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In order to clarify the relationship among nutritional quality of highland barley flour, processing quality and edible quality of noodles, the flour of 21 highland barley varieties in Qinghai Province was used as raw the materials. The key indexes for evaluating the suitability of highland barley noodle processing were screened out through correlation analysis and cluster analysis to construct an evaluation system for the suitability of highland barley noodle processing. The results showed that the contents of starch, fat, the fiber and the protein of highland barley flour were 69.95%~83.36%, 0.87%~2.38%, 1.13%~3.69%, and 6.88%~11.64%, respectively. Beiqing No. 8 (gate) had the highest peak viscosity (2 378.50 mPa·s), and Kunlun No. 15 (Dulan) had the highest regeneration value (756.00 mPa·s). Kunlun No. 16 (Guinan) had the best water holding capacity (4.32 g/g), and Chai Qing No. 1 (Dulan) had the highest oil holding capacity (0.94 g/g). Kunlun No. 14 (Guide) had the largest solubility (27.46%), and Kunlun No. 15 (Dulan) had the largest expansion (9.15%). Kunlun No. 18 (gate) had the greatest transparency (28.40%), and freeze-thaw stability was the largest (77.16%). The nutritional quality and processing characteristics of highland barley noodles were significantly related to the cooking quality and texture characteristics of noodles, flour water content, total starch content, resistant starch content, flour L* value and peak viscosity were the key indicators to evaluate the suitability of highland barley noodle processing. Through the construction of processing suitability evaluation system, the evaluation level of highland barley noodle processing suitability was determined. Beiqing No. 9 (Xining), Kunlun No. 14 (Xining), Kunlun No. 17 (Menyuan), Chai Qing No. 1 (Guinan) were screened out, while Kunlun No. 14 (Guinan), Kunlun No. 15 (Guinan) and other 6 highland barley flours were suitable for processing into highland barley noodles. The results of this study could provide a theoretical basis for the selection of raw materials for processing highland barley noodles.

In this study, we established a new methodology for preparing 5-nucleotidase (5-NT) with the aim of enhancing our understanding of its enzyme activity and laying a basis for regulating the content of umami-enhancing nucleotides in pork. 5-NT was prepared with Sephadex gel filtration and reverse-phase high-performance liquid chromatography, and its enzymatic properties and catalytic activity were evaluated. The results show that the molecular weight of the prepared 5-NT was 57 kDa, the optimal catalytic temperature was 40 °C, and the optimal pH was 8. Zn2+, and sucrose showed inhibitory effects on the activity of 5-NT, while K+, Na+, Ca2+, Mg2+, glucose, fructose, and trehalose promoted the activity of the studied compound. The prepared 5-NT exhibited higher catalytic activity and selectivity against IMP compared with its commercial counterpart, while its catalytic activity against XMP was not significant (p > 0.05). In brief, we established a new methodology for preparing 5-NT, enhancing our understanding of its enzyme activity and providing a solid basis for regulating the content of umami-enhancing nucleotides in pork through the control of endogenous 5-NT activity.

Objective: This study aims to investigate how the impact of preoperative sarcopenia and inflammatory markers for laryngeal cancer patients and develop a new scoring system to predict their prognosis. Materials and methods: Patients who underwent laryngectomy for laryngeal cancer (LC) from December 2015 to December 2020 at the Second Affiliated Hospital of Fujian Medical University were included. Independent prognostic factors were determined using univariate and multivariate analyses. A new scoring system (SFAR) was established based on FAR and preoperative sarcopenia, and statistically analyzed. Results: 198 cases included in this study that met the admission criteria. Multivariate analysis shown that preoperative sarcopenia, pTNM stage, and FAR were independent prognostic factors for laryngeal cancer. Based on these three indicators, we developed the SFAR scoring system. Multivariate analysis showed that SFAR was an independent predictor of laryngeal cancer (p < 0.001). SFAR was then incorporated into a prognostic model that included T-stage and N-stage, and a column-line graph was generated to accurately predict its survival. Conclusion: Systemic inflammation and sarcopenia are significantly associated with postoperative prognosis in laryngeal cancer. A new scoring system (SFAR) had implications for improving the prognosis of patients undergoing surgery for laryngeal cancer. [ABSTRACT FROM AUTHOR]

