Probiotic Compounds Enhanced Recovery after Surgery for Patients with Distal Gastric Cancer: A Prospective, Controlled Clinical Trial.

BACKGROUND: Enhanced recovery after surgery (ERAS) for radical distal gastrectomy needs to be improved urgently. We investigated the effects of probiotic compounds (including Lactobacillus plantarum, L. rhamnosus, L. acidophilus, and Bifidobacterium animalis subsp.lactis) on enhance recovery after gastrectomy. METHODS: The patients in this prospective study were divided into probiotic group (PG group, n = 36) and placebo group (CG group, n = 38), taking corresponding capsule according to the protocol during the perioperative period. We compared the trends in perioperative hematologic findings and the postoperative outcomes. Patients' feces were collected for bacterial 16S rRNA sequencing. Patients were followed up at 1 month postoperatively. RESULTS: After the application of probiotics, the patients' postoperative inflammatory response level was reduced, and the trend of postoperative NLR decrease was significantly faster in the patients of the PG group than in the CG group (P = 0.047, partial η2 = 0.054). The trend of postoperative increase in serum albumin concentration in the patients of the PG group was significantly better than that in the CG group (P = 0.016, partial η2 = 0.078). In addition, patients in the PG group met discharge criteria earlier postoperatively and had fewer medical expenses. The quality of life of PG group was improved postoperatively. Postoperative inflammation-related markers, including the ratio of Firmicutes/Bacteroidetes, were increasing in untreated patients. In addition, the postoperative microbial diversity and abundance in the PG group remained stable. CONCLUSIONS: Probiotic compounds can reduce the inflammatory response after gastrectomy and enhance the recovery of the DGC patients by maintaining the stability of the gut microbiota.

Linc-NSC affects cell differentiation, apoptosis and proliferation in mouse neural stem cells and embryonic stem cells in vitro and in vivo.

BACKGROUND: Stem cell therapy is a promising therapeutic strategy. In a previous study, we evaluated tumorigenicity by the stereotactic transplantation of neural stem cells (NSCs) and embryonic stem cells (ESCs) from experimental mice. Twenty-eight days later, there was no evidence of tumor formation or long-term engraftment in the NSCs transplantation group. In contrast, the transplantation of ESCs caused tumor formation; this was due to their high proliferative capacity. Based on transcriptome sequencing, we found that a long intergenic non-coding RNA (named linc-NSC) with unknown structure and function was expressed at 1100-fold higher levels in NSCs than in ESCs. This finding suggested that linc-NSC is negatively correlated with stem cell pluripotency and tumor development, but positively correlated with neurogenesis. In the present study, we investigated the specific role of linc-NSC in NSCs/ESCs in tumor formation and neurogenesis. METHODS: Whole transcriptome profiling by RNA sequencing and bioinformatics was used to predict lncRNAs that are widely associated with enhanced tumorigenicity. The expression of linc-NSC was assessed by quantitative real-time PCR. We also performed a number of in vitro methods, including cell proliferation assays, differentiation assays, immunofluorescence assays, flow cytometry, along with in vivo survival and immunofluorescence assays to investigate the impacts of linc-NSC on tumor formation and neurogenesis in NSCs and ESCs. RESULTS: Following the knockdown of linc-NSC in NSCs, NSCs cultured in vitro and those transplanted into the cortex of mice showed stronger survival ability (P < 0.0001), enhanced proliferation(P < 0.001), and reduced apoptosis (P < 0.05); the opposite results were observed when linc-NSC was overexpressed in ESCs. Furthermore, the overexpression of linc-NSC in ECSs induced enhanced apoptosis (P < 0.001) and differentiation (P < 0.01), inhibited tumorigenesis (P < 0.05) in vivo, and led to a reduction in tumor weight (P < 0.0001). CONCLUSIONS: Our analyses demonstrated that linc-NSC, a promising gene-edited target, may promote the differentiation of mouse NSCs and inhibit tumorigenesis in mouse ESCs. The knockdown of linc-NSC inhibited the apoptosis in NSCs both in vitro and in vivo, and prevented tumor formation, revealing a new dimension into the effect of lncRNA on low survival NSCs and providing a prospective gene manipulation target prior to transplantation. In parallel, the overexpression of linc-NSC induced apoptosis in ESCs both in vitro and in vivo and attenuated the tumorigenicity of ESCs in vivo, but did not completely prevent tumor formation.

