Abstract:Objective To analyze the correlation between the preoperative Nutritional Risk Screening 2002(NRS 2002)score and the postoperative complications and short-term prognosis of patients with gastric cancer after laparoscopy.Methods A total of 118 gastric cancer patients who underwent laparoscopic radical gastrectomy in Qingdao Central Hospital,University of Health and Rehabilitation Sciences from January 2023 to January 2025 were included and observed.The nutritional risk of all patients was evaluated by the NRS 2002 score before the operation and they were grouped.The preoperative and intraoperative clinical data,the occurrence of complications within 30 days after the operation and the short-term prognostic indicators were statistically analyzed.Results Among 118 patients with gastric cancer,42 cases had nutritional risk(total nutritional score≥3),with an incidence rate of 35.59%(42/118),and they were classified as the nutritional risk group.The remaining 76 cases did not have nutritional risks(total nutritional score＜3)and were classified as the non-nutritional risk group.Patients in the nutritionally at-risk group had significantly higher rates of overall postoperative complications,intra-abdominal infection,and delayed gastric emptying compared to the non-risk group(P＜0.05).No significant differences were observed between the two groups in the incidence of anastomotic leakage,surgical site infection,intra-abdominal hemorrhage,postoperative obstruction,or duodenal stump leakage(P＞0.05).Regarding Clavien-Dindo complication grading,the incidence of Grade I complications did not differ significantly between the groups(P＞0.05).However,the nutritionally at-risk group had a significantly higher incidence of complications graded≥Ⅱ compared to the non-risk group(P＜0.05).Compared to the non-risk group,patients in the nutritionally at-risk group had significantly longer times to first postoperative flatus,first postoperative liquid diet intake,and postoperative hospital stay.They also incurred significantly higher total hospitalization costs,had significantly lower serum albumin(ALB)levels at 1 month postoperatively,and experienced a significantly higher 30-day readmission rate(P＜0.05).Conclusions Routine preoperative nutritional risk screening using the NRS 2002 system for gastric cancer patients,combined with intensified perioperative nutritional support and management for those identified at risk,represents a critical strategy for improving postoperative outcomes.

Abstract:To promote the standardized development and application of surgical big data in China,this consensus was formulated through literature review,questionnaire surveys,and on-site expert discussions.It addresses key aspects including platform architecture,data acquisition,standardization,quality control,privacy protection,storage and integration,management and sharing,artificial intelligence-based technical support,and clinical and research applications.Its objectives are to standardize the construction and management of surgical big data platforms in China,to facilitate the translation of big data into surgical practice,research,and smart healthcare,and to provide a reference framework for enhancing the quality and safety of surgical care.

Abstract:Objective To investigate the expression of proteolipid protein 2(PLP2)in lung adenocarcinoma(LUAD)tissues and its association with clinicopathological features,patient prognosis,and the tumor immune microenvironment,and to evaluate its clinical value as a potential diagnostic biomarker and therapeutic target.Methods The differences in mRNA expression PLP2 in LUAD and normal lung tissues were analyzed using the Gene Expression Profiling Interactive Analysis(GEPIA)database,and their correlation with overall survival(OS)was assessed.Tumor tissue samples from 67 LUAD patients who underwent surgical resection at Jiangsu Cancer Hospital from May 2013 to July 2019 were collected.Immunohistochemistry(IHC)was used to detect PLP2 protein expression level,as well as the infiltration levels of CD8+T cells and CD33+myeloid-derived suppressor cells(MDSCs).The relationships between PLP2 expression,clinicopathological features,and patient prognosis were also analyzed.The TIMER database was utilized to evaluate the correlation between PLP2 expression and immune cell infiltration.Results GEPIA analysis revealed that PLP2 mRNA expression level was significantly higher in LUAD tissues than in normal lung tissues(P＜0.05),and high PLP2 expression was associated with poorer overall survival(OS)(P=0.001).IHC analysis further confirmed that the positive expression rate of PLP2 protein in LUAD tissues was significantly higher than that in adjacent normal tissues(P＜0.001).High PLP2 expression was significantly correlated with lymph node metastasis and TNM stage(P＜0.05).Survival analysis showed that patients with high PLP2 expression had significantly lower OS compared to those with low PLP2 expression(P=0.011).In the immune microenvironment analysis,PLP2 expression was negatively correlated with CD8+T cell infiltration level(r=-0.42,P＜0.001)and positively correlated with CD33+MDSC infiltration level(r=0.51,P＜0.001).Conclusions PLP2 is highly expressed in LUAD tissues and is closely associated with lymph node metastasis,TNM stage,and poor patient prognosis.PLP2 may promote LUAD progression by modulating CD8+T cell and CD33+MDSC infiltration,thereby reshaping the tumor immune microenvironment.PLP2 holds potential as a diagnostic biomarker and immunotherapeutic target for precision treatment of LUAD,and provides a new theoretical basis for the precise diagnosis treatment of lung adenocarcinoma.