Comprehensive Summary The difunctionalization of bicyclo[1.1.0]butanes is an under‐explored transformation that accesses to moieties that are otherwise difficult to prepare. Herein, a new oxidative radical alkylarylation of N‐aryl bicyclobutyl amides with C(sp3)−H feedstocks is achieved in an atom‐economic and photocatalyst‐ and light‐free manner. This protocol follows a sequential C(sp3)–H/C(sp2)–H functionalization, providing an efficient route for diversity‐oriented synthesis of functionalized 3‐spirocyclobutyl oxindoles. In particular, a wide range of C(sp3)−H feedstocks, including ether, alcohol, amine, thioether, polychlorinated methane, silane, acetone, acetonitrile, toluene, and alkane are all suitable for the C(sp3)−H functionalization, demonstrating the broad applicability of this transformation. [ABSTRACT FROM AUTHOR]

Objective This study assesses the status and determinants of treatment delays among patients with rifampicin-resistant tuberculosis (RR-TB) in Guizhou Province, 2016-2022, aiming to inform the development of RR-TB control strategies in the region. Methods Data on RR-TB patients from 2016 to 2022 were extracted from the "Tuberculosis Management Information System," a subsystem of the "China Disease Prevention and Control Information System." The trend in treatment delay rates over time was analyzed using Trend chi-square test, while logistic regression models were used to examine the factors influencing these delays. Results From 2016 to 2022, Guizhou Province reported 513 cases of treatment delays among patients with rifampicin-resistant tuberculosis (RR-TB), resulting in a treatment delay rate of 23.29%. The rate of treatment delays decreased from 2016 to 2019 (Trend chi-square test = 9.099, P = 0.003), reaching its lowest in 2018 at 10.53%. However, from 2020 to 2022, the rate of treatment delays exhibited an upward trend (Trend chi-square test = 5.937, P = 0.015), peaking in 2021 at 31.62%. Multivariable analysis indicated that compared to migrant populations, patients undergoing initial treatment, and those tested with molecular biological drug sensitivity tests, non-migrant patients (OR = 1.496, 95%CI = 1.198 to 1.867), new patients (OR = 1.774, 95%CI = 1.344 to 2.342), patients with relapse (OR = 1.494, 95%CI = 1.110 to 2.011), and those tested using traditional drug sensitivity methods (OR = 2.985, 95%CI = 2.323 to 3.834) were at higher risk for treatment delays. Conclusion From 2016 to 2022, the overall trend of treatment delays in rifampicin-resistant tuberculosis (RR-TB) patients in Guizhou Province showed a decline. However, there was an increasing trend during the COVID-19 pandemic. This suggests a need to enhance the prevention and control of drug-resistant tuberculosis in key areas such as Bijie City. There is also a need to intensify health education for patients with drug resistance, implement patient-centered care systems for those patients, expand the application of molecular biological drug sensitivity testing techniques, and strengthen the referral and admission mechanisms for RR-TB patients. [ABSTRACT FROM AUTHOR]

