In recent years，significant progress has been made in diabetes research both domestically and internationally，new diagnosis and treatment techniques and methods have been constantly emerging，and clinical research evidence has been continuously accumulated and updated. To keep pace with these important developments，the Diabetes Branch of the Chinese Medical Association has actively organized experts to update the China Guidelines for the Prevention and Treatment of Diabetes. This update aims to provide a more comprehensive and scientific guide for diabetes prevention and treatment，greatly promote the standardized and integrated management of diabetes by clinicians，and ensure that patients receive standardized and personalized treatment plans to improve therapeutic outcomes and quality of life.

Over the years，the American Diabetes Association（ADA） has been actively committed to the development and promotion of standards for the diagnosis，treatment，and daily care of diabetes. Since 1989，it has updated the diabetes diagnosis and treatment standards every year，which have become one of the most authoritative guidelines in diabetes and have been recognized and adopted by various countries. On December 10，2024，the 2025 Standards of Care in Diabetes were released，incorporating the latest evidence-based medicine content related to diabetes and its complications and comorbidities. It aims to provide guidance on the diagnosis，treatment，and management of the condition for clinicians，patients and their families，and researchers. This article interprets the major updates from the Standards.

Bladder cancer is the most common malignancy of the urinary system，and its treatment relies on accurate detection and long-term monitoring，which are crucial for improving patient’s prognosis. Currently，cystoscopy is the primary method for diagnosing and monitoring bladder cancer，but its invasive nature poses significant discomfort to patients. Liquid biopsy，which non-invasively detects biomarkers such as DNA，RNA，and proteins in body fluids for information no disease status，has gained increasing attention in recent years for its potential in invasive tumor detection. Liquid biopsy holds promise as a novel approach to diagnosing and monitoring bladder cancer.

Febrile infection-related epilepsy syndrome is an inflammation-related acute encephalopathy that occurs in previously healthy children and adolescents. It is clinically characterized by super-refractory status epilepticus that occurs after a febrile infection and is often associated with poor prognosis. In recent years，with a deeper understanding of this disease，the treatment approaches have shifted to early and timely immunotherapy and comprehensive support on the basis of standardized anti-epileptic seizure treatment. This review comprehensively elaborates the definition，clinical characteristics，auxiliary examinations，pathogenesis，diagnosis and evaluation，treatment，prognosis，and future research directions of febrile infection-related epilepsy syndrome，aiming to enhance understanding and improve prognosis.

Objective To investigate the features and changing trend of choroidal thickness and choroidal vascularity in the macular region of adult patients with myopia by using swept-source optical coherence tomography（SS-OCTA）. Methods A cross-sectional study was conducted among 138 adult patients with myopia（138 right eyes），aged 18-36 years，who attended the outpatient service of Department of Ophthalmology，The First Affiliated Hospital of Chongqing Medical University，from April 2023 to October 2023，and routine ophthalmic examination was performed for all patients，including refractive status and axial length（AL）. According to spherical equivalent （SE），the patients were divided into low myopia group（-3D<SE≤-0.5D），moderate myopia group（-6D<SE≤-3D），and high myopia group （SE≤-6D）. SS-OCTA was used to observe and quantify mean choroidal thickness（MCT），choriocapillaris blood flow area（CBFA），choroidal vessel volume（CVV），and choroidal vessel index（CVI） of the 3 mm×3 mm macular region. MCT and choroidal vascularity parameters were compared between the groups with different degrees of myopia，and their changing trends were analyzed. Results There were significant differences between the groups with different degrees of myopia in MCT，CBFA，CVV，and CVI in the central fovea，the parafovea，and the whole macular region within the 3 mm×3 mm area，which decreased with the increase in the degree of myopia（P<0.01）. After elimination of confounding factors，the partial correlation analysis showed that MCT，CBFA，CVV，and CVI in the whole macular region were positively correlated with SE（r=0.457，0.434，0.395，and 0.401，all P=0.000） and were negatively correlated with AL（r=-0.470，-0.360，-0.465，and -0.468，all P=0.000）. The stepwise linear regression analysis showed that MCT gradually increased with the increase in SE（t=2.459，P=0.015） and CVV（t=8.632，P=0.000）. Conclusion MCT in the macular region shows heterogeneous distribution in adult patients with myopia，and MCT and choroidal vascularity parameters in the macular region decrease with the increase in the degree of myopia，while choroidal vascularity closely affects choroidal thickness. The choroid may be an important biomarker for myopia，and the research findings of this study can help to reveal the association between myopia and the choroid.