Abstract:Pathological nipple discharge is one of the common clinical manifestations of breast diseases,the most common cause of which is benign breast lesions,mainly intraductal papilloma.In addition,about 5%to 10%of patients with pathological nipple discharge are malignant breast tumors,and intraductal papilloma also has a certain risk of malignant transformation.Therefore,early screening of breast ductal malignant lesions with nipple discharge as the main manifestation has important clinical significance.At present,there are many methods for the specific examination of pathological nipple discharge,including ultrasound,X-ray,nuclear magnetic resonance,galactography,ductography,and discharge cytology,but there are some limitations in practical clinical application.At the same time,the detection of nipple discharge tumor markers has attracted increasing attention in recent years due to the non-invasive collection of clinical specimens and high patient acceptance.However,related studies are complex and diverse,and it is difficult to guide clinical application.Therefore,this paper reviews the research on diagnostic methods of breast cancer related to nipple discharge at home and abroad in recent years,providing reference and basis for clinical diagnosis and treatment of such patients.

Abstract:Bladder cancer is a malignant tumor of urinary system with high incidence rate.Pathological diagnosis is the gold standard for confirming bladder cancer.Traditional pathological diagnosis is influenced by differences in the professional level of physicians,and has subjectivity and diagnostic limitations,which may lead to missed diagnosis or misdiagnosis.As an important branch of artificial intelligence,deep learning can improve the repeatability,objectivity and automation of pathological diagnosis of bladder cancer to a certain extent.This not only helps alleviate the pressure of the shortage of pathologists in China,but also promotes the development of precision medicine.At present,the application of deep learning in pathological diagnosis of bladder cancer is still in its initial stage,and this field is faced with many challenges,such as big data and standardization requirements,low model acceptability,ethical and privacy issues,and single data mode.In response to the above challenges,technical breakthroughs such as establishing a standardized database,improving model transparency,and developing multimodal prediction models will effectively promote the implementation and application of deep learning in the practice of pathological diagnosis of bladder cancer.

Abstract:Even under oxygen-rich conditions,tumor cells preferentially utilize aerobic glycolysis for energy production—a phenomenon known as the"Warburg effect".Originally regarded as a metabolic anomaly,this effect is now recognized as a central adaptive strategy that drives tumorigenesis,immune evasion,metastasis,and therapeutic resistance.This review summarizes recent advances in tumor glucose metabolism research across four key dimensions.Basic mechanisms:The Warburg effect is redefined as a survival program that supports biosynthesis,redox homeostasis,and signaling,orchestrated by oncogenes(e.g.,c-Myc,HIF-1α),tumor suppressors(e.g.,p53,PTEN),and the microenvironment,and integrated with epigenetic regulation via metabolites such as acetyl-CoA and α-ketoglutarate;Immune microenvironment modulation:Tumor-associated macrophages(TAMs)undergo metabolic reprogramming toward an M2-like phenotype,where lactate,acetyl-CoA,and O-GlcNAcylation act as key mediators to establish an immunosuppressive niche;Metastasis promotion:Excessive glucose restriction can induce metabolic stress,triggering neuroendocrine-like programs and epithelial-mesenchymal transition(EMT),paradoxically enhancing lung metastasis;Clinical translation:Inhibitors targeting critical nodes—such as GLUT1,HK2,LDHA,monocarboxylate transporters(MCTs),and O-GlcNAc transferase(OGT)—are under development,with combination strategies involving immune checkpoint blockade,radiotherapy/chemotherapy,and targeted therapy showing promise.Future efforts should move beyond broad metabolic inhibition toward precision modulation of the"metabolism-signaling-immunity"axis.