The bicarbonate-activated hydrogen peroxide (BAP) system is widely studied for organic pollutant degradation in wastewater treatment. Ca2Co2O5, a heterogeneous catalyst containing multivalent cobalt including Co(II) and Co(III), was herein investigated as a BAP activator, and Acid Orange 7 (AO7) was used as a model pollutant. Ca2Co2O5 exhibited good activation performance. The degradation rate and the initial rate constant of the Ca2Co2O5-activated BAP system were 5.4 and 11.2 times as high as the BAP system, respectively. The removal rate of AO7 reached 90.9% in 30 min under optimal conditions (AO7 20 mg/L, Ca2Co2O5 0.2 g/L, H2O2 1 mM, NaHCO3 5 mM, pH 8.5, 25℃). The Ca2Co2O5 catalyst exhibited good stability and recyclability, retaining 85% of AO7 removal rate in the fifth run. Compared to the BAP system, a lower dosage of H2O2 was required and a higher initial concentration of pollutants allowed for effective degradation in the Ca2Co2O5-BAP system. X-ray photoelectron spectroscopy was used to analyze the catalytic mechanism. The analysis showed that the good catalytic performance of Ca2Co2O5 attributes to its high proportion of oxygen vacancies and Co(III) species, and the presence of Ca. The active species O2•−, •OH, and 1O2 are responsible for the degradation, as indicated by the quenching experiments. The degradation mechanism of AO7 was speculated based on UV–Vis spectral analysis and the identification of degradation intermediates. The azo form, naphthalene and benzoic rings in the AO7 structure are destroyed in the decomposition. This research provides a feasible approach to designing effective and reusable BAP activators for pollutant degradation in wastewater treatment. [ABSTRACT FROM AUTHOR]

Objective: To investigate the role and mechanism of Nur77 in lung adenocarcinoma cell apoptosis and autophagy. Methods: Five cases of lung adenocarcinoma tissues which were confirmed by pathology and para-cancerous tissues were collected from the Affiliated Southwest Hospital of Youjiang Medical University for Nationalities (People's Hospital of Bai.se). The expression of Nur77 in lung adenocarcinoma and para-cancerous tissues was detected with immunofluorescence. Nur77-associated pathways were analyzed with bioinformatics analysis. Human bronchial epithelial (BEAS-2B) cells and human lung cancer (A549) cells were cultured in vitro and designated as BEAS-2B and A549 groups, respectively. In both groups, Nur77 mRNA expression was measured with RT-qPCR, the expression of Nur77, LC3, PI3K, p-PI3K, AKT, and p-AKT was assessed with western blotting, and the fluorescence intensity of Nur77 was determined with immunofluorescence. A549 cells were transfected with si-NC or si-Nur77, referred to as si-NC or si-Nur77 groups, respectively, and non-transfected cells serving as the control group (Con). Nur77 expression was analyzed with RT-qPCR, and the expression of Nur77, LC3, PI3K, p-PI3K, AKT, p-AKT, cas-pase-3, Bax, and Bcl-2 was examined using Western blot. Cell apoptosis was assessed by flow cytometry.Results: Lung adenocar-cinoma tissues exhibited higher levels of Nur77 protein expression compared to para-cancerous tissues. Bioinformatics analysis demonstrated a correlation between Nur77 and the PI3K/AKT pathway. The mRNA and protein expression of Nur77 (P<((.((((1) and the ratio of LC3 II /LC3 I, p-AKT/AKT (P<((.((5), and p-PI3K/PI3K (P<((.((1) were higher in the A549 group than in the BEAS-2B group. Compared with the si-NC group, the si-Nur77 group exhibited decreased Bcl-2 expression (P<((.((5), increased Caspase-3 and Bax expression (P<((.((1), and elevated LC3 I /LC3 I ratio (P<((.((1), along with reduced p-AKT/ AKT (P<((.((5) and p-PI3K/PI3K (P<((.((1) ratios and significantly enhanced apoptosis (P<((.((5).Conclusion: Nur77 down-regulation accelerates autophagy and apoptosis in lung cancer cells, which may be achieved by the inhibition of the PI3K/AKT pathway. [ABSTRACT FROM AUTHOR]