Objective To investigate the efficacy and safety of ketogenic diet，anakinra，and tocilizumab in the treatment of febrile infection-related epilepsy syndrome（FIRES） through a meta-analysis. Methods With FIRES，ketogenic diet，anakinra，and tocilizumab as search terms，the databases of PubMed，Embase，Web of Science，the Cochrane Library，Clinicalttrials.gov，CNKI，Wanfang Data，and VIP were searched for related articles published up to December 13，2024. Two reviewers independently screened the articles according to the inclusion and exclusion criteria and assessed the risk of bias of the studies included. Review Manager was used to perform the meta-analysis. Results Among the 549 studies，45 case reports and case series met the inclusion criteria，and there were 45 retrospective studies in total，among which 25，8，and 17 were included in the ketogenic diet group，the tocilizumab group，and the anakinra group，respectively，with 66 patients in the ketogenic diet group，8 in the the tocilizumab group，and 54 in the anakinra group. There were 3 case reports，in which all 3 patients were treated with tocilizumab and anakinra. The meta-analysis showed that in the treatment of FIRES in the acute stage，ketogenic diet，anakinra，and tocilizumab showed a response raet of 68%（95%CI=51%-85%，I²=71%，P<0.01），57%（95%CI=35%-80%，I²=71%，P<0.01），and 100%（95%CI=79%-100%，I²=0%，P=1.00），respectively，with no statistical differences between studies. The survival rate was 96%（95%CI=89%-100%，I²=0%，P=1.00） in the ketogenic diet group，96%（95%CI=89%-100%，I²=0%，P=1.00） in the anakinra group，and 100%（95%CI=80%-100%，I²=0%，P=1.00） in the tocilizumab group. The incidence rate of adverse reactions was 22%（95%CI=7%-37%，I²=81%，P<0.01） in the ketogenic diet group，19%（95%CI=2%-36%，I²=67%，P<0.01） in the anakinra group，and 0%（95%CI=0%-21%，I²=0%，P=1.00） in the tocilizumab group. Conclusion Ketogenic diet，anakinra，and tocilizumab can reduce the frequency of seizures in acute stage of FIRES，and ketogenic diet and anakinra treatment have a relatively high incidence rate of adverse reactions. Hypoglycemia and infection are adverse reactions commonly observed during treatment.

Objective To investigate the association between albumin-corrected anion gap（ACAG） and short- to long-term death outcomes in patients with acute pancreatitis（AP）. Methods This retrospective study was based on the Medical Information Mart for Intensive Care-IV database，and the adult patients who were diagnosed with AP and were admitted to the intensive care unit were enrolled in this study. Cox regression risk analysis，receiver operating characteristic（ROC） curve analysis，Kaplan-Meier survival curve analysis，restricted cubic spline，and subgroup analysis were used to investigate the value of ACAG in predicting the death outcome of AP patients. Results A total of 444 patients were enrolled in this study，and according to the death status of the patients on day 28 after admission，the patients were divided into survival group with 412 patients and death group with 32 patients，with a mortality rate of 7.2% on day 28 after admission. The multivariate Cox regression analysis showed that ACAG was an independent predictive factor for all-cause mortality rate on day 28 after admission in AP patients（hazard ratio［HR］=1.18，95%CI=1.05-1.32），while it was not an independent predictive factor for death outcome on days 90（HR=1.05，95%CI=0.97-1.14） and 180（HR=1.01，95%CI=0.94-1.09） and at 1 year（HR=1.02，95%CI=0.95-1.10）. The ROC curve analysis showed that ACAG had an area under the ROC curve（AUC） of 0.732（95%CI=0.632-0.832） in predicting 28-day death outcome，which was better than that of AG（AUC=0.665，95%CI=0.550-0.781） and serum albumin（Alb）（AUC=0.655，95%CI=0.550-0.761） and was similar to that of Sequential Organ Failure Assessment（SOFA） score（AUC=0.745，95%CI=0.651-0.838）. The ROC curve showed that the optimal cut-off value of ACAG was 21.375. Based on the cut-off value of ACAG of 21.375，the patients were divided into high-value group and normal-value group，and the Kaplan-Meier curve analysis showed that the patients with a high level of ACAG had a significantly higher mortality rate than those with normal ACAG（P<0.001）. The subgroup analysis showed that the results were stable. Conclusion ACAG can be used as an independent predictive factor for all-cause mortality rate on day 28 after admission in AP patients，with a better efficacy than AG and Alb and a similar efficacy to SOFA. However，it is not significantly associated with 90-day，180-day，and 1-year death outcomes in AP patients.

Ubiquitination is one of the ways of post-translational modification in proteins，which performs mainly through seven lysine residues（K6，K11，K27，K29，K33，K48，K63） and one methionine residue（M1） of ubiquitin. It has been found that different ubiquitin linkages play important roles in regulating proteasomal degradation，DNA damage response，and antiviral immunity response. In this review，the roles of different types of ubiquitination modifications in tumorigenesis and viral infection，and the underline molecular mechanisms in recent years are summarized，aiming to provide reference for the functional study of different ubiquitin modification.

