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Abstract Minimally invasive pancreaticoduodenectomy (MIPD) has been routinely performed in major centers, and its feasibility and efficacy in tumor treatment have been highly recognized. Malnutrition has been associated with higher rates of morbidity, and increased mortality in surgical patients. The effect of the nutritional status on MIPD outcomes still remains unclear and controversial. The clinical data of 207 consecutive patients who had MIPD between June 2017 and December 2022 were retrospectively analyzed. A multidimensional nutrition assessment was performed before surgery. Multivariable analysis and propensity score matching (PSM) was performed to identify the association of preoperative nutritional status on postoperative short-term prognosis(Morbidity–Mortality, Clavien-Dindo classification ≥ IIIa, postoperative pancreatic fistulas and biliary fistula). In the multivariable analysis, sarcopenia (OR 9.74, 95% CI 3.34–43.03) was associated with postoperative morbidity and sarcopenia (OR 6.74, 95% CI 2.24–30.24) was associated with major complications. In the cohort after PSM, sarcopenia remained independently associated with morbidity (OR 12.44, 95% CI 3.72- 59.16) and major complications (OR 8.14, 95% CI 2.13- 43.83). Sarcopenia before MIPD has an impact on postoperative outcomes. Nutritional status assessment, especially sarcopenia, should be part of the routine preoperative procedures to provide early and appropriate nutritional support for MIPD patients.

IntroductionObservational investigations have examined the impact of glucosamine use on the risk of cancer and non-neoplastic diseases. However, the findings from these studies face limitations arising from confounding variables, reverse causation, and conflicting reports. Consequently, the establishment of a causal relationship between habitual glucosamine consumption and the risk of cancer and non-neoplastic diseases necessitates further investigation.MethodsFor Mendelian randomization (MR) investigation, we opted to employ single-nucleotide polymorphisms (SNPs) as instruments that exhibit robust associations with habitual glucosamine consumption. We obtained the corresponding effect estimates of these SNPs on the risk of cancer and non-neoplastic diseases by extracting summary data for genetic instruments linked to 49 varied cancer types amounting to 378,284 cases and 533,969 controls, as well as 20 non-neoplastic diseases encompassing 292,270 cases and 842,829 controls. Apart from the primary analysis utilizing inverse-variance weighted MR, we conducted two supplementary approaches to account for potential pleiotropy (MR-Egger and weighted median) and assessed their respective MR estimates. Furthermore, the results of the leave-one-out analysis revealed that there were no outlying instruments.ResultsOur results suggest divergence from accepted biological understanding, suggesting that genetically predicted glucosamine utilization may be linked to an increased vulnerability to specific illnesses, as evidenced by increased odds ratios and confidence intervals (95% CI) for diseases, such as malignant neoplasm of the eye and adnexa (2.47 [1.34–4.55]), benign neoplasm of the liver/bile ducts (2.12 [1.32–3.43]), benign neoplasm of the larynx (2.01 [1.36–2.96]), melanoma (1.74 [1.17–2.59]), follicular lymphoma (1.50 [1.06–2.11]), autoimmune thyroiditis (2.47 [1.49–4.08]), and autoimmune hyperthyroidism (1.93 [1.17–3.18]). In contrast to prior observational research, our genetic investigations demonstrate a positive correlation between habitual glucosamine consumption and an elevated risk of sigmoid colon cancer, lung adenocarcinoma, and benign neoplasm of the thyroid gland.ConclusionCasting doubt on the purported purely beneficial association between glucosamine ingestion and prevention of neoplastic and non-neoplastic diseases, habitual glucosamine ingestion exhibits dichotomous effects on disease outcomes. Endorsing the habitual consumption of glucosamine as a preventative measure against neoplastic and non-neoplastic diseases cannot be supported.