A novel terahertz polarization isolator using a two-dimensional square lattice tellurium rod array is numerically investigated at the interesting band of 0.22 THz in this short paper. The isolator is designed by inserting six hexagonal tellurium rods into a fully polarized photonic crystals waveguide with high efficiency of −0.34 dB. The TE and TM photonic band gaps of the 7 × 16 tellurium photonic crystals are computed based on the plane wave expansion method, which happen to coincide at the normalized frequency domain from 0.3859(a/λ) to 0.4033(a/λ), corresponding to the frequency domain from 0.2152 to 0.2249 THz. The operating bandwidth of the tellurium photonic crystals waveguide covers 0.2146 to 0.2247 THz, calculated by the finite element method. The six hexagonal tellurium rods with smaller circumradii of 0.16a serve to isolate transverse electric waves and turn a blind eye to transverse magnetic waves. The polarization isolation function and external characteristic curves of the envisaged structure are numerically simulated, which achieves the highest isolation of −33.49 dB at the central frequency of 0.2104 THz and the maximum reflection efficiency of 98.95 percent at the frequency of 0.2141 THz. The designed isolator with a unique function and high performance provides a promising approach for implementing fully polarized THz devices for future 6G communication systems. [ABSTRACT FROM AUTHOR]

In this study, we established a new methodology for preparing 5′−nucleotidase (5′−NT) with the aim of enhancing our understanding of its enzyme activity and laying a basis for regulating the content of umami−enhancing nucleotides in pork. 5′−NT was prepared with Sephadex gel filtration and reverse−phase high−performance liquid chromatography, and its enzymatic properties and catalytic activity were evaluated. The results show that the molecular weight of the prepared 5′−NT was 57 kDa, the optimal catalytic temperature was 40 °C, and the optimal pH was 8. Zn2+, and sucrose showed inhibitory effects on the activity of 5′−NT, while K+, Na+, Ca2+, Mg2+, glucose, fructose, and trehalose promoted the activity of the studied compound. The prepared 5′−NT exhibited higher catalytic activity and selectivity against IMP compared with its commercial counterpart, while its catalytic activity against XMP was not significant (p > 0.05). In brief, we established a new methodology for preparing 5′−NT, enhancing our understanding of its enzyme activity and providing a solid basis for regulating the content of umami−enhancing nucleotides in pork through the control of endogenous 5′−NT activity. [ABSTRACT FROM AUTHOR]

In order to investigate the application potential of prolyl endopeptidase (PEP) in the enzymatic preparation of bone collagen peptides, the amino acid sequence characteristics of bovine bone collagen (BBC), porcine bone collagen (PBC) and chicken bone collagen (CBC) were comparatively analyzed, and their potential enzymatic cleavage sites and theoretical hydrolysis degrees were predicted. Collagen hydrolyzed by PEP at 55 ℃ and pH 8.0 was characterized by hydrolysis degree, molecular mass distributionand scanning electron microscopy (SEM). Infrared spectroscopy, X-ray diffraction (XRD) and circular dichroism (CD) spectroscopy were used to explore the structural changes of collagen during enzymatic digestion. The results showed that PEP could hydrolyze the three collagens. The hydrolysis degree of PBC was the highest (51.35%), followed by those of BBC (22.81%) and CBC (29.81%). The molecular masses of the three collagen hydrolysates were mostly distributed below 500 Da. Spectroscopic analysis showed that PEP destroyed the triple helix structure of collagen, and then degraded it. Therefore, PEP can efficiently enzymatically hydrolyze collagen into small molecule peptides, which provides a basis for the enzymatic preparation of functional collagen-derived peptides.