Objective To assess the efficacy and safety of a novel domestic single-port robotic surgical system for lobectomy through an animal experiment，and to lay the groundwork for its clinical application. Methods An experimental Large White pig （male，40 kg） was selected to undergo left lower lobectomy and systematic lymph node dissection under the assistance of the SHURUI^® single-port surgical robot. Its feasibility，safety，and efficacy during the perioperative period were evaluated. Results Left lower lobectomy and systematic lymph node dissection were performed successfully with the single-port robotic surgical system with snake-like arms. The total operative time was 115 min，the docking time was 5 min，the operative time inside the chest cavity was 100 min，the time for lobectomy was 85 min，and the time for lymph node dissection was 15 min. The blood loss was about 20 mL. During operation，there was no damage to the lung，pericardium，vessels，or nerves；no conversion to open surgery； no interference or clash between instruments or instance of instruments moving away from the field of vision； no injuries of the vessels，lung，or chest wall caused by blind operation；and no system failure. The pig showed stable vital signs during and after the operation，and recovered well without relevant complications after the surgery. Conclusion The SHURUI^® single-port robotic surgical system is safe and feasible for performing lobectomy in pigs.

Objective To investigate the role of heat shock transcription factor 1（HSF1） in hepatitis B virus X protein（HBx）-driven migration and invasion of hepatocellular carcinoma（HCC） cells，and to preliminarily explore the mechanism of HSF1 mediating HBx-driven HCC progression. Methods 4D label-free quantitative proteomics and Western blot were used to analyze the effect of HBx on HSF1 expression. HBx was overexpressed in the HCC cell lines Huh7 and MHCC97H，and its impact on the mRNA and protein levels and stability of HSF1 was assessed by RT-PCR and Western blot. The Cancer Genome Atlas database was used to analyze the expression of HSF1 in hepatitis B virus（HBV）-associated HCC tissues and its relationship with tumor stage/grade and patient prognosis，and Western blot was used to measure the expression of HSF1 in HBV-associated HCC tissues. HBx was overexpressed in HCC cells，followed by HSF1 knockdown or cell treatment with the HSF1 inhibitor KRIBB11，and Transwell migration and invasion assay，scratch assay，and F-actin staining experiment were performed to analyze the role of HSF1 in HBx-driven HCC cell migration and invasion. GEO and HCMDB datasets were used to identify the downstream target of HSF1，and the role of downstream target c-Myb in HSF1-mediated HBx-driven HCC progression. Results HBx upregulated HSF1 protein levels without significantly affecting its mRNA expression，through enhancing HSF1 protein stability. HSF1 was highly expressed in HBV-associated HCC tissues，and its elevated expression correlated with tumor stage/grade and poor prognosis. HBx overexpression significantly promoted the migration，invasion，wound-healing capacity，and pseudopodia formation capacity of Huh7 and MHCC97H cells，while HSF1 knockdown or KRIBB11 treatment significantly attenuated the HBx-driven migration and invasion of HCC. HSF1 promoted the expression of the metastasis-associated protein c-Myb，and c-Myb overexpression in HSF1-knockdown HCC cells restored the promotive effect of HBx on HCC cell migration and invasion. Conclusion HBx enhances HSF1 protein stability to promote its expression. Upregulation of c-Myb by HSF1 plays a pivotal role in HBx-driven HCC cell migration and invasion. Targeting HSF1 may help to delay the progression of HBV-associated HCC.

Objective To investigate the effect and mechanism of action of human umbilical cord mesenchymal stem cell conditional medium（uMSC-CM） in promoting the healing of combined radiation and wound injury（CRWI）. Methods A total of 42 male C57BL mice were randomly divided into trauma group，CRWI control group，and CRWI treatment group，with 14 mice in each group. A mouse model of skin CRWI was established by whole body irradiation with 4 Gy γ-ray combined with full-thickness skin defect wound with a diameter of 1 cm. The mice in the CRWI treatment group were given intraperitoneal injection of 5 mg/kg uMSC-CM once every other day，while those in the other two groups were given injection of an equal volume of serum-free DMEM medium. Photographs and HE staining were used to assess wound healing；CD31 immunofluorescent staining was used to observe neovascularization；α-SMA immunohistochemical staining was used to observe cell migration；Masson staining was used to evaluate collagen deposition；Ki67 and TUNEL staining were used to measure proliferation and apoptosis；Western blot was used to measure the expression levels of apoptosis-related proteins and PI3K/AKT signaling pathway proteins. Primary skin fibroblasts of mice were divided into control group，irradiation group，and irradiation treatment group. Edu staining and colony formation assay were used to detect cell proliferation；cell scratch assay and Transwell assay were used to detect cell migration；flow cytometry was used to measure cell apoptosis；Western blot was used to measure the expression levels of PI3K/AKT signaling pathway proteins. Results In this study，uMSC-CM significantly promoted the healing of CRWI（P<0.05），and the histological results showed that uMSC-CM could promote angiogenesis，cell migration，and collagen fiber deposition in CRWI. Further analysis showed that uMSC-CM increased cell proliferation and reduced cell apoptosis in CRWI（P<0.05）. Western blot showed that uMSC-CM promoted the protein expression levels of phosphorylated PI3K and phosphorylated AKT（P<0.05）. In vitro cell experiments showed that uMSC-CM promoted the proliferation and migration of mouse dermal fibroblasts and reduced apoptosis after irradiation（P<0.05），and Western blot showed that uMSC-CM promoted the protein expression levels of phosphorylated PI3K and phosphorylated AKT after irradiation（P<0.05）. Conclusion This study shows that uMSC-CM accelerates CRWI wound healing，possibly by activating the PI3K/AKT signaling pathway to promote the proliferation and migration of fibroblasts and inhibit their apoptosis.

