Explore the vast range of titles available.

IntroductionColorectal cancer (CRC) incidence is increasing, and treating low rectal cancer poses challenges in balancing oncological control with functional preservation. While preoperative chemoradiotherapy (CRT) improves sphincter preservation, anastomotic leakage (AL) remains a major complication. This trial aims to compare the efficacy of modified pull-through procedure versus coloanal anastomosis (CAA) with temporary stoma in low rectal cancer patients following preoperative CRT.Methods and analysisThis is a multicentre, assessor-blinded, randomised controlled trial. A total of 216 patients with low rectal cancer (≤7 cm from the anal verge) after preoperative CRT will be enrolled and randomly assigned (1:1) to undergo either the modified pull-through procedure or CAA with temporary stoma. The primary outcome is the incidence of AL within 1 month. Secondary outcomes include complications (Clavien-Dindo classification), length of hospital stay, anorectal function (LARS score (Low Anterior Resection Syndrome Score)), and quality of life (EQ-5D questionnaire (EuroQol five dimensions questionnaire)). Patients will be followed for 36 months.Ethics and disseminationThe study has obtained ethics approval from the Biomedical Ethics Committee of West China Hospital, Sichuan University (ethics approval ID: 2025-Review-(144)). All centres have obtained local institutional review board approval. Results will be disseminated via academic conferences and peer-reviewed journals to optimise clinical practice for low rectal cancer surgery.Trial registration numberChiCTR2500100246.

To identify the primary concerns and unmet needs of patients with melasma on social media using qualitative analysis and AI-based keyword extraction. We conducted a qualitative study of melasma patient discussions using publicly available posts on Facebook and Baidu. The data were collected between January 2014 and October 2024. ChatGPT-4o was used for keyword extraction and classification. A total of 1106 related posts were analyzed, revealing 284 unique tags and 2434 keywords. Treatment and prevention were the most discussed topics, with patients seeking information on effective, long-term, and affordable treatment. Daily care and mental health accounted for 29.2% of the total, focusing on skincare routines, sun protection, and lifestyle modification. Etiology and clinical features were observed in 14.8% of the posts, whereas 2.4% addressed diagnosis and differentiation. This study identified key concerns of patients with melasma using AI-based keyword extraction and qualitative analysis, highlighting the need for healthcare professionals to engage in digital patient education, clarify misinformation, support patient self-management, and integrate mental health considerations into melasma care. Future research should focus on AI-based interventions to enhance patient engagement and self-management.

Patients with port-wine stain (PWS) and related syndromes often face multifaceted challenges in disease management, including prolonged treatment cycles, appearance-related distress, and psychological burdens. Social media has become an important platform for these individuals to obtain information and share experiences. However, there is a lack of systematic qualitative research exploring their genuine needs. This study analyzes content from social media to identify patients' core concerns during the diagnostic and therapeutic process, providing both theoretical foundations and practical references for developing patient-centered care models. This study systematically analyzed PWS-related posts published between 2010 and 2023 across open social media platforms including Twitter, Facebook, and Baidu. A stratified sampling method was applied, and natural language processing was used to extract keywords and thematic sentences. Through expert review and AI-assisted classification, core patient needs in disease management were qualitatively summarized and categorized. A total of 1528 social media posts were analyzed, yielding 4,190 extracted keywords categorized into six major themes. Treatment-related concerns were the most prominent (30.04%), particularly focusing on treatment choices, side effects, and delayed efficacy. Diagnostic confusion was also frequently mentioned (24.41%). A significant number of posts conveyed emotional distress and a strong desire for shared experiences, with emotional support themes accounting for 4.19%, highlighting their importance. Some patients proactively shared treatment journeys, contributing to a supportive and empathetic community atmosphere. This study distilled key needs from authentic patient expressions and found that beyond clinical diagnosis and treatment, PWS patients also highly value emotional support and anxiety relief regarding relapse. These findings underscore the necessity of building patient-centered care systems that integrate emotional and psychological support while managing treatment expectations. Future studies should combine quantitative research and clinical data to refine variable analyses and develop educational and intervention strategies tailored to real online patient needs.