Background: The current surgical methods for managing incisions after nipple excision in breast reconstruction patients are limited. However, double purse-string suture (DPS) shows promise in the treatment of nipple excision. This study aimed to investigate the safety and aesthetic outcomes of DPS nipple reconstruction in early breast cancer patients who underwent endoscopic skin-sparing mastectomy (E-SSM) and breast reconstruction., Methods: We retrospectively analyzed the clinical data of 87 early breast cancer patients with nipple excision who underwent E-SSM with breast reconstruction. According to the suture methods of nipple incision, all patients were divided into the spindle suture (SS) group, single purse-string suture (SPS) group, and DPS group, with SS and SPS groups combined as the traditional suture (TS) group. Then, we compared the groups' differences in aesthetic outcomes, surgical safety, and oncological safety., Results: A total of 87 patients with 88 breasts were enrolled in this study (SS n=17, SPS n=21, DPS n=50). Patients in the DPS group had significantly better nipple reconstruction satisfaction, Harris scale and any complications incidence than the TS group (all p <0.05). For nipple reconstruction satisfaction and any complication, the adjusted OR (95%CI) of the DPS group were 6.314(1.095-36.415) (p=0.039) and 0.124(0.018-0.863) (p=0.035) compared with the SS group. One patient in the SS group had vertebral metastases, and no recurrence, metastasis, or death has been observed in the other two groups during the follow-up period., Conclusions: DPS is an effective and safe nipple reconstruction procedure for patients undergoing E-SSM with breast reconstruction, delivering excellent aesthetic outcomes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Dai, Chung, Liang, Xie, Zhang, Qiu, Yang, Zhou, Feng and Du.)

Background: Thromboelastography (TEG) can objectively reflect the formation, development and rupture process of thrombosis in patients, but there are limited data on whether TEG can be used as a predictive tool for recurrence in patients with acute ischemic stroke., Objective: To explore the TEG risk of recurrence in patients with acute ischemic stroke predictive value., Methods: A total of 441 patients with acute ischemic stroke who met the research criteria in the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from January 2020 to December 2021 were selected as the research objects. TEG was measured in all patients, and the main parameters of TEG (R value, indicating coagulation reaction time; K value and Angle, the rate of blood clot formation; MA value, indicating the maximum amplitude). The primary outcome of this study was ischemic stroke recurrence. Recurrent events included cerebral infarction, cerebral hemorrhage, TIA, and were determined by combining imaging events and clinical events. Logistic regression analysis was used to explore the influencing factors of recurrence in patients with acute ischemic stroke., Results: Fifty-six patients (12.7%) had recurrence. Multivariate Logistic regression analysis showed that: Age [OR = 1.078, 95%CI(1.024, 1.135)], triglyceride [OR = 1.541, 95%CI(1.033, 2.298)], glycosylated hemoglobin [OR = 1.401, 95%CI(1.097, 1.790)], history of hypertension [OR = 16.046, p  < 0.05], 95%CI(4.726, 54.489), R value [OR = 0.533, 95%CI(0.351, 0.809)], MA value [OR = 1.399, 95%CI(1.004, 1.949)] were independent influencing factors for hemorrhagic transformation in patients with acute ischemic stroke., Conclusion: TEG has some value in predicting recurrence in patients with acute ischemic stroke, and the MA value in TEG [AUC = 0.806 (95%CI:0.747-0.867), with a sensitivity of 78.6% and a specificity of 70.4%], predicted the most significant efficiency of AIS recurrence., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Guo, Shen, Lu, Zhou, Hao, Lan and Xu.)