Abstract:Malignant tumors pose a severe threat to human health and have emerged as a major global public health challenge.Compared with healthy individuals,cancer patients often exhibit a hypermetabolic state and metabolic disorders,which originate from the complex metabolic reprogramming of cancer cells.This process not only provides the necessary bioenergy and biosynthetic precursors for the rapid proliferation,invasion,and metastasis of cancer cells but also profoundly remodels the tumor immune microenvironment(TIME),leading to impaired immune surveillance and subsequent promotion of immune evasion and cancer progression.Therefore,in-depth investigation into the regulatory mechanisms of aberrant tumor energy metabolism on the immune microenvironment and potential therapeutic interventions has become a cutting-edge focus in current cancer research.This article systematically reviews recent advances,aiming to provide a theoretical foundation for novel anti-tumor therapeutic strategies targeting the"metabolism-immune"axis.

Abstract:Objective To investigate the impact of thoracoscopy combined with laparoscopy(VATS+LAP)for esophagectomy on postoperative recovery and long-term survival in patients with esophageal cancer.Methods Fifty patients with esophageal cancer admitted to Meishan People's Hospital from January 2019 to January 2022 were selected and divided into two groups based on the surgical approach:the Thoracoscopy(VATS)group which underwent thoracoscopic esophagectomy alone,and the Thoracoscopy combined with Laparoscopy(VATS+LAP)group which underwent thoracoscopic combined with laparoscopic esophagectomy.Perioperative indicators(operation time,intraoperative blood loss,drainage tube indwelling time,hospital stay),postoperative pain,quality of life,complications,and the 2-year cumulative survival rate were compared between the two groups after treatment.Results The VATS+LAP group had lower operation time,intraoperative blood loss,postoperative drainage tube indwelling time,postoperative hospital stay,and postoperative pain VAS scores at 2,12,and 24 hours compared to the VATS group(P＜0.05).There was no statistically significant difference in the number of lymph nodes dissected between the two groups(P＞0.05).The quality of life QLQ-C30 scores at 1,6,and 12 months postoperatively in the VATS+LAP group were higher than those in the VATS group(P＜0.05).The incidence of postoperative complications in the VATS+LAP group was lower than that in the VATS group(P＜0.05).The 2-year cumulative survival rate in the VATS+LAP group was higher than that in the VATS group(P＜0.05).Conclusions Compared to VATS alone,VATS+LAP offers significant advantages for patients with esophageal cancer in terms of shortening recovery time,reducing postoperative pain,improving quality of life,and enhancing long-term survival rates,with higher safety,and is recommended for clinical application.