Objective To construct a mouse model of house dust mite（HDM）-induced allergic asthma with cognitive impairment. Methods C57 BL/6 mice aged 6-8 weeks were used as the study subjects. HDMs were used intranasally to induce allergic asthma in mice（HDM group）. Simultaneously，a normal saline control group（NS group） and a blank control group（CN group） were established. At week 2 and month 1 of model construction，cognitive ability was tested using Barnes maze；pulmonary function was determined by nebulization with acetyl-β-methylcholine chloride solution，and pathological changes in lung and brain tissues were evaluated using hematoxylin-eosin staining，immunohistochemistry，and Western blotting. Results At week 2，there were no significant differences in the enhanced pause（Penh），inflammatory cell infiltration around the bronchi，time and frequency of mice finding escape boxes，and changes in mature neuronal marker neuronal nuclei antigen（NeuN） and synaptophysin in the brain in the HDM group compared with the CN and NS groups；no neuroinflammation occurred in the brain. At month 1，compared with the CN and NS groups，the HDM group showed a significant increase in Penh and a large amount of inflammatory cell infiltration around the bronchi；the time of mice finding escape boxes significantly increased（F=19.600，P<0.001），and the frequency significantly decreased（F=10.150，P=0.002）；the NeuN-positive area in the hippocampus of mice significantly decreased（F=6.449，P=0.012），and synaptophysin was significantly reduced（F=16.200，P=0.004）；activation of microglial cells and neuroinflammation occurred. Conclusion This study successfully constructed a mouse model of HDM-induced allergic asthma with cognitive impairment，providing a good animal model for exploring the mechanism of cognitive impairment caused by allergic asthma and drug intervention research.

Objective To investigate the value of diameter of pulmonary nodules，radiological indicators，serum tumor markers（CEA，CYFRA21-1，and SCC），and methylation of HOXA7 and SOX17 in circulating tumor DNA（ctDNA） in the early diagnosis of lung cancer. Methods A total of 60 patients with malignant pulmonary nodules and 60 patients with benign pulmonary nodules who were admitted to our hospital from September 2021 to December 2022 were enrolled as lung cancer group and benign nodule group，respectively，and 80 healthy individuals who underwent physical examination in our hospital during the same period of time were enrolled as control group. The three groups were compared in terms of the diameter of nodules，spiculation sign，levels of serum tumor markers，and methylation rates of HOXA7 and SOX17 in plasma ctDNA，and a multivariate regression analysis was performed to identify the independent risk factors for carcinogenesis and establish a predictive model. The receiver operating characteristic（ROC） curve was used to evaluate the diagnostic performance of the model. Results Compared with the benign nodule group and the control group，the lung cancer group had significantly higher diameter of pulmonary nodules，proportion of patients with spiculation sign，CEA，ProGRP，CYFRA21-1，and methylation rates of serum HOXA7，and SOX17，and the lung cancer group had a significantly higher level of SCC than the control group（all P<0.05）. The diameter of pulmonary nodules，spiculation sign，and methylation rates of HOXA7 and SOX17 in serum ctDNA were independent risk factors for malignant pulmonary nodules （P<0.05），and a predictive model was established as Y=e^x/（1+e^x ），where x=-7.233+（0.108×nodule diameter）+（3.860×spiculation sign）+（0.021×HOXA7 methylation rate）+（0.043×SOX17 methylation rate）. The predictive model had an area under the ROC curve （AUC） of 0.981，with a significantly larger AUC than each indicator alone and the Mayo and LCBP models（P<0.05）. Conclusion The diameter of pulmonary nodules，spiculation sign，and methylation rates of HOXA7 and SOX17 in ctDNA have a relatively high value in the early diagnosis of lung cancer，and the predictive model based on these indicators can significantly improve diagnostic performance.