Wastewater irrigation is used to supplement agricultural irrigation because of its benefits and freshwater resource scarcity. However, whether wastewater irrigation for many years affects the electron transfer capacity (ETC) of natural organic matter in soil remains unclear, and organic matter could influence the decomposition and mineralization of substances with redox characteristics in soil through electron transfer, ultimately affecting the soil environment. The composition of soil humic substances (HS) is highly complex, and the effects of soil humic acid (HA) and fulvic acid (FA) on ETC is poorly understood. In this study, we separately evaluated the responses of the electron-accepting capacity (EAC) and electron-donating capacity (EDC) of soil HA and FA in agricultural fields to various durations of wastewater irrigation. Results showed that the EAC of HA and FA increased significantly with increasing the duration of wastewater irrigation. When wastewater irrigation lasted for 56 years, the EAC of HA showed a higher increment (590 %) than that of FA (223 %). The EDC of soil HA and FA, conversely, decreased compared to the control, with the highest reduction of 35.6 % for HA and 65.9 % for FA. Specifically, the EDC of HA gradually decreased starting from 29 years of wastewater irrigation, whereas the decrease in the EDC of FA exhibited no clear pattern in relation to the duration of wastewater irrigation. Increased soil organic matter and total nitrogen content under long-term wastewater irrigation led to an increase in sucrase and phosphatase activities, along with an increase in EAC and a decrease in EDC of HS. This suggests that soil enzyme activities may ultimately lead to changes in ETC. The results of this research provide practical insights into the redox system in soil and its driving role in soil organic matter transformation and nutrient cycling under wastewater irrigation., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objective: To systematically evaluate the efficacy of acupuncture in the treatment of cognitive impairment in Alzheimer's disease (AD) by meta-analysis, in order to provide evidence-based evidence for the application of acupuncture therapy in the clinical process of AD., Methods: From the establishment of the database to December 31, 2022, China Biomedical Literature Database (CBM), China National Knowledge Network (CNKI), VIP database, WanFang Database, Pubmed, Embase and Cochrane Library Database were systematically searched. To collect published randomized controlled clinical trials (RCTS) of acupuncture in the treatment of cognitive impairment in AD. The subjects in the intervention group were given acupuncture alone or combined with other treatments the same as the control group; the control group received conventional Western medicine treatment. The main outcome indicators of the study were cognitive function assessment of subjects, including: Simple Mental State Examination Scale (MMSE), Assessment of daily Living Ability Scale (ADL), Alzheimer's Disease Cognitive Function Assessment Scale (ADAS-Cog), TCM syndrome score (SDSD), Montreal Cognitive Test (MoCA), Secondary outcome indicators were the occurrence of adverse reactions. Literature screening, data extraction, and quality evaluation of the included literature were performed independently by two researchers, according to bias risk assessment tools recommended in the Cochrane manual. Data were analyzed by RevMan5.3 software. Dichotomous variables were represented by risk ratio (OR) and 95% CI, and continuity variables were represented by mean difference (MD) and 95% CI. For heterogeneity analysis, when P > 0.1 and I 2 ≤ 50%, fixed effect model was applied. When P ≤ 0.1 and I 2 > 50%, the random effects model is applied., Results: A total of 1,172 eligible subjects were included in 18 RCTS, including 595 in the intervention group and 577 in the control group. The results of meta-analysis are as follows: acupuncture intervention group improved MMSE [MD = 1.67, 95% CI (0.94, 2.41), P < 0.00001], ADL [MD = -1.18, 95% CI (-3.09, 0.72), P = 0.22], ADAS-Cog [MD = 3.31, 95% CI (5.84, 0.78), P = 0.01], SDSD [MD = 2.40, 95% CI (3.53, 1.26), P < 0.0001], MoCA [MD = 4.80, 95% CI (3.74, 5.86), P = 0.04] were better than the control group. No serious adverse reactions related to acupuncture were observed in the intervention group, and the incidence and severity of adverse reactions were lower than those in the control group, with statistical significance [OR = 0.17, 95% CI (0.04, 0.67), P = 0.01]., Conclusion: Existing data show that acupuncture therapy has certain advantages in improving cognitive dysfunction and improving self-care ability of patients with Alzheimer's disease. However, due to the small number of RCTS and cases evaluating the efficacy of acupuncture, and the possibility of measurement bias and selectivity bias in included studies, it is still unable to conduct high-intensity demonstration on its effectiveness. Further large-scale, high-quality randomized, double-blind controlled trials are needed to evaluate its efficacy., Systematic Review Registration: https://inplasy.com/inplasy-2021-12-0125/, identifier: INPLASY2021120125., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Guo, Shen, Ealing, Zhou, Lu and Ning.)