3D hydrogel microfibers promote the differentiation of encapsulated neural stem cells and facilitate neuron protection and axon regrowth after complete transactional spinal cord injury.

Spinal cord injury (SCI) can cause permanent impairment to motor or sensory functions. Pre-cultured neural stem cell (NSC) hydrogel scaffolds have emerged as a promising approach to treat SCI by promoting anti-inflammatory effects, axon regrowth, and motor function restoration. Here, in this study, we performed a coaxial extrusion process to fabricate a core-shell hydrogel microfiber with high NSC density in the core portion. Oxidized hyaluronic acid, carboxymethyl chitosan, and matrigel blend were used as a matrix for NSC growth and to facilitate the fabrication process. During thein vitrodifferentiation culture, it was found that NSC microfibers could differentiate into neurons and astrocytes with higher efficiency compared to NSC cultured in petri dishes. Furthermore, duringin vivotransplantation, NSC microfibers were coated with polylactic acid nanosheets by electrospinning for reinforcement. The coated NSC nanofibers exhibited higher anti-inflammatory effect and lesion cavity filling rate compared with the control group. Meanwhile, more neuron- and oligodendrocyte-like cells were visualized at the lesion epicenter. Finally, axon regrowth across the whole lesion site was observed, demonstrating that the microfiber could guide renascent axon regrowth. Experiment results indicate that the NSC microfiber is a promising bioactive treatment for complete SCI treatment with superior outcomes.

Experience of diet in patients with inflammatory bowel disease: A thematic synthesis of qualitative studies.

AIM: To synthesise the dietary expesriences of patients with inflammatory bowel disease by reviewing relevant qualitative studies. BACKGROUND: Diet plays a crucial role in the development and progression of inflammatory bowel disease (IBD). There is no specific diet that can be recommended for all patients. We conducted a synthesis of qualitative studies to gain a comprehensive understanding of the dietary management experience of patients with IBD, aiming to provide better dietary guidance in the future. DESIGN: A qualitative synthesis was conducted following the Thomas and Harden method and reported following the ENTREQ statement. METHODS: Qualitative studies were systematically searched in five electronic databases: PubMed, PsycINFO, Embase, CINAHL, and Web of Science. There was no time limit for publication, and all database searches were up to 10 May, 2023. The Joanna Briggs Institute Qualitative Assessment and Review Instrument was utilised to appraise the quality of the included studies. Data for inclusion in articles were extracted and analysed using a thematic synthesis method. RESULTS: Six studies involving 119 patients were eventually included. The studies were conducted in six different countries. Four major themes were identified: the diet of patients with IBD is completely different from the normal one; manage symptoms and live with the disease by modifying diet; psychological adjustment to eating (be frustrated; worried and afraid; feel ashamed; growth and resilience); barriers and challenges (barriers from perceived social support; conflicts between diet and nutrition; challenges from food hedonism and cravings). CONCLUSIONS: Patients with IBD highlighted the distinction between their diet and the normal diet. Dietary modifications were used as a way to manage symptoms and live with the disease. In addition to physical symptoms, patients experienced diet-related psychological changes. Dietary modifications in patients with IBD encounters difficulties and challenges, necessitating prompt guidance and intervention. (1) The implementation of dietary modifications in patients with IBD encounters numerous obstacles and complexities, necessitating prompt guidance and intervention. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. REGISTRATION: The protocol was registered with PROSPERO (CRD42023391545).

Towards a Real-Life Understanding of the Altered Functional Behaviour of the Default Mode and Salience Network in Chronic Pain: Are People with Chronic Pain Overthinking the Meaning of Their Pain?

Chronic pain is a source of substantial physical and psychological suffering, yet a clear understanding of the pathogenesis of chronic pain is lacking. Repeated studies have reported an altered behaviour of the salience network (SN) and default mode network (DMN) in people with chronic pain, and a majority of these studies report an altered behaviour of the dorsal ventromedial prefrontal cortex (vmPFC) within the anterior DMN. In this topical review, we therefore focus specifically on the role of the dorsal vmPFC in chronic pain to provide an updated perspective on the cortical mechanisms of chronic pain. We suggest that increased activity in the dorsal vmPFC may reflect maladaptive overthinking about the meaning of pain for oneself and one's actions. We also suggest that such overthinking, if negative, may increase the personal "threat" of a given context, as possibly reflected by increased activity in, and functional connectivity to, the anterior insular cortex within the SN.