Abstract:Objective To investigate the sensitization mechanism of Xiao'ai Jiedu Decoction in regulating the polarization of tumor-associated macrophages(TAMs)for programmed death receptor-1(PD-1)monoclonal antibody treatment of advanced non-small cell lung cancer(NSCLC).Methods A mouse lewis lung carcinoma(LLC)tumor-bearing model was established by subcutaneously injecting 0.1 mL of LLC cell suspension into the right axilla.Forty tumor-bearing mice were randomly divided into four groups(n=10 per group):Model group,PD-1 monoclonal antibody group,Xiao'ai Jiedu Decoction group,and PD-1+Xiao'ai Jiedu Decoction group.The model group received intragastric administration of normal saline and intraperitoneal injection of phosphate-buffered solution.The PD-1 monoclonal antibody group received intragastric administration of sterile normal saline and intraperitoneal injection of PD-1 monoclonal antibody(200 μg/mouse).The Xiao'ai Jiedu Decoction group received intragastric administration of Xiao'ai Jiedu Decoction water decoction(15.75 g/kg/d of raw medicine)and intraperitoneal injection of phosphate-buffered solution.The PD-1+Xiao'ai Jiedu Decoction group received intragastric administration of Xiao'ai Jiedu Decoction water decoction and intraperitoneal injection of PD-1 monoclonal antibody(200 μg/mouse).The treatment lasted for 28 days.Tumor volume was measured on days 14,18,22,and 26 after intervention.Immunohistochemical staining was used to detect the enrichment of M2 macrophages in tumor tissues.Flow cytometry was employed to determine the proportion of TAMs subsets in tumor tissues.Western blot was used to measure the protein expression levels of phosphodiesterase 4D(PDE4D),protein kinase B(AKT),and p-AKT in tumor tissues.Results Compared with the model group,tumor volumes in the PD-1 monoclonal antibody group,Xiao'ai Jiedu Decoction group,and PD-1+Xiao'ai Jiedu Decoction group were reduced on days 14,18,22,and 26(P＜0.05).Compared with the PD-1 monoclonal antibody group and Xiao'ai Jiedu Decoction group,tumor volumes in the PD-1+Xiao'ai Jiedu Decoction group were further reduced on days 14,18,22,and 26(P＜0.05).Compared with the model group,the positive rates of macrophage mannose receptor(CD206),and the proportion of M2 macrophages in the PD-1 monoclonal antibody group,Xiao'ai Jiedu Decoction group,and PD-1+Xiao'ai Jiedu Decoction group were decreased(P＜0.05),while the proportion of M1 macrophages and the M1/M2 ratio were increased(P＜0.05).Compared with the PD-1 monoclonal antibody group and Xiao'ai Jiedu Decoction group,the PD-1+Xiao'ai Jiedu Decoction group showed lower positive rates of CD206(P＜0.05)and higher proportions of M1 macrophages and M1/M2 ratios(P＜0.05).Compared with the model group,the protein expression levels of PDE4D and the p-AKT/AKT ratio in the PD-1 monoclonal antibody group,Xiao'ai Jiedu Decoction group,and PD-1+Xiao'ai Jiedu Decoction group were decreased(P＜0.05).Compared with the PD-1 monoclonal antibody group and Xiao'ai Jiedu Decoction group,the PD-1+Xiao'ai Jiedu Decoction group exhibited lower PDE4D protein expression and p-AKT/AKT ratio(P＜0.05).Conclusions Xiao'ai Jiedu Decoction may regulate the polarization state of TAMs by inhibiting the PDE4D/AKT axis,promoting their transformation into the M1 phenotype and suppressing M2 polarization,thereby enhancing the anti-NSCLC efficacy of PD-1 monoclonal antibody.

Abstract:Objective To explore the application effect of sodium hyaluronate gel in microwave ablation(MWA)for thyroid nodules and provide a reference for clinical selection.Methods The data of 85 patients who underwent thyroid MWA in Xuzhou Central Hospital from January 2022 to October 2023 were retrospectively collected.Among them,50 patients used normal saline injection for isolation(control group),and 35 patients used normal saline injection for isolation fixed with sodium hyaluronate gel for isolation fixation(observation group).The effect of microwave ablation and postoperative complications were compared between the two groups.Results The incidence of postoperative hoarseness,coughing while drinking water,intraoperative bleeding,neck pain and neck swelling was not statistically different between the two groups.The overall incidence of complications in the observation group was significantly lower than that in the control group(5.7%vs 26.0%,P=0.016),and the operation time was significantly shorter than that in the control group([32.03±3.29]min vs.[34.34±4.98]min,P=0.012).Conclusions Compared with normal saline,the use of sodium hyaluronate gel as a liquid isolation fixative in MWA can shorten the treatment time and reduce the overall incidence of postoperative complications in patients.

Abstract:Objective To investigate the clinical and pathological features and key points for differential diagnosis of parathyroid carcinoma.Methods A retrospective review was conducted on the clinical and pathological data of 28 cases of parathyroid carcinoma from January 2007 to February 2024 in the Pathology Department of Jiangsu Province Hospital.The relevant pathological slides were re-examined and analyzed.Results Of the 28 parathyroid carcinoma patients,12 were male and 16 were female,with an average age of 52.4±11.6 years.The average tumor size was 28.07±9.42 mm,and there was a significant elevation in preoperative serum calcium levels and parathyroid hormone(PTH)values.Microscopically,the tumors exhibited an invasive growth pattern.In 22 cases,tumor infiltration into the surrounding tissues was observed,and intravascular tumor thrombi were present in 15 cases.Histologically,the tumors were arranged in a sheet,nest,or trabecular pattern,with cells that were round,with clear or eosinophilic cytoplasm.The majority of cells showed mild to moderate atypia,with slightly enlarged nuclei that were round or oval,surrounded by a perinuclear halo,fine chromatin,and visible nucleoli.In cases of multiple recurrences,there was an increase in cellular atypia,with bizarre nuclei and increased mitotic figures,and tumor necrosis was observed in some cases.Conclusions Parathyroid carcinoma is a rare malignancy that poses challenges for accurate preoperative and intraoperative diagnosis.When the tumor boundaries with surrounding tissues are indistinct during surgery,it is imperative to excise the parathyroid gland along with the adherent tissues for pathological examination to establish a definitive diagnosis.