Abstract Background Ulcerative colitis (UC) is a chronic inflammatory disease of the colonic mucosa, with a gradually increasing incidence. Therefore, it is necessary to actively seek targets for the treatment of UC. Methods Common differentially expressed genes (DEGs) were screened from two microarray data sets related to UC. Protein−protein interaction network was constructed to find the hub genes. The UC mouse model and cell model were induced by dextran sulfate sodium (DSS). The pathological changes of colon tissue were observed by hematoxylin‐eosin staining. Immunohistochemistry and immunofluorescence were performed to detect the expressions of Ki67 and Claudin‐1. The performance of mice was observed by disease activity index (DAI). The effect of TOP2A on proliferation, inflammation, oxidative stress, and interleukin‐17 (IL‐17) signaling pathway in UC model was measured by cell counting kit‐8, enzyme‐linked immunosorbent assay, and western blot. Results Through bioinformatics analysis, 295 common DEGs were screened, and the hub gene TOP2A was selected. In UC model, there was obvious inflammatory cell infiltration in the colon and less goblet cells, while si‐TOP2A lessened it. More Ki67 positive cells and less Claudin‐1 positive cells were observed in UC model mice. Furthermore, knockdown of TOP2A increased the body weight and colon length of UC mice, while the DAI was decreased. Through in vivo and in vitro experiments, knockdown of TOP2A also inhibited inflammation and IL‐17 signaling pathway, and promoted proliferation in DSS‐induced NCM460 cells. Conclusion Knockdown of TOP2A alleviated the progression of UC by suppressing inflammation and inhibited IL‐17 signaling pathway.

The present work demonstrated the potential of different agro-waste mixtures to produce ethanol. The forest soil bacterium (Streptomyces sp.) was exploited for the saccharification of the agro-waste mixture formulated by extreme vertices mixture design and the hydrolysate produced by saccharification was used for fermentation. The best formulation contained 43.33% orange peel, 33.33 % pumpkin pulp + seeds, and 23.33% pomegranate peel which exhibited significantly high reducing sugar (22.36 ± 0.54 mg/g dry weight) among all other mixtures. The hydrolysate of this mixture when supplemented with 2% w/v fructose produced a maximum of 7.86 ± 0.08% v/v ethanol by the yeast isolated from the brewer’s spent grains. Thus, easily available waste could be a promising source for yeast isolation and feedstock for ethanol production. Further, this study aids to reduce the risk of health, and environmental pollution, and developing the economy.

Abstract Sparse arrays with O(N) sensors can offer ON2 number of degrees of freedom by exploiting the difference co‐array that can be obtained from the second‐order statistics of received signals. In this article, a novel sparse array with seven subarrays (SA‐7S) by carefully assembling the subarrays is proposed, and the resulting SA‐7S can generate a hole‐free uniform difference co‐array. The sensor locations of the SA‐7S array are uniquely determined by a closed‐form expression and the number of achievable degrees of freedom is analytically presented as well. Theoretical analysis shows that the SA‐7S can provide a higher number of degrees of freedom than most sparse linear arrays. Simulations are performed to validate the advantage of the proposed array in terms of uDOFs, mutual coupling and direction of arrival estimation performance.

Objective To explore the influence of different teaching strategies on the clinical teaching effect of Eight-year Medical Program students in Endocrinology Department. Methods This study conducted an online questionnaire for evaluation of the teaching quality of training for attending doctors, residents and the effect of small lectures of medical students. Participants were students from 6th-8th grades of Eight-year Program of clinical medicine in Peking Union Medical Colleges Hospital, rotating in the Department of Endocrinology from December 2021 to April 2022. Results Questionnaires were distributed to 48 medical students who had completed the rotation of Endocrinology Department. A total of 40 valid questionnaires were recovered with a recovery rate of 83.3%. The attending doctors and residents in the ward performed well in the daily teaching activities. The busy clinical work was a main factor affecting the teaching quality. Most medical students prepared lectures within 6 hours. In addition to mastering relevant knowledge, lectures also improved the speech ability, literature retrieval ability and slide production ability of students. Conclusions Adopting diverse teaching strategies and organizing various forms of traning activity are conducive to arouse the learning enthusiasm of medical students and comprehensively improve their post competencies.