TREM2 gene induces differentiation of induced pluripotent stem cells into dopaminergic neurons and promotes neuronal repair via TGF-ß activation in 6-OHDA-lesioned mouse model of Parkinson's disease.

OBJECTIVE: Induced pluripotent stem cells (iPSCs) hold a promising potential for rescuing dopaminergic neurons in therapy for Parkinson's disease (PD). This study clarifies a TREM2-dependent mechanism explaining the function of iPSC differentiation in neuronal repair of PD. METHODS: PD-related differentially expressed genes were screened by bioinformatics analyses and their expression was verified using RT-qPCR in nigral tissues of 6-OHDA-lesioned mice. Following ectopic expression and depletion experiments in iPSCs, cell differentiation into dopaminergic neurons as well as the expression of dopaminergic neuronal markers TH and DAT was measured. Stereotaxic injection of 6-OHDA was used to develop a mouse model of PD, which was injected with iPSC suspension overexpressing TREM2 to verify the effect of TREM2 on neuronal repair. RESULTS: TREM2 was poorly expressed in the nigral tissues of 6-OHDA-lesioned mice. In the presence of TREM2 overexpression, the iPSCs showed increased expression of dopaminergic neuronal markers TH and DAT, which facilitated the differentiation of iPSCs into dopaminergic neurons. Mechanistic investigations indicated that TREM2 activated the TGF-ß pathway and induced iPSC differentiation into dopaminergic neurons. In vivo data showed that iPSCs overexpressing TREM2 enhanced neuronal repair in 6-OHDA-lesioned mice. CONCLUSION: This work identifies a mechanistic insight for TREM2-mediated TGF-ß activation in the regulation of neuronal repair in PD and suggests novel strategies for neurodegenerative disorders.

Personalized Multimodal Lifestyle Intervention as the Best-Evidenced Treatment for Chronic Pain: State-of-the-Art Clinical Perspective.

Chronic pain is the most prevalent disease worldwide, leading to substantial disability and socioeconomic burden. Therefore, it can be regarded as a public health disease and major challenge to scientists, clinicians and affected individuals. Behavioral lifestyle factors, such as, physical (in)activity, stress, poor sleep and an unhealthy diet are increasingly recognized as perpetuating factors for chronic pain. Yet, current management options for patients with chronic pain often do not address lifestyle factors in a personalized multimodal fashion. This state-of-the-art clinical perspective aims to address this gap by discussing how clinicians can simultaneously incorporate various lifestyle factors into a personalized multimodal lifestyle intervention for individuals with chronic pain. To do so the available evidence on (multimodal) lifestyle interventions targeting physical (in)activity, stress, sleep and nutritional factors, specifically, was reviewed and synthetized from a clinical point of view. First, advise is provided on how to design a personalized multimodal lifestyle approach for a specific patient. Subsequently, best-evidence recommendations on how to integrate physical (in)activity, stress, sleep and nutritional factors as treatment targets into a personalized multimodal lifestyle approach are outlined. Evidence supporting such a personalized multimodal lifestyle approach is growing, but further studies are needed.

On the Number of Linear Regions of Convolutional Neural Networks with Piecewise Linear Activations.

One fundamental problem in deep learning is understanding the excellent performance of deep Neural Networks (NNs) in practice. An explanation for the superiority of NNs is that they can realize a large family of complicated functions, i.e., they have powerful expressivity. The expressivity of a Neural Network with Piecewise Linear activations (PLNN) can be quantified by the maximal number of linear regions it can separate its input space into. In this paper, we provide several mathematical results needed for studying the linear regions of Convolutional Neural Networks with Piecewise Linear activations (PLCNNs), and use them to derive the maximal and average numbers of linear regions for one-layer PLCNNs. Furthermore, we obtain upper and lower bounds for the number of linear regions of multi-layer PLCNNs. Our results suggest that deeper PLCNNs have more powerful expressivity than shallow PLCNNs, while PLCNNs have more expressivity than fully-connected PLNNs per parameter, in terms of the number of linear regions.

Evaluation of Loquat Jam Quality at Different Cooking Times Based on Physicochemical Parameters, GC-IMS and Intelligent Senses.