Abstract:Objective To analyze the prognostic significance of C-reactive protein,albumin and lymphocyte(CALLY)scores and hemoglobin,albumin,lymphocyte and platelet count(HALP)scores in bladder cancer.Methods Two hundred four patients with bladder cancer who were treated in Shanghai Eighth People's Hospital and Hongqi Hospital Affiliated to Mudanjiang Medical University from January 2020 to June 2022 were selected as the study subjects,and they were divided into a modeling group(n=114)and a validation group(n=90).The clinicopathological data of bladder cancer patients were collected,and Cox proportional hazard regression model was applied to analyze the risk factors affecting the progression-free-survival(PFS)of bladder cancer.Kaplan-Meier Plotter was used to analyze the level of CALLY score,HALP scores and the PFS of bladder cancer patients.Pearson's correlation analysis was performed to evaluate the correlation among CALLY scores,HALP scores,and urinary carcinoembryonic antigen(CEA).Receiver operating characteristic(ROC)curves and the Hosmer-Lemeshow(H-L)test were employed to evaluate the discriminatory ability and calibration of the scoring systems,followed by validation of the predictive model.Results The levels of CALLY scores and HALP scores were significantly correlated with muscle-invasive,pathological grade,TNM stage,and lymph node metastasis(P＜0.05),but not related to age,gender and the diameter of tumors(P＞0.05).Cox multivariate regression analysis revealed that high urinary CEA,low CALLY scores and low HALP scores were independent risk factors for poor PFS of bladder cancer(P＜0.05).The median PFS was 28.8 months for patients with high CALLY scores,which was significantly longer than 24.7 months for those with low CALLY scores(P＜0.001);The median PFS was 28.9 months for patients with high HALP scores,which was significantly longer than 25.0 months for those with low HALP scores(P＜0.001).The levels of CALLY scores and HALP scores were negatively correlated with CEA(r=-0.429,-0.462,P＜0.001).In the modeling group,the area under the ROC curve(AUC)was 0.859 and 0.904,with H-L test results of P=0.329 and 0.287,respectively.In the validation group,the AUC were 0.837 and 0.879,with H-L test results of P=0.201 and 0.206,respectively.Conclusions CALLY scores and HALP scores are predictive factors for poor prognosis of bladder cancer,and the combined detection with urinary CEA offers certain prognostic significance for bladder cancer.

Abstract:Objective To evaluate the diagnostic value of thyroglobulin(Tg),carcinoembryonic antigen(CEA),and vascular endothelial growth factor(VEGF)in thyroid cancer.Methods The clinical data of 102 thyroid cancer patients admitted to Qinhuai Medical Zone of Eastern Theater Command General Hospital from January 2021 to January 2024 were selected as the observation group;in addition,92 patients with benign thyroid lesions during the same period were selected as the control group.The serum levels of Tg,CEA and VEGF in both groups were measured.Logistic regression analysis was used to evaluate the relationship between serum Tg,CEA,VEGF levels and the occurrence of thyroid cancer,and the receiver operating characteristic(ROC)curve was used to assess the application value of combined detection of Tg,CEA and VEGF in the diagnosis of thyroid cancer.Results Pathological examination results showed that in the observation group,there were 4 cases of medullary carcinoma,3 cases of follicular carcinoma,and 95 cases of papillary carcinoma;in the control group,there were 19 cases of thyroid adenoma,61 cases of nodular goiter,and 12 cases of Hashimoto's thyroiditis.The serum levels of Tg,CEA,and VEGF in the observation group were(75.01±10.14)ng/mL,(11.01±3.45)ng/mL,and(67.54±8.69)pg/mL,respectively,which were all higher than those in the control group[(47.75±6.81)ng/mL,(5.91±1.06)ng/mL,and(53.78±6.74)pg/mL],with statistically significant differences(P＜0.05).Logistic analysis revealed that increased serum levels of Tg(OR=1.234,95％CI 1.117-1.362,P＜0.001),CEA(OR=1.860,95％CI 1.282-2.699,P=0.001),and VEGF(OR=1.147,95％CI 1.028-1.279,P=0.014)were all risk factors for thyroid cancer(P＜0.05).The ROC curve indicated that the area under the curve(AUC)of the combined detection of Tg,CEA,and VEGF for thyroid cancer assessment was 0.944.Conclusions The combined detection of serum Tg,CEA and VEGF has high diagnostic accuracy for thyroid cancer.