Objective To propose a standardized low-dose computed tomography（LDCT） protocol for lung cancer screening，and to provide guidance for rational and standardized application of LDCT for the detection and diagnosis of pulmonary nodules. Methods The experts from the Chinese Society of Imaging Technology participated in the formulation of technical specifications for LDCT lung cancer screening. This consensus was based on recent advances on LDCT lung cancer screening at home and abroad and the epidemiology of lung cancer in China，covering the applicable scope，scanning parameters，range of radiation dose，and image quality control standards. Results This consensus specifies that the effective dose of LDCT for lung cancer screening should be less than or equal to 1 mSv. According to the body mass index（BMI） of examinees，for small BMI（<18.5 kg/m²），medium BMI（18.5-24.9 kg/m²），and large BMI（≥25 kg/m²），the recommended tube voltages are ≤100 kV，100~120 kV，and 120 kV，respectively，and the recommended tube currents are 20 mAs，30 mAs，and 30 mAs，respectively. The reconstruction kernel is recommended to be standard or medium. Using the vertebral spinous processes as landmarks，the scanning range should be from the upper edge of the T1 spinous process to the lower edge of the T12 spinous process for examinees with BMI ≥21 kg/m² and from the upper edge of the T1 spinous process to the lower edge of the L1 spinous process for those with BMI <21 kg/m². Scanning should be performed using the breath-hold technique at the end of deep inspiration. The recommended image post-processing methods include multi-planar reconstruction，10-mm maximum intensity projection，3 mm minimum intensity projection，and multi-slice volume reconstruction. Conclusion This expert consensus on the whole process of LDCT for lung cancer screening can facilitate homogeneous scanning across different medical institutions，improving the mutual recognition of imaging results.

Objective To investigate the effect of adenosine deaminase acting on RNA 1（ADAR1） on the proliferation，migration，and invasion of liver hepatocellular carcinoma（LIHC） cells. Methods The gene expression profiling interactive analysis website GEPIA was used to obtain the expression level and prognostic value of ADAR1 in LIHC； proteins were extracted from human hepatocellular carcinoma specimens，and Western blot was used to measure the expression level of ADAR1. HepG2 and Huh7 cells were transfected with ADAR1 p150 and p110 overexpression plasmids or small interfering RNAs targeting both ADAR1 p150 and p110，and Western blot and qPCR were used to measure the expression of ADAR1 in cells after transfection. CCK-8 assay was used to observe the effect of ADAR1 on the proliferative ability of hepatocellular carcinoma cells，and scratch assay and Transwell assay were used to observe the effect of ADAR1 on the migration and invasion of LIHC cells. Finally，the DAVID online database was used to analyze the signaling pathways related to ADAR1，and Western blot was used to measure the expression of proteins associated with the signaling pathways. Results The protein expression level of ADAR1 in hepatocellular carcinoma tissue was significantly higher than that in paracancerous tissue，which was consistent with the prediction based on bioinformatics，and the high expression of ADAR1 was associated with the poor prognosis of hepatocellular carcinoma. CCK-8 assay showed that overexpression of ADAR1 promoted the proliferation ability of hepatocellular carcinoma cells（P<0.05），and knockdown of ADAR1 reduced the proliferation ability of hepatocellular carcinoma cells（P<0.05）. Scratch assay and Transwell assay showed that overexpression of ADAR1 significantly promoted the migration and invasion of hepatocellular carcinoma cells（P<0.05），and knockdown of ADAR1 inhibited the migration and invasion abilities of hepatocellular carcinoma cells（P<0.05）. The results of DAVID online analysis showed that ADAR1 was mainly enriched in the Wnt signaling pathway. Western blot showed that overexpression of ADAR1 inhibited the expression of GSK3β and the phosphorylation level of β-catenin，and knockdown of ADAR1 increased the expression of GSK3β and the phosphorylation level of β-catenin. Conclusion The results of this study show that there is a high expression level of ADAR1 in LIHC，which can activate the Wnt/β-catenin signaling pathway and thus promote the proliferation，migration，and invasion of hepatocellular carcinoma.

