo explore lymph node (LN)-related derived indicators as clinical cure markers for gastric cancer (GC) after gastrectomy.MethodsData of resected GC patients were extracted from the SEER database and our own department. Propensity score matching (PSM) was used to balance the baseline differences between the clinical cure and the nonclinical cure groups. The area under the curve (AUC) and decision curve analysis (DCA) were used to choose the optimal marker, and survival analysis was used to validate the clinical value of the most effective marker.ResultsAfter PSM, the differences in age, sex, race, location, surgical type, and histologic type between the two groups were significantly reduced (all P > 0.05), and the AUCs of examined LNs (ELNs), negative LNs (NLNs), ESR (ELNs/tumor size), ETR (ELNs/T-stage), NSR (NLNs/tumor size), NTR (NLNs/T-stage), EPR (ELNs/PLNs) and NPR (NLNs/PLNs) were 0.522, 0.625, 0.622, 0.692, 0.706, 0.751, 7.43, and 7.50, respectively. When NTR was 5.9, the Youden index of 0.378 was the highest. The sensitivity and specificity were 67.5% and 70.3% in the training group and 66.79% and 67.8% in the validation group, respectively. DCA showed that NTR had the largest net clinical benefit, and patients with NTR greater than 5.9 had significantly prolonged overall survival in our own cohort.ConclusionNLNs, NTR, NSR, ESR, ETR, NPR and EPR can be used as clinical cure markers. However, NTR was the most effective, and the best cutoff value was 5.9.

Introduction:A systematic review analysis was used to assess the profile of mitochondrial involvement in adipose tissue regulation and potential reagents to intervene in obesity through the mitochondrial pathway.Methods:Three databases, PubMed, Web of Science, and Embase, were searched online for literature associated with mitochondria, obesity, white adipose tissue, and brown adipose tissue published from the time of their creation until June 22, 2022, and each paper was screened.Results:568 papers were identified, of which 134 papers met the initial selection criteria, 76 were selected after full-text review, and 6 were identified after additional searches. A full-text review of the included 82 papers was performed.Conclusion:Mitochondria play a key role in adipose tissue metabolism and energy homeostasis, including as potential therapeutic agents for obesity.

目的 探究血管内介入联合替罗非班治疗超溶栓时间窗急性脑梗死的临床效果.方法 前瞻性选择2019年1月至12月我院收治的超溶栓时间窗急性脑梗死患者68例作为研究对象,随机分为对照组与观察组各34例.对照组患者行Solitaire AB支架取栓术治疗,观察组在Solitaire AB支架取栓术过程中经动脉鞘管注射替罗非班,比较两组患者治疗前后大脑血流学指标、神经功能(NIHSS)、日常生活自理能力(ADL)评分变化情况,并随访1年记录两组主要不良脑血管事件的发生情况.结果 治疗前,两组患者左右侧大脑中动脉、基底动脉血流比较差异无统计学意义(P＞0.05).治疗后2周复查,观察组左右侧大脑中动脉、基底动脉血流均显著高于对照组(P＜0.05).观察组患者治疗后2周的NIHSS评分明显低于对照组,ADL评分明显高于对照组(P＜0.05).观察组治疗后相关出血事件发生率5.88％,与对照组比较,差异无统计学意义(P＞0.05).随访1年,观察组主要不良脑血管事件发生率5.88％,较对照组(23.53％)明显降低(P＜0.05).结论 血管内介入联合替罗非班治疗超溶栓时间窗急性脑梗死能够有效改善患者大脑动脉血流,促进神经功能及日常生活自理能力恢复,并可显著减少不良脑血管事件发生,改善预后,值得推广应用.