The study compared and analyzed the quality of loquat jam with different cooking times through physicochemical parameters, headspace-gas chromatography-ion migration spectroscopy (HS-GC-IMS) and intelligent senses. The results showed that with the prolongation of the cooking time, the color of loquat jam slowly deepened, the energy significantly increased, the adhesiveness, gumminess, hardness and chewiness enhanced, the free amino acid content increased from 22.40 to 65.18 mg/g. The organic acid content increased from 1.64 to 9.82 mg/g. Forty-seven volatile flavor compounds were identified in five types of loquat jam using HS-GC-IMS, among which the relative content of aldehydes was sharply higher than that of other chemical substances, playing an important role in the flavor formation of loquat jam. LJ0, LJ1 and LJ2 had higher aldehyde content, followed by LJ3 and LJ4 had the lowest aldehyde content. The orthogonal partial least squares-discriminant analysis (OPLS-DA) screened 15 marker compounds that could distinguish five types of loquat jam. The E-nose results showed a significant difference in olfactory sense between loquat jam cooked for 100 and 120 min. The E-tongue results corroborated the results of free amino acids (FAAs) and organic acids, indicating that the gustatory sense of loquat jam changed significantly when the cooking time reached 120 min. The results provided a basis for further research on the relationship between the cooking process and quality characteristics of loquat jam.

The Role of the Brain-Derived Neurotrophic Factor in Chronic Pain: Links to Central Sensitization and Neuroinflammation.

Chronic pain is sustained, in part, through the intricate process of central sensitization (CS), marked by maladaptive neuroplasticity and neuronal hyperexcitability within central pain pathways. Accumulating evidence suggests that CS is also driven by neuroinflammation in the peripheral and central nervous system. In any chronic disease, the search for perpetuating factors is crucial in identifying therapeutic targets and developing primary preventive strategies. The brain-derived neurotrophic factor (BDNF) emerges as a critical regulator of synaptic plasticity, serving as both a neurotransmitter and neuromodulator. Mounting evidence supports BDNF's pro-nociceptive role, spanning from its pain-sensitizing capacity across multiple levels of nociceptive pathways to its intricate involvement in CS and neuroinflammation. Moreover, consistently elevated BDNF levels are observed in various chronic pain disorders. To comprehensively understand the profound impact of BDNF in chronic pain, we delve into its key characteristics, focusing on its role in underlying molecular mechanisms contributing to chronic pain. Additionally, we also explore the potential utility of BDNF as an objective biomarker for chronic pain. This discussion encompasses emerging therapeutic approaches aimed at modulating BDNF expression, offering insights into addressing the intricate complexities of chronic pain.

Perturbation diversity certificates robust generalization.

Whilst adversarial training has been proven to be one most effective defending method against adversarial attacks for deep neural networks, it suffers from over-fitting on training adversarial data and thus may not guarantee the robust generalization. This may result from the fact that the conventional adversarial training methods generate adversarial perturbations usually in a supervised way so that the resulting adversarial examples are highly biased towards the decision boundary, leading to an inhomogeneous data distribution. To mitigate this limitation, we propose to generate adversarial examples from a perturbation diversity perspective. Specifically, the generated perturbed samples are not only adversarial but also diverse so as to certify robust generalization and significant robustness improvement through a homogeneous data distribution. We provide theoretical and empirical analysis, establishing a foundation to support the proposed method. As a major contribution, we prove that promoting perturbations diversity can lead to a better robust generalization bound. To verify our methods' effectiveness, we conduct extensive experiments over different datasets (e.g., CIFAR-10, CIFAR-100, SVHN) with different adversarial attacks (e.g., PGD, CW). Experimental results show that our method outperforms other state-of-the-art (e.g., PGD and Feature Scattering) in robust generalization performance.

Messages are Never Propagated Alone: Collaborative Hypergraph Neural Network for Time-Series Forecasting.

This paper delves into the problem of correlated time-series forecasting in practical applications, an area of growing interest in a multitude of fields such as stock price prediction and traffic demand analysis. Current methodologies primarily represent data using conventional graph structures, yet these fail to capture intricate structures with non-pairwise relationships. To address this challenge, we adopt dynamic hypergraphs in this study to better illustrate complex interactions, and introduce a novel hypergraph neural network model named CHNN for correlated time series forecasting. In more detail, CHNN leverages both semantic and topological similarities via an interaction model and hypergraph diffusion process, thereby constructing comprehensive collaborative correlation scores that effectively guide spatial message propagation. In addition, it incorporates short-term temporal information to generate efficient spatio-temporal feature maps. Lastly, a long-term temporal module is proposed to generate future predictions utilizing both temporal attention and a gated recurrent network. Comprehensive experiments conducted on four real-world datasets, i.e., Tiingo, Stocktwits, NYC-Taxi, and Social Network demonstrate that the proposed CHNN markedly outperforms a range of benchmark methods.