Objective To investigate the important clinical features and prognosis of febrile infection-related epilepsy syndrome （FIRES）. Methods A retrospective analysis was performed for the data of 15 children with FIRES who were hospitalized and treated in Peking University First Hospital from March 2022 to June 2024，including clinical features，treatment regimens，and prognosis，and follow-up was performed by telephone. Results The median duration of status epilepticus was 15 days for all children. Of all 15 children，14（93.3%） were comorbid with disturbance of consciousness，8（53.3%） were comorbid with respiratory failure and underwent endotracheal incubation，and 13（86.7%） had been admitted to the intensive care unit. In the acute stage，7 children underwent the examination of various inflammatory factors in blood and cerebrospinal fluid，including interleukin（IL）-1β，IL-2，IL-4，IL-5，IL-6，IL-8，IL-10，and tumor necrosis factor-α，and all 7 children had significant increases in the levels of inflammatory factors in cerebrospinal fluid，which were significantly higher than the levels of inflammatory factors in serum. Of all 15 children，12（80%） had diffuse slow wave changes on electroencephalography，and migrating focal seizures were detected in 7 children（46.7%）. Cranial magnetic resonance imaging（MRI） manifestations in the acute stage included temporal and insular cortical edema（60%），abnormal white matter signal（33.3%），and claustrum sign（13.3%），and MRI features in the chronic stage included the deepening of cerebral sulci（75%） and ventricular dilatation（33.3%）. The treatment in the acute stage included intravenous drip of gamma-globulin and high-dose methylprednisolone in 15 children（effective in 2 children），ketogenic diet in 4 children （effective in 1 child），tocilizumab in 5 children（effective in 3 children），and anakinra in 2 children（effective in 1 child）. As of the last follow-up，the median duration of disease was 14.0 months（4-65 months） for all patients，and only 2 children achieved complete seizure control，while the remaining 13 children had refractory epilepsy. Cognitive impairment was observed in 93.3% of the children. Conclusion FIRES often has acute and severe conditions，and first-line immunotherapies often have a poor therapeutic effect. Tocilizumab and anakinra may be effective in some patients with seizures in the acute stage.

Lidocaine，as an amide local anesthetic，is widely used in cancer patients in the perioperative period. This article summarizes the effect of lidocaine on cell proliferation，invasion，and metastasis of common tumors in clinical practice based on both basic and clinical studies，including breast cancer，gastric cancer，colon cancer，and lung cancer，and it also reviews the clinical application of lidocaine in the perioperative treatment of patients with these four types of cancer. It is necessary to explore the mechanism of action of lidocaine in various types of cancer，develop individualized administration regimens based on the treatment characteristics of different tumors，and optimize perioperative treatment strategies for cancer patients through novel formulations，which may provide a theoretical basis for lidocaine in assisting tumor therapy in the perioperative period.

Osteoporosis is a systemic metabolic bone disease，which can cause decreased bone density，bone microstructure destruction，and decreased bone strength，thus increasing the risk of fracture. With the aging of China’s population，an increasing number of patients are suffering from osteoporosis. This condition and its related complications continue to affect patients’ daily activities and reduce their quality of life. In recent years，global researchers have conducted increasingly in-depth research on this disease，leading to progress in its pathogenesis and clinical diagnosis and treatment. Literature search revealed that chronic liver and kidney dysfunction，alcohol consumption，and endocrine dysfunction can affect the development of osteoporosis by influencing bone metabolism. The Wnt signaling pathway，bone growth factor related signaling pathway，and RANKL/RANK/OPG signaling pathway are the key signaling pathways affecting the development of osteoporosis. Moreover，bisphosphonates and denosumab are commonly used drugs in the clinical treatment of osteoporosis. For individuals at high risk of osteoporotic fractures，bone-forming agents such as teriparatide and romosozumab can be considered. A rational sequence of drug therapy can help enhance the effectiveness of osteoporosis treatment. In this article，we will review the above advances to raise the awareness of clinicians and society about this disease，and help clinicians make better treatment decisions.

Objective To establish a mouse model of spinal cord injury （SCI），and to investigate the effect of electroacupuncture（EA） intervention on cell apoptosis after acute SCI and its mechanism. Methods Female C57BL/6 mice were used to establish a model of SCI，and after successful modeling，the mice were randomly divided into SCI group，EA group，and Rosiglitazone group（R group）；a sham-operation group（Sham group） was also established. After successful modeling，the mice in the EA group were given EA at bilateral Jiaji points and Zusanli once a day for 14 days，those in the R group were given intraperitoneal injection of the PPARγ agonist Rosiglitazone（5 mg/kg），and those in the Sham group and the SCI group were not given any specific treatment. BMS score was used to assess motor function；HE staining and immunofluorescence assay were used to observe pathological changes after SCI；RNA-Seq and TMT/iTRAQ techniques were used to identify the targets and mechanisms of EA；Western blot was used to measure the protein expression levels of PPARγ，CD36，Hba-a1，Hbb-bt，and caspase-3. Results Compared with the SCI group，the EA group and the R group had improvements in hindlimb motor function，tissue structure，and the number of surviving cells. The EA group and the R group had a significant reduction in the expression of caspase-3 and significant increases in the expression of PPARγ and CD36，and the EA group had significant reductions in the expression of Hba-a1 and Hbb-bt. In addition，RNA-Seq and TMT/iTRAQ techniques，significant analysis，Venn analysis，and dual-omics analysis identified Hba-a1 and Hbb-bt as the target genes of EA. The KEGG pathway enrichment analysis showed that EA had a significant effect on the PPAR signaling pathway. Conclusion By regulating the PPARγ-CD36 signaling pathway，EA can promote the clearance of Hba-a1 and Hbb-bt after SCI，reduce the expression level of caspase-3，alleviate cell apoptosis，and facilitate the recovery of spinal cord nerve function.