The treatment plan for non-ampullary duodenal neuroendocrine tumors (d-NETs) with diameters 1–2 cm remains controversial. We therefore aimed to compare the prognostic effects of endoscopic treatment and surgical resection on non-ampullary d-NETs with 1–2 cm diameters. A total of 373 eligible patients were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was performed to match patients 1:1 according to clinicopathological characteristics. Disease-specific survival (DSS) and overall survival (OS) were calculated. Before PSM, there was no significant difference in DSS or OS (all P > 0.05), but the T stage, N stage, and TNM stage were significantly different between the two surgical methods (all P < 0.05). After 1:1 PSM, the differences in clinicopathological characteristics were significantly reduced (all P > 0.05). Survival analysis showed that tumor grade was correlated with DSS and that age was correlated with OS (all P < 0.05); however, the surgical method and other clinicopathological characteristics were not correlated with prognosis (all P > 0.05). Subgroup survival analysis of patients with T2N0M0 disease and tumors invading the lamina propria or submucosa showed that the 5-year DSS and OS rates were not significantly different according to the surgical approach (all P > 0.05). The surgical approach has no significant effect on the prognosis of patients with non-ampullary d-NETs with 1–2 cm diameters, especially those with T2N0M0 disease. This suggests that endoscopic treatment may be a preferred option for these patients.

Nobiletin can regulate lipid metabolism and protect the central nervous system. However, its role in the enteric nervous system (ENS) of obese subjects is still unclear. To investigate the ENS protective effects and mechanism of nobiletin in obese mice, male C57BL/6 mice were fed a chow diet and a high-fat diet (HFD) for 8 weeks. The identified obese and control mice were grouped and administered vehicle, nobiletin 40 mg/kg, 100 mg/kg or 200 mg/kg daily for 4 weeks. The major indexes of obesity, intestinal transit rate, PGP9.5, nNOS, TNF-α, IL-1β, IL-6, IL-10, Bcl2 and Bax were measured. The full-length transcriptome was used to analyze differentially expressed genes (DEGs) in the colon. The results indicated that nobiletin effectively improved major indexes of obesity and bowel motility function, suppressed the expression of TNF-α, IL-1β, IL-6 and Bax, and upregulated the expression of IL-10, Bcl2, PGP9.5 and nNOS. Based on full-length transcriptome sequencing, nobiletin regulated lipid metabolism and inflammation via the PPAR and NOD-like receptor signaling pathways. Trem2 expression was significantly reduced in obese mice. However, Trem2 expression was significantly increased after nobiletin treatment in obese mice. The enrichment analysis showed that Trem2 plays an important role in enteric neuroinflammation. In conclusion, nobiletin regulates lipid metabolism and inflammation in obese mice. Trem2 is a potential target of nobiletin for ENS protection in obese mice.

Background Although obesity is caused by different factors, individual susceptibility to obesity differs among people under the same circumstances. The microbiota in the caecum or fresh faeces and metabolites in blood or urine contribute to obesity resistance; however, the microbiota or metabolites in the small intestine have not been extensively studied. Methods To investigate the relationship between the microbiota or metabolites in the small intestine and susceptibility to obesity, eighty-eight male C57BL/6 mice were fed a high-fat diet (HFD) for 8 weeks to establish two models of obesity and obesity resistance. For further study, six mice were chosen from among the obesity models, and twelve mice were randomly chosen from among the obesity resistance models. After fasting plasma glucose and behavioural testing, the mice were fed in single cages for another 4 weeks to observe their weight and food intake. All mice were sacrificed at 20 weeks of age. Serum ALT, AST, HDL, LDL, TG and TC levels were measured using an automatic biochemical analyser. The microbiota and metabolites in the small intestine contents were analysed using 16 S sequencing and an ultrahigh-performance liquid chromatographic system, respectively. Transcripts in the jejunum were evaluated using full-length transcriptome sequencing and verified by qPCR. Results The results showed that HFD induced depression and anxiety behaviours and higher fasting plasma glucose, ALT, AST, HDL, LDL, TG and TC levels in the obese mice; however, these levels were improved in obese resistance mice. The correlation analysis showed that the phosphatidylcholine, TG, and phosphatidylethanolamine levels were higher in obese mice and correlated positively with intestinal microflora ( Desulfovibrio and Gemella ) and the Cxcl10 gene. A higher abundance of Clostridium_sensu_stricto_1 in obesity-resistant mice correlated negatively with the metabolite contents (neuromedin N and enkephalin L) and Pck1 gene expression and correlated positively with certain metabolites (5-hydroxy-L-tryptophan, cinnamyl alcohol and 1 H-indole-3-acetamide) and genes expression (Gdf15, Igfbp6 and Spp1). Conclusion Clostridium_sensu_stricto_1 , neuromedin N, enkephalin L, Pck1, 5-hydroxy-L-tryptophan, Cxcl10 and cinnamyl alcohol may be novel biomarkers in the small intestine for obesity/obesity resistance. These might be helpful for obesity prevention or for treating obese patients.