Simultaneous determination of spiropidion and its five major metabolites in sweet orange fruit and various processing by-products using ultra-high performance liquid chromatography-tandem mass spectrometry.

The present work reported the application of an ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method for simultaneous analysis of spiropidion and its five major metabolites in sweet orange fruit and by-products throughout the whole industrial juicing process of the orange fruit. The reversed-dispersive solid phase extraction (r-DSPE) with multi-walled carbon nanotubes (MWCNTs) was employed for the extraction and purification. The established method was validated and satisfactory parameters (linearity, trueness, precision, sensitivity, matrix effect and stability) were obtained. And then, the field trial of spiropidion on sweet oranges has been conducted and the effect of commercial juicing processing on the residue of spiropidion and its metabolites was further investigated. The various processing factors (PFs) for washing, juicing, sterilization, concentrating and essential oil collecting were also determined. The final results indicated that washing processing reduced residues by 18.4%; the juicing step allowed a significant decrease of the spiropidion residue by 34.2-70.8%, with PFs value in the range of 0.290-0.658. However, high level of residual spiropidion (ranging from 4.016 to 4.205 mg/kg) was detected in orange essential oil, with PFs value of 17.157. All the above results demonstrated the efficiency of the established method in the routine control analysis of spiropidion residues in sweet orange fruits and their by-products, and will facilitate the further intensive research on its spatial distribution, transfer and degradation during the different processing procedures of the sweet orange fruits.

Lower and upper bounds for numbers of linear regions of graph convolutional networks.

Graph neural networks (GNNs) have become a popular choice for analyzing graph data in the last few years, and characterizing their expressiveness has become an active area of research. One popular measure of expressiveness is the number of linear regions in neural networks with piecewise linear activations. In this paper, we present estimates for the number of linear regions in classic graph convolutional networks (GCNs) with one layer and multiple-layer scenarios and ReLU activation function. We derive an optimal upper bound for the maximum number of linear regions for one-layer GCNs and upper and lower bounds for multi-layer GCNs. Our simulated results suggest that the true maximum number of linear regions is likely closer to our estimated lower bound. These findings indicate that multi-layer GCNs have exponentially greater expressivity than one-layer GCNs per parameter, implying that deeper GCNs are more expressive than their shallow counterparts.

Reactive A1 Astrocyte-Targeted Nucleic Acid Nanoantiepileptic Drug Downregulating Adenosine Kinase to Rescue Endogenous Antiepileptic Pathway.

Resistance to traditional antiepileptic drugs is a major challenge in chronic epilepsy treatment. MicroRNA-based gene therapy is a promising alternative but has demonstrated limited efficacy due to poor blood-brain barrier permeability, cellular uptake, and targeting efficiency. Adenosine is an endogenous antiseizure agent deficient in the epileptic brain due to elevated adenosine kinase (ADK) activity in reactive A1 astrocytes. We designed a nucleic acid nanoantiepileptic drug (tFNA-ADKASO@AS1) based on a tetrahedral framework nucleic acid (tFNA), carrying an antisense oligonucleotide targeting ADK (ADKASO) and A1 astrocyte-targeted peptide (AS1). This tFNA-ADKASO@AS1 construct effectively reduced brain ADK, increased brain adenosine, mitigated aberrant mossy fiber sprouting, and reduced the recurrent spontaneous epileptic spike frequency in a mouse model of chronic temporal lobe epilepsy. Further, the treatment did not induce any neurotoxicity or major organ damage. This work provides proof-of-concept for a novel antiepileptic drug delivery strategy and for endogenous adenosine as a promising target for gene-based modulation.

Whole brain inputs to major descending pathways of the anterior lateral motor cortex.