Objective Malnutrition is prevalent among patients with chronic obstructive pulmonary disease（COPD） and closely associated with adverse outcomes. This study aimed to evaluate the effectiveness of three nutritional indices in predicting all-cause mortality among COPD patients. Methods Based on the National Health and Nutrition Examination Survey（NHANES），this study included 1640 patients with COPD surveyed from 1999 to 2018. The optimal cutoff values for controlling nutritional status（CONUT） score，geriatric nutritional risk index（GNRI），and prognostic nutritional index（PNI） were determined using receiver operating characteristic curves. The predictive value of these nutritional indices was assessed using the area under the receiver operating characteristic curve and C-index. Their predictive abilities were compared using the net reclassification improvement and integrated discrimination improvement. A Cox regression analysis was conducted to explore the association of the three nutritional indices with all-cause mortality. Results Log-rank tests revealed lower overall survival rates in patients with higher nutritional risks（P<0.001）. In multivariate Cox regression adjusting for all covariates，CONUT score（hazard ratio ［HR］=1.31，95%CI=1.03-1.67，P=0.030），GNRI（HR=2.02，95%CI=1.26-3.24，P=0.004），and PNI（HR=2.05，95%CI=1.53-2.75，P<0.001） were independently associated with all-cause mortality. Conclusion This study confirms that the three nutritional indices are effective predictors of all-cause mortality in COPD patients. Compared with PNI，CONUT score and GNRI demonstrate improved predictive abilities，and they are recommended for routine screening for high-risk malnutrition in COPD patients.

Minimally invasive liver surgery has a marked clinical effect on specific cases and is currently considered an alternative to open surgery. Compared with open surgery，laparoscopy can improve perioperative outcomes and provide equivalent oncological outcomes. Nevertheless，open surgery is still performed in certain cases due to the reasons such as the deep location of the tumor and the difficulty in exposing the liver and controlling bleeding. Robotic surgery brings new development to minimally invasive surgery with its advantages of three-dimensional image and wrist-mounted instruments. Overall，current evidence suggests that robotic surgery is safe and feasible in liver surgery，with considerable short- and long-term oncological outcomes. Since robotic surgery is a relatively new technique，there are few large-scale high-quality studies. The studies published in this area mainly include retrospective reviews and case-control studies，and large-scale randomized prospective studies are needed to further support its application in clinical practice.

Objective To investigate the genetic heterogeneity of multiple myeloma（MM） and the important regulatory role of immune cells in its pathophysiology by using bioinformatics techniques. Methods The datasets of GSE125364 and GSE72213 associated with MM were obtained from the gene expression omnibus database of National Center for Biotechnology Information，and bioinformatics and machine learning methods were used to identify the key genes for the diagnosis of MM. Pathways associated with the differentially expressed genes in MM were analyzed to calculate immune cell infiltration，and molecular biology experiments were used for validation. Results In this study，a total of 410 differentially expressed genes were obtained by the bioinformatics methods based on the gene microarray data of MM from public databases，among which 259 were downregulated and 151 were upregulated in MM patients compared with controls. The gene ontology enrichment analysis showed that the differentially expressed genes were mainly involved in the biological processes such as DNA replication，chromosome segregation，and mitosis； as for cellular localization，they were mainly enriched in chromosomal region and the spindle apparatus； as for molecular function，they were mainly enriched in single-stranded DNA helicase activity，DNA catalysis，and ATP-dependent activity. The KEGG pathway enrichment analysis showed that the main signaling pathways included cell cycle，the p53 signaling pathway，cellular senescence，and DNA replication. The GSEA analysis showed that in the control group，the genes were mainly enriched in cell cycle，DNA replication，purine metabolism，and ribosomes，while in the MM group，the genes were mainly enriched in the adipokine signaling pathway，cell adhesion molecules，ribonucleic acid polymerase，and ascorbate and aldarate metabolism pathways. Two genes，CPXM1 and UROD，were obtained for the diagnosis of MM by support vector machine-recursive feature elimination algorithm，and the immune infiltration analysis via CIBERSORTx showed that CPXM1 and UROD were associated with immune infiltration； qRT-PCR validation was performed in MM.1S cells （P<0.05）. Conclusion Bioinformatics methods can be used to effectively analyze the differentially expressed genes between MM patients and the normal control population，and the key genes CPXM1 and UROD are obtained for the diagnosis of MM and are associated with immune infiltration，which can be used as new targets for subsequent basic and clinical experimental studies on MM.