Objective To review the experience of metabolic evaluation of urinary stones in Peking Union Medical College Hospital, and summarize the ‘PUMCH model’ of metabolic evaluation. Methods With descriptive evaluation method, this study reviewed and analyzed 534 metabolic evaluation cases in the urology department of Peking Union Medical College Hospital from Jan. 2016 to Dec. 2021. The distribution differences of stone patients in gender, medical history, stone shape, stone composition, renal function, systemic metabolism and 24-hour urine metabolism were observed. Results This study found that males were more than females in terms of gender differences in stone patients; The average course of stone disease was about 10 years, and the first symptom was mainly renal colic; Calcium oxalate was the most common stone component; Kidney stone was more than urethral stone; Hyperlipidemia was the most common in patients with stones; The low concentration of urinary citrate was the most significant. Conclusions As a new method of stone diagnosis and treatment, the ‘PUMCH model’ of metabolic evaluation can comprehensively evaluate the patients' stone incidence and systemic metabolic abnormalities, which has a strong guiding role in stone treatment and prevention.

Abstract Background Mild cognitive impairment (MCI) is a transitional state between normal ageing and dementia. Most MCI patients will progress to dementia within 5 years; therefore, early intervention for MCI is important for delaying the occurrence and progression of dementia. Yi Shen Fang (YSF) granules are a promising traditional Chinese medicine (TCM) treatment that shows great neuroprotective potential against cognitive impairment, as evidenced in clinical and basic studies. This trial aims to systematically evaluate the efficacy and safety of YSF granules in elderly people with MCI. Methods This study is a multicentre, randomized, double-blind, parallel-group, controlled trial. Based on the results of previous clinical trials, 280 elderly patients with MCI will be randomly divided into a treatment group (n = 140) and control group (n = 140). The study will last 33 weeks, including 1 week of screening, 8 weeks of intervention, and 24 weeks of follow-up. The primary outcomes will be the changes in Montreal Cognitive Assessment (MoCA) and Memory and Executive Screening (MES) scores before and after the intervention. The secondary outcome measures will be homocysteine (HCY) levels, Functional Assessment Questionnaire (FAQ) scores and event-related potential (ERP) detection in typical cases. The TCM symptom scale is a combined measure of syndrome differentiation and treatment. During this study, the classifications and characteristics of adverse events, the times of occurrence and disappearance, the measures of treatment, their impact on the primary disease, and outcomes will be reported truthfully. Discussion This study will provide valuable clinical evidence that YSF can help to improve the cognitive function of elderly people with MCI, and the results will be disseminated via conferences and publications. Trial registration Chinese Clinical Trial Registry, ChiCTR2000036807. Registered on August 25, 2020.

Abstract Background XPO1 mediates the nuclear export of several proteins, mainly tumor suppressors. KPT‐330 (Selinexor) is a selective inhibitor of XPO1 that has demonstrated good therapeutic effects in hematologic cancers. Methods We used TCGA and GTEx pan‐cancer database to evaluate XPO1 mRNA expression in various tumors. Cell proliferation assay and colony formation assay were used to analyze the in vitro antitumor effects of XPO1 inhibitor KPT‐330. Western blot was performed to explore the specific mechanisms. Results We found that XPO1 was highly expressed across a range of cancers and associated with poor prognosis in hepatobiliary and pancreatic tumors. We revealed that the XPO1 inhibitor KPT‐330 triggered the nuclear accumulation of the p53 protein and significantly disrupted the proliferation of cholangiocarcinoma cells. Mechanistically, the XPO1 inhibitor, KPT‐330, reduced BIRC6 expression by inhibiting the PI3K/AKT pathway to decrease p53 degradation and improve its stability. Conclusion Therefore, XPO1 may be a potential therapeutic target in cholangiocarcinoma, mediated by its effects on KPT‐330.