Background: Although oxidative stress is involved in the pathophysiological process of chronic rhinosinusitis with nasal polyps (CRSwNP), the specific underlying mechanism is still unclear. Whether antioxidant therapy can treat CRSwNP needs further investigation., Methods: Immunohistochemistry, immunofluorescence, western blotting and quantitative polymerase chain reaction (qPCR) analyses were performed to detect the distribution and expression of oxidants and antioxidants in nasal polyp tissues. qPCR revealed correlations between oxidase, antioxidant enzymes and inflammatory cytokine levels in CRSwNP patients. Human nasal epithelial cells (HNEpCs) and primary macrophages were cultured to track the cellular origin of oxidative stress in nasal polyps(NPs) and to determine whether crocin can reduce cellular inflammation by increasing the cellular antioxidant capacity., Results: The expression of NOS2, NOX1, HO-1 and SOD2 was increased in nasal epithelial cells and macrophages derived from nasal polyp tissue. Oxidase levels were positively correlated with those of inflammatory cytokines (IL-5 and IL-6). Conversely, the levels of antioxidant enzymes were negatively correlated with those of IL-13 and IFN-γ. Crocin inhibited M1 and M2 macrophage polarization as well as the expression of NOS2 and NOX1 and improved the antioxidant capacity of M2 macrophages. Moreover, crocin enhanced the ability of antioxidants to reduce inflammation via the KEAP1/NRF2/HO-1 pathway in HNEpCs treated with SEB or LPS. Additionally, we observed the antioxidant and anti-inflammatory effects of crocin in nasal explants., Conclusion: Oxidative stress plays an important role in the development of CRSwNP by promoting various types of inflammation. The oxidative stress of nasal polyps comes from epithelial cells and macrophages. Antioxidant therapy may be a promising strategy for treating CRSwNP., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Zhou, Zhou, Liu, Liu, Meng, Wen, Luo, Liu, Li, Ba and Du.)

Background: Due to the short operation time and no need for special instruments, reverse-sequence endoscopic nipple-sparing mastectomy (R-E-NSM) with direct-to-implant breast reconstruction (DIBR) has been rapidly becoming popular in the last three years. However, there has yet to be an evaluation of its oncologic safety or the feasibility of discharging patients within 24 h., Materials and Methods: In this single-centre retrospective cohort study, individuals diagnosed with stage 0-III breast cancer between May 2020 and April 2022 who underwent traditional open mastectomy or R-E-NSM with DIBR were included. Follow-up started on the date of surgery and ended in December 2023. Data, including demographics, tumour characteristics, medium-term oncological outcomes, and postoperative complications, were collected and analyzed. Propensity score matching (PSM) was performed to minimize selection bias., Results: This study included 1679 patients [median (IQR) age, 50 [44-57) years]. Of these, 344 patients underwent R-E-NSM with DIBR (RE-R group), and 1335 patients underwent traditional open mastectomy (TOM group). The median [IQR] follow-up time was 30 [24-36] months [29 (23-33) months in the RE-R group and 30([24-36) months in the TOM group]. Regarding before or after PSM, the P value of local recurrence-free survival (LRFS, 0.910 and 0.450), regional recurrence-free survival (RRFS, 0.780 and 0.620), distant metastasis-free survival (DMFS, 0.061 and 0.130), overall survival (OS, 0.260 and 0.620), disease-free survival (DFS, 0.120 and 0.330) were not significantly different between the RE-R group and the TOM group. The 3y-LRFS and 3y-DFS rates were 99.0% and 97.1% for the RE-R group and 99.5% and 95.3% for the TOM group, respectively. The rates of any complications and major complications were not significantly different between the RE-R patients who were discharged within 24 h and the RE-R patients who were not discharged within 24 h ( P =0.290, P =0.665, respectively) or the TOM patients who were discharged within 24 h ( P  =0.133, P =0.136, respectively)., Conclusions: R-E-NSM with DIBR is an innovative oncologic surgical procedure that not only improves cosmetic outcomes but also ensures reliable oncologic safety and fewer complications, enabling patients to be safely discharged within 24 h. A long-term prospective multicenter assessment will be supporting., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)