Objective To investigate the prognostic value of serum chloride ion concentration in critically ill or clinically stable patients with decompensated cirrhosis. Methods A retrospective study was conducted among the patients with decompensated cirrhosis who attended the intensive care unit （ICU） and Department of Gastroenterology， The First Hospital of Lanzhou University， from January 2017 to January 2022，and the patients were divided into ICU cohort and Gastroenterology cohort. The outcome event for the ICU cohort was in-hospital death. A logistic regression analysis was used to investigate the association between serum chloride levels and ICU mortality rate； the receiver operating characteristic（ROC） curve was plotted and the area under the ROC curve（AUC） was calculated to assess the value of blood chloride level in predicting ICU mortality rate. The patients in the Gastroenterology cohort were followed up with the outcome event of all-cause mortality rate， and the Cox regression analysis and the Kaplan-Meier analysis were used to investigate the value of blood chloride level in predicting mortality rate. Results In the ICU cohort， serum chloride ion was significantly associated with in-hospital mortality in the ICU（odds ratio=0.934， 95%CI=0.871-0.993，P=0.035），and blood chlorine had an AUC of 0.687 in predicting in-hospital mortality in the ICU. In the Gastroenterology cohort， serum chloride ion concentration was significantly associated with mortality rate in the subgroup with a Child-Pugh score of <10 （hazard ratio=0.906，95%CI=0.822-0.997，P=0.043）， and hypochloremia was associated with a lower survival rate. Conclusion Hypochloremia is associated with the increase in mortality rate in patients with decompensated cirrhosis.

Objective To establish a nomogram prediction model for bronchopulmonary dysplasia（BPD） in infants with neonatal respiratory distress syndrome（NRDS），and to investigate its application value. Methods A total of 378 infants with NRDS who were admitted to The First Affiliated Hospital of Gannan Medical University from September 2019 to June 2023 were enrolled，and according to the presence or absence of BPD，they were divided into NRDS group with 271 infants and NRDS+BPD group with 107 infants. The high-risk factors associated with BPD in infants with NRDS were selected，and a least absolute shrinkage and selection operator regression analysis was used to optimize the indicators in the risk prediction model for BPD. Finally four indicators highly associated with BPD in infants with NRDS were obtained，i.e.，gestational age，birth weight，duration of continuous positive airway pressure（CPAP），and duration of invasive mechanical ventilation（IMV），which were included in the multivariate logistic regression analysis to establish a nomogram model for predicting the risk of BPD in infants with NRDS using R software. The Bootstrap method was used for internal validation of the nomogram model； the receiver operating characteristic curve（ROC） curve was used to evaluate the discriminatory ability of the model，and the calibration curve was used to assess its accuracy in prediction. Results The logistic regression analysis showed that birth weight（odds ratio［OR］=0.998，95%CI=0.997-0.999，P<0.05），duration of CPAP（OR=1.128，95%CI=1.093-1.164，P<0.05），and duration of IMV（OR=1.121，95%CI=1.056-1.090，P<0.05） were independent risk factors for BPD in infants with NRDS. The ROC curve and the calibration curve were plotted，and the results showed that the model had an area under the ROC curve（AUC） of 0.906（95%CI=0.877-0.938）. The Bootstrap method was used to perform 1000 times of resampling for internal validation，and the results showed an AUC of 0.904（95%CI=0.807-1.000）. The calibration curve showed good consistency in this study. Conclusion Birth weight，duration of CPAP，and duration of IMV are independent risk factors for BPD in infants with NRDS based on the multivariate logistic regression analysis，and a nomogram model is successfully established for predicting the risk of BPD in infants with NRDS.

Objective To identify novel MicroRNA biomarkers of intervertebral disc degeneration（IDD） and related pain symptoms，and to explore the underlying molecular mechanisms. Methods Genome-wide association studies（GWAS） data for MicroRNAs，back pain，and sciatica were obtained from a published article and the GWAS Catlog database. IDD-associated MicroRNA and mRNA expression data were downloaded from the GEO database. Key MicroRNAs were identified using Mendelian randomization and bioinformatics analyses. The biological functions of their target genes were explored based on the GeneMANIA database. Results Mendelian randomization analysis showed that has-miR-204-5p had significant causal effects with both back pain（GCST90018797，OR=0.9761） and sciatica（GCST90044614，OR=0.8957）. Moreover，bioinformatics analysis revealed that has-miR-204-5p was significantly less expressed in IDD tissues，and its three target genes（COL3A1，RPLP1，and TCF4） were abnormally highly expressed in IDD tissues. In addition，biological function enrichment analysis revealed that the three target genes were mainly enriched in biological functions closely related to IDD，such as collagen，ribosome，and the Wnt signaling pathway. Conclusion Has-miR-204-5p is a reliable IDD biomarker that plays an important role in IDD and associated pain symptoms.