目的 构建初诊结直肠癌脑转移患者(SBCRC)生存预测模型.方法 回顾性分析SEER数据库2010～2016年SBCRC患者临床病理及治疗数据.用多因素Cox比例风险模型确定独立预后因素;然后用R软件建立列线图预测模型及验证.结果 单因素分析结果显示年龄、肿瘤位置、CEA、放疗、化疗、是否手术是SBCRC预后危险因素(P<0.05),而组织分化程度、性别、T分期、N分期与SBCRC预后无关(P>0.05).多因素分析结果显示年龄、化疗、骨转移、CEA阳性和是否手术治疗是影响SBCRC患者的独立预后因素(P<0.05).列线图预后模型的C-index为0.749(95％C I:0.726～0.772),半年及1年ROC曲线下面积分别为0.823和0.788,同时校准曲线显示列线图预测半年、1年生存率与实际观察半年和1年生存率有很好的一致性.结论 基于年龄、CEA、骨转移、是否手术及化疗建立的列线图预测效果良好.

目的 探究小胶质细胞表达的胸腺素β4(Tβ4)与脑缺血/再灌注损伤(I/R)后PI3K/AKT通路的关系.方法 拟采用局灶脑I/R的模型[21只成年雄性SPF级SD大鼠分为假手术组(Sham组,6只)和模型组(I/R组,15只)]和使用BV2细胞建立氧糖剥夺/再灌注(OGD/R)模型(分为对照组、OGD/R组、shRNA Tβ4+Control组、shRNA Tβ4+OGD/R组、Control shRNA+Control组、Control shRNA+OGD/R组),配合基因干扰技术,使用免疫组化、免疫荧光等方法检测大脑皮层及BV2细胞Tβ4表达水平,蛋白质印迹检测PI3K/AKT通路蛋白水平的变化.结果 与Sham组相比,大鼠局灶脑I/R损伤后,大脑皮层Tβ4蛋白表达显著升高,尤其是I 2 h/R 48 h组(P<0.0001).体外实验证实,与Control组相比,OGD/R损伤后Tβ4的在BV2细胞表达明显升高,尤其OGD 6 h/R 48 h组升高最明显(P<0.0001),p-PI3K/PIK和p-AKT/AKT比值也升高(P<0.001),而当Tβ4基因被干扰时,p-PI3K/PIK(P<0.05)和p-AKT/AKT(P<0.01)也受到抑制.结论 局灶性脑I/R损伤后,Tβ4在大脑皮质小胶质细胞高表达,并且小胶质细胞高表达的Tβ4可能通过影响PI3K/AKT通路影响大脑缺血/再灌注损伤后的修复.

When only the TNM classification is used to predict survival in gastric cancer (GC) patients, the impact of the degree of lymphadenectomy on the prognosis is neglected. This study aimed to establish a more effective nomogram based on the log odds of negative lymph nodes/T stage ratio (LONT) to predict survival in surgically treated GC patients. The data of resected GC patients were extracted from the Surveillance, Epidemiology, and End Results Program (SEER) database. Univariate and multivariate Cox regression analyses were used to identify the significant prognostic factors. The prognostic performance was assessed using a calibration plot, concordance index (C-index), and area under the (time-dependent receiver operating characteristic) curve (AUC) to compare the predicted survival probability based on the nomogram score groups. The results showed LONT as an independent prognostic factor for cancer-specific survival (CSS) and overall survival (OS), independent of clinicopathological factors. After removing potential redundancy, only LONT, T stage, N stage, location and age were used in the final nomogram model. The model had a higher C-index (0.736 ± 0.012) and AUC (0.798) than the TNM staging system (0.685 ± 0.012 and 0.744). The nomogram score could predict a significant survival difference between any two adjacent groups in terms of CSS and OS. High LONT is associated with improved survival of gastric cancer patients, independent of other clinicopathological factors. The prognostic nomogram model based on LONT could effectively predict CSS and OS for resectable GC patients.