Abstract:Objective To investigate the role of sevoflurane(SEV)in regulating and inducing macrophage M2 polarization on the malignant progression of esophageal cancer and its possible mechanism.Methods Mononuclear THP-1 cells were induced to differentiate into M0 macrophages(M φ)using phorbol myristic acid acetate(100 nmol/L).The experiments were divided into control group,M φ group,M φ+SEV group,M φ+overexpression control(oe-NC)group,M φ+heme oxygenase-1(HO-1)overexpression(oe-HO-1)group,M φ+knockdown control(sh-NC)group,M φ+HO-1 knockdown(sh-HO-1)group,M φ+SEV+sh-HO-1 group,M φ+oe-interleukin-6(IL-6)group,M φ+oe-IL-6+sh-NC group,and M φ+oe-IL-6+sh-HO-1 group.KYSE180 human esophageal cancer cells were cultured separately in macrophages conditioned medium from each group.qRT-PCR and Western blot were used to detect the mRNA and protein expression of IL-6,HO-1,and macrophage polarization related genes,while Transwell assay was used to detect cancer cell migration and invasion.Results In macrophages,Arg1,YM1,IL-4,IL-6 and HO-1 expression was elevated and iNOS expression was decreased in the Mφ+SEV group compared to the Mφ group;Arg1,YM1 and IL-4 expression was increased and iNOS expression was decreased in the Mφ+oe-HO-1 group compared to the Mφ+oe-NC group;compared to the Mφ+sh-NC group,Mφ+sh-HO-1 group had decreased Arg1,YM1 and IL-4 expression and elevated iNOS expression;compared with the Mφ+SEV group,the Mφ+SEV+sh-HO-1 group had decreased Arg1,YM1 and IL-4 expression and elevated iNOS expression.Analysis of the Starbase website showed that there was a co-expression relationship between IL-6 and HO-1 in esophageal cancer tissue samples from TCGA database.Compared with the Mφ+oe-NC group,IL-6 and HO-1 expression was elevated in the Mφ+oe-IL-6 group;compared with the Mφ+oe-NC group,IL-6,HO-1,Arg1,YM1,and IL-4 expression was elevated in the Mφ+oe-IL-6 group,and iNOS expression was decreased;and compared with the Mφ+sh-NC group,IL-6,HO-1,Arg1,YM1,and IL-4 expression was decreased in the Mφ+sh-IL-6 group,and iNOS expression was elevated;compared with Mφ+SEV group,IL-6,HO-1,Arg1,YM1 and IL-4 expression was decreased and iNOS expression was elevated in Mφ+SEV+sh-IL-6 group(P＜0.05).In KUSE180 cells,the number of migrating and invading cells was elevated in the Mφ and Mφ+SEV groups compared to the Control group;the number of migrating and invading cells was higher in the Mφ+SEV group compared to the Mφgroup;the number of migrating and invading cells was elevated in the Mφ+oe-HO-1 group compared to the Mφ+oe-NC group;the number of migrating and invading cells was decreased in the Mφ+sh-HO-1 group compared to the Mφ+sh-NC group;the number of migrating and invading cells was decreased in the Mφ+SEV+sh-HO-1 group compared to the Mφ+SEV group;the number of migrating and invading cells was increased in the Mφ+oe-IL-6 group compared to the Mφ+oe-NC group;the number of migrating and invading cells decreased in the Mφ+oe-IL-6+sh-HO-1 group compared with the Mφ+oe-IL-6+sh-NC group(P＜0.05).The differences were statistically significant.Conclusions SEV may promote macrophage M2 polarization by activating the IL-6/HO-1 pathway,and accelerate esophageal cancer cell migration and invasion.