Digital health interventions (DHIs) are increasingly used in dermatology to improve patients' quality of life (QoL). This systematic review (PROSPERO: CRD420250628076) synthesized 14 studies categorized into four WHO intervention types, including telemedicine, targeted client communication, personal health tracking, and client-to-client communication, and evaluated for their effects on QoL and related psychosocial outcomes. Among telemedicine studies (n = 8), six reported non inferior or superior QoL versus in person care. Targeted client communication (n = 4) showed mixed QoL effects but improved mental health and self efficacy. Personal health tracking (n = 1) did not significantly improve QoL, while client to client communication (n = 1) provided psychosocial support. Overall, DHIs may improve QoL in dermatology, but evidence is limited by methodological heterogeneity, risk of bias, and short follow up. Future evaluations should prioritize standardized core outcome sets and integrate AI with in time adaptive interventions to deliver personalized psychological support, ensuring algorithmic equity from the outset.

The entity model of slope arch framework in highway was monitored in stress and displacement at different time. Though the date of different points collected, the mechanical mechanism can be studied, and the analysis was done between calculation results and entity model. The studying results show that the stress of point were increasing at first and then mitigating, and the stress increase undulating as the distance from the slope top increase. The date of monitor and finite element analysis model indicate that the point on the arch toe is the worst stress place, and the total displacement increase nonlinear as the distance from the slope top increases, and the bump phenomenon exists in the bottom of slope, the points are likely to be broken.

Using system analysis theory and methods, a dynamic model of a water resource supply and demand system was built to simulate trends in the supply and demand of water in the Changsha-Zhuzhou-Xiangtan （Chang-Zhu-Tan） urban agglomeration for the period 2012 to 2030. Four scenarios were examined; namely, a traditional development model, an economic development model, a water-saving model, and a coordinated development model. （i） The problem of balancing water resource supply and demand is becoming increasingly conspicuous with a growing population and a rapidly developing economy. （ii） By 2030, water demand is set to reach a total of 105.1 × 10^8 m^3, with a water supply of 5.4 × 10^8 m^3. A coordinated development model for water resource supply could meet the growing demands of socio-economic development, and generate huge comprehensive benefits. This will be the best solution for the development and utilization of a water resource supply and demand system in the Chang-Zhu-Tan urban agglomeration. （iii） We should accelerate the construction of water conservation projects, strengthen the management of water conservation, optimize economic structures, enhance our awareness of the importance of protecting water resources, hasten the recycling of waste water and environmental improvement, and promote utilization efficiency, and support the capabilities of water resources to meet our expectations.

This study aimed to investigate alterations in whole-brain cortical thickness (CT) and cortical and subcortical gray matter volume (GMV) in patients with Alzheimer's disease (AD) compared with healthy controls (HC) using voxel-based morphometry (VBM) and surface-based morphometry (SBM). Furthermore, we sought to develop a combined predictive model based on these neuroimaging markers and assess their potential clinical utility for the early detection and diagnosis of AD. A total of 42 patients diagnosed with mild-to-moderate AD and 49 demographically matched HC were recruited for this study. VBM and SBM analyses were performed on three-dimensional T1-weighted magnetization-prepared rapid gradient echo (3D T1-MPRAGE) imaging sequences to identify brain regions that exhibited statistically significant differences between the AD and HC groups. Brain regions showing significant group differences were selected as the regions of interest (ROIs). Pearson's correlation analysis was used to assess the relationship between extracted neuroimaging metrics (CT, cortical GMV, and subcortical GMV) and cognitive performance. Predictive models were constructed using CT (from SBM), cortical GMV, and subcortical GMV (from VBM) metrics derived from ROIs, both individually and in combination. Model performance in discriminating between patients with AD and HCs was evaluated using a receiver operating characteristic (ROC) curve analysis. Compared to HCs, patients with AD exhibited significant CT reductions primarily in the transverse temporal gyrus, superior temporal gyrus, supramarginal gyrus, insula, temporal pole, entorhinal cortex, and fusiform gyrus. Significant GMV reductions in patients with AD were observed predominantly in the hippocampus, parahippocampal gyrus, posterior temporal lobe, inferior temporal gyrus, middle temporal gyrus, limbic lobe structures, fusiform gyrus, amygdala, and thalamus, as detected by VBM analysis. Extracted CT, cortical GMV, and subcortical GMV measurements from the ROIs demonstrated significant positive correlations with both MMSE and MoCA scores. In patients with AD, VBM and SBM showed overlapping cortical GMV and CT reductions. Volume/thickness reduction was correlated with lower MMSE/MoCA scores, confirming functional relevance. ROC analysis revealed that combining CT and GMV improved cognitive impairment prediction compared to single measures. This integrated approach may enhance clinical diagnosis and early risk identification of AD.