The anterior lateral motor cortex (ALM) is critical to subsequent correct movements and plays a vital role in predicting specific future movements. Different descending pathways of the ALM are preferentially involved in different roles in movements. However, the circuit function mechanisms of these different pathways may be concealed in the anatomy circuit. Clarifying the anatomy inputs of these pathways should provide some helpful information for elucidating these function mechanisms. Here, we used a retrograde trans-synaptic rabies virus to systematically generate, analyze, and compare whole brain maps of inputs to the thalamus (TH)-, medulla oblongata (Med)-, superior colliculus (SC)-, and pontine nucleus (Pons)-projecting ALM neurons in C57BL/6J mice. Fifty-nine separate regions from nine major brain areas projecting to the descending pathways of the ALM were identified. Brain-wide quantitative analyses revealed identical whole brain input patterns between these descending pathways. Most inputs to the pathways originated from the ipsilateral side of the brain, with most innervations provided by the cortex and TH. The contralateral side of the brain also sent sparse projections, but these were rare, emanating only from the cortex and cerebellum. Nevertheless, the inputs received by TH-, Med-, SC-, and Pons-projecting ALM neurons had different weights, potentially laying an anatomical foundation for understanding the diverse functions of well-defined descending pathways of the ALM. Our findings provide anatomical information to help elucidate the precise connections and diverse functions of the ALM.NEW & NOTEWORTHY Distinct descending pathways of anterior lateral motor cortex (ALM) share common inputs. These inputs are with varied weights. Most inputs were from the ipsilateral side of brain. Preferential inputs were provided by cortex and thalamus (TH).

Simultaneous determination of the nematicide fluensulfone and its two major metabolites in soils by ultra-high performance liquid chromatography-tandem mass spectrometry.

A fast and sensitive method for simultaneously detecting nonfumigant nematicide fluensulfone (FSF) and its two major metabolites [3,4,4-trifluorobut-3-ene-1-sulfonic acid (BSA) and 5­chloro-1,3-thiazole-2-sulfonic acid (TSA)] in different types of agricultural soils (black soil, krasnozem, sierozem) was established and validated through ultra-high performance liquid chromatography-tandem mass spectrometry. The samples were prepared by a modified quick, easy, cheap, effective, rugged, and safe method. The soil samples were firstly extracted with acetonitrile/water (4/1) and then purified with multi-walled carbon nanotubes (MWCNTs). Parameters influencing purification efficiency and recoveries, such as the type and the amount of sorbent were evaluated and compared. The overall average recoveries of three target analytes in soils were in the range of 73.1%-113.9% and the relative standard deviations (including intra-day and inter-day precision) were less than 12.7%. The limit of quantification was 5 µg/kg for all three compounds. The established method was successfully applied to examine the degradation of FSF and the formation of its two major metabolites in three different types of soil, indicating its efficacy in investigating the environmental behavior of FSF in agricultural soil system.

Inhibition of ACSL4 Alleviates Parkinsonism Phenotypes by Reduction of Lipid Reactive Oxygen Species.

Ferroptosis is a programmed cell death pathway that is recently linked to Parkinson's disease (PD), where the key genes and molecules involved are still yet to be defined. Acyl-CoA synthetase long-chain family member 4 (ACSL4) esterifies polyunsaturated fatty acids (PUFAs) which is essential to trigger ferroptosis, and is suggested as a key gene in the pathogenesis of several neurological diseases including ischemic stroke and multiple sclerosis. Here, we report that ACSL4 expression in the substantia nigra (SN) was increased in a 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-treated model of PD and in dopaminergic neurons in PD patients. Knockdown of ACSL4 in the SN protected against dopaminergic neuronal death and motor deficits in the MPTP mice, while inhibition of ACSL4 activity with Triacsin C similarly ameliorated the parkinsonism phenotypes. Similar effects of ACSL4 reduction were observed in cells treated with 1-methyl-4-phenylpyridinium (MPP+) and it specifically prevented the lipid ROS elevation without affecting the mitochondrial ROS changes. These data support ACSL4 as a therapeutic target associated with lipid peroxidation in PD.

Application of the Xi robotic platform for familial adenomatous polyposis with ultra-low rectal cancer: exploration of minimally invasive and refined therapies.

When a familial adenomatous polyposis (FAP) patient's rectal polyp undergoes malignant transformation, the surgeon needs to consider how to balance the quality of surgery with the patient's quality of life. Here, we present a case of robotic surgery in a patient with familial adenomatous polyposis and ultra-low rectal cancer. Fiberoptic colonoscopy found that hundreds of polyp-like bulges were diffusely distributed throughout the colon, and a malignant mass was found at the end of the rectum. The patient underwent total colectomy with abdominoperineal extended radical resection for rectal cancer using the Xi robotic platform. The patient recovered well in the postoperative period. The ileostomy was well used. And the patient was in good health and metastasis free at 9 months postoperatively. We identified total colectomy combined with extended radical rectal resection under the assistance of the da Vinci robot platform is of great benefit to the patient.