Abstract:Objective To compare the short and long-term curative effects of total laparoscopy,laparoscopic-assisted surgery,and complete laparotomy in the simultaneous resection in the treatment of colorectal cancer with liver metastasis.Methods Clinical research published in Pubmed,Embase,Web of Science,Cochrane Library,CNKI,and Wanfang Database comparing total laparoscopy,laparoscopic-assisted surgery,and complete laparotomy in the simultaneous resection and treatment of colorectal cancer with liver metastasis.A software,RevMan 5.3,Stata13 and R4.3.3 was used for the Meta-analysis of the extracted data.Results 18 studies were included in the pooled analysis.There were 1 655 instances in total,543 in the group that underwent total laparoscopy,378 in the group that underwent laparoscopic procedure with assistance,and 734 in the group that underwent complete laparotomy.The pairwise comparisons showed that the pure laparoscope group had better intra-operative hemorrhagic volume(MD=-154.62,95％CI:-220.08 to-89.17),number of intra-operative blood transfusions(MD=-1.81,95％CI:-2.86 to-1.15),postoperative complications(MD=-1.65,95％CI:-2.20 to-1.24),and hospital stay(MD=-2.90,95％CI:-3.83 to-1.96)than the complete laparotomy group,except that the surgery was less rapid(MD=47.99,95％CI:28.57 to 67.42)(all P＜0.05).The difference in overall and tumor-free survival was not statistically significant.The pure laparoscopic group had a longer operative time than the laparoscopic-assisted group(MD=40.26,95％CI:17.35 to 63.16),and the overall postoperative survival rate was not as high as that of the laparoscopic-assisted group(HR=1.69 95％CI:1.03 to 2.78)(all P＜0.05).There was no significant difference between the two groups in intra-operative hemorrhagic volume,intra-operative blood transfusion number,postoperative complications,and postoperative hospital stay.Conclusions Laparoscopic assist may be the best surgical approach for simultaneous resection of colorectal cancer with liver metastases under current conditions.However,the pure laparoscopy technology should only be used cautiously in centers that meet certain requirements and for appropriate cases.

Abstract:Surgical resection remains the cornerstone of curative treatment for esophageal carcinoma.Although the widespread adoption of minimally invasive techniques has improved patients' prognosis,postoperative complications,particularly pulmonary infections,continue to be a critical factor contributing to elevated mortality rates.This review systematically synthesizes recent domestic and international research,focusing on three key areas:the optimization of diagnostic criteria for postoperative pulmonary infections,multidimensional analysis of risk factors,and the exploration of novel predictive indicators.Furthermore,it evaluates the clinical efficacy of existing prevention and management strategies.The aim of this review is to provide a theoretical foundation for precision clinical interventions and to provide reference for the design of future multicenter clinical trials.

Abstract:The 2025 European Association of Urology(EAU)guidelines on non-muscle-invasive bladder cancer(NMIBC)have been published with the update and structural optimization of diagnosis,treatment,and follow-up strategies for NMIBC,integrating the latest evidence-based medicine evidence and international cutting-edge concepts.In terms of diagnosis,the guidelines emphasized the importance of magnetic resonance imaging(MRI)combined with the Vesical Imaging-reporting and Data System(Ⅵ-RADS)in the staging of bladder cancer.With respect to treatment strategies,the guidelines refined the prognostic stratification based on the histological subtypes of bladder cancer,clarified the definition and classification of bacillus Calmette-Guérin(BCG)failure,and systematically evaluated various bladder-preserving treatment options for BCG-unresponsive tumors.In addition,the guidelines added a new chapter on pragmatic de-intensification strategies for NMIBC intervention,and put forward practical medical recommendations for elderly and frail patients.The guidelines also explored the potential application of urinary molecular markers in the follow-up of NMIBC.This update provides clinicians with more targeted and pragmatic diagnostic and treatment guidance,and is expected to further improve the prognosis and quality of life of patients.

Abstract:Objective This study aims to evaluate the efficacy of denosumab combined with intensity-modulated radiotherapy(IMRT)in patients with bone metastases from non-small cell lung cancer(NSCLC).Methods This randomized controlled trial included One hundred and twenty six NSCLC patients with bone metastases who were treated at the Qiaozhou Hospital of Tongji University Affiliated East Hospital fromMarch 2022 to December 2022.Patients were randomly divided into the study group(Sixty three cases,receiving denosumab combined with IMRT)and the control group(Sixty three cases,receiving only IMRT).Bone pain relief,bone metabolism markers(bone-specific alkaline phosphatase[BALP],C-terminal telopeptide of type Ⅰ collagen[β-CTX],N-terminal propeptide of type Ⅰ collagen[PINP]),health status(Karnofsky Performance Status[KPS]score),quality of life(FACT-L score),and the occurrence of skeletal-related events(SREs)were assessed before and after treatment.A 2-year follow-up was conducted,and overall survival(OS)and progression-free survival(PFS)were evaluated using the Kaplan-Meier method.Results After treatment,the research group demonstrated superior bone pain relief compared to the control group,with a statistically significant difference(P＜0.05).Both groups showed decreased levels of ALP and PTH,increased 25(OH)D levels,and improved KPS and FACT-L scores,with the research group outperforming the control group,indicating statistically significant differences(P＜0.05).The incidence of skeletal-related events(SREs)in the research group was 30.16％,significantly lower than the 50.79％observed in the control group(P＜0.05).After a 2-year follow-up,the median OS in the study group was 19.47±2.15 months,and the median PFS was 10.15±1.74 months,both significantly better than the control group(OS:16.92±2.03 months,PFS:8.07±1.46 months)(P＜0.05).Conclusions Denosumab combined with intensity-modulated radiotherapy significantly improves clinical outcomes in NSCLC patients with bone metastases.This combination therapy effectively alleviates bone pain,improves bone metabolism,reduces the occurrence of skeletal-related events,enhances quality of life,and significantly prolongs overall survival and progression-free survival.

Abstract:Long noncoding RNA(lncRNA)has been found to play an important role in regulating the occurrence and development of head and neck squamous cell carcinoma(HNSCC).LncRNA can act as either an oncogene or a tumor suppressor,influencing the proliferation,invasion,migration,and chemoresistance of HNSCC.This article reviews the recent research progress on lncRNA related to HNSCC.LncRNA in body fluids has the potential to become a non-invasive biomarker,and antisense oligonucleotides and engineered exosomes targeting specific lncRNA may emerge as focal points.

Abstract:Objective To analyze the trends of gastric cancer incidence and mortality in Huai'an City from 2013 to 2021 and predict their changes from 2022 to 2026,providing a theoretical basis for developing gastric cancer prevention and control strategies.Methods Data were obtained from the tumor registry data submitted by seven tumor registries in Huai'an City(2013-2021).Excel and SPSS 20.0 were used to calculate gastric cancer incidence(mortality)rates,age-standardized incidence(mortality)rates(China standard,ASIRC;World standard,ASIRW),truncated rates(35-64 years),and cumulative rates(0-74 years).JoinPoint 4.8.0.1 was employed to compute the average annual percentage change(AAPC).Excel 2013 was utilized to establish a GM(1,1)for predicting gastric cancer incidence and mortality from 2022 to 2026 in Huai'an City.Results From 2013 to 2021,the crude incidence rate of gastric cancer in Huai'an City was 32.97/100 000(ASIRC:18.48/100000;ASIRW:18.17/100 000),and the crude mortality rate was 24.66/100 000(ASMRC:13.16/100 000;ASMRW:12.72/100 000).Incidence remained low before age 45,rose rapidly thereafter,and peaked at 75-79 years.Mortality remained low before age 50,increased sharply with age,and peaked at 80-84 years.The AAPC for gastric cancer incidence in the total population,males,and rural areas of Huai'an City showed declining trends(-1.64％,-1.73％,and-1.66％,respectively;P＜0.05),while trends for females and urban areas were not statistically significant(AAPC:-1.39％and-1.63％,P＞0.05).After age standardization,ASIRC declined significantly in all subgroups(total population:-4.50％;males:-4.54％;females:-4.20％;urban:-4.18％;rural:-4.83％;P＜0.05).Rural mortality showed an upward trend(AAPC:1.34％,P＜0.05),while trends for the total population,males,females,and urban areas were non-significant(AAPC:0.53％,0.25％,0.35％,-0.24％;P＞0.05).After standardization,ASMRC declined significantly in the total population(-2.59％),males(-2.94％),urban(-2.75％),and rural areas(-2.42％,P＜0.05),but not in females(-2.63％,P＞0.05).GM(1,1)predictions indicated declining incidence and mortality from 2022 to 2026.Conclusions Gastric cancer incidence and ASIRC/ASMRC in Huai'an City are decreasing,with gender and urban-rural disparities in epidemiological patterns.Targeted prevention strategies for gastric cancers should be prioritized.