Endometriosis-associated ovarian cancer (EAOC) is a rare subtype of ovarian cancer arising from the malignant transformation of endometriosis (EMS). Despite growing clinical awareness, its underlying pathogenic mechanisms are not fully understood. Epithelial-mesenchymal transition (EMT) plays a crucial role in the progression of various diseases, but the specific EMT changes in EAOC formation remain unclear. We retrieved transcriptomic data for EAOC and single-cell data for EMS from public databases and systematically analyzed EMT levels, EMT subtypes, and factors inducing EMT in both EMS and EAOC. Immunohistochemistry and Masson staining further validated the EMT and fibrosis levels in both EMS and EAOC. The study found that the overall EMT levels in EAOC were significantly lower than in EMS, primarily due to the reduction in type 2 EMT levels associated with fibrosis. Furthermore, this study indicated that the abundant C7 fibroblasts in EMS lesions might contribute to epithelial cell proliferation and EMT. However, the abundance of C7 fibroblasts was significantly reduced in EAOC, suggesting its potential regulatory role in EMT. We found that, during the progression from EMS to EAOC, the level of type 2 EMT decreased, and we also discovered that C7 fibroblasts could act as potential regulators of EMT. These findings expand our understanding of the malignant transformation of EAOC and provide new insights for the development of new diagnostic and therapeutic strategies.

Background In previous study, we found that the content of medium-chain fatty acid Caprylic Acid (FFA C8:0) may be an important risk factor of obesity induced prostate cancer (PCa). However, the relationship between FFA C8:0 and PCa has not been reported. In this study, we explored whether the FFA C8:0 can promotes the progression of PCa by up-regulating Krüppel-like factor 7 (KLF7). Methods We collected tissues from PCa patients and Benign Prostate Hyperplasia (BPH), constructed a primary-tumor bearing mouse model with obesity through high-fat diet, and observed the tumor formation ability of PCa cells. In vitro, CCK8 assay, plate cloning, Transwell and scratch experiment were used to detect the changes in biological behavior of PCa cells stimulated by FFA C8:0. Results First, we found that the expression level of KLF7 is higher in PCa tissues of patients, and the expression of KLF7 is positively correlated with tumour-promoting gene IL-6, while it is negative correlated with another tumour-suppressor gene p21. Then, this study found that PCa cells were more likely to form tumors in diet induced obese mice. Compared with the normal diet group (ND), the expression levels of KLF7 in tumor tissues in high-fat diet group (HFD) were higher. Futhermore, we verified that high concentrations of FFA C8:0 can promote the biological behavior of PCa cells by activating KLF7/IL-6/p21 signaling pathway, which is mediated by the GPR84. Conclusions Our research may provide a potential target for clinical prevention and treatment of PCa which induced by obesity.

Homologous recombination (HR) repair is an important determinant of chemosensitivity. However, the mechanisms underlying HR regulation remain largely unknown. Cysteine-rich intestinal protein 1 (CRIP1) is a member of the LIM/double-zinc finger protein family and is overexpressed and associated with prognosis in several tumor types. However, to date, the functional role of CRIP1 in cancer biology is poorly understood. Here we found that CRIP1 downregulation causes HR repair deficiency with concomitant increase in cell sensitivity to cisplatin, epirubicin, and the poly ADP-ribose polymerase (PARP) inhibitor olaparib in gastric cancer cells. Mechanistically, upon DNA damage, CRIP1 is deubiquitinated and upregulated by activated AKT signaling. CRIP1, in turn, promotes nuclear enrichment of RAD51, which is a prerequisite step for HR commencement, by stabilizing BRCA2 to counteract FBXO5-targeted RAD51 degradation and by binding to the core domain of RAD51 (RAD51 184–257 ) in coordination with BRCA2, to facilitate nuclear export signal masking interactions between BRCA2 and RAD51. Moreover, through mass spectrometry screening, we found that KPNA4 is at least one of the carriers controlling the nucleo-cytoplasmic distribution of the CRIP1–BRCA2–RAD51 complex in response to chemotherapy. Consistent with these findings, RAD51 inhibitors block the CRIP1-mediated HR process, thereby restoring chemotherapy sensitivity of gastric cancer cells with high CRIP1 expression. Analysis of patient specimens revealed an abnormally high level of CRIP1 expression in GC tissues compared to that in the adjacent normal mucosa and a significant negative association between CRIP1 expression and survival time in patient cohorts with different types of solid tumors undergoing genotoxic treatments. In conclusion, our study suggests an essential function of CRIP1 in promoting HR repair and facilitating gastric cancer cell adaptation to genotoxic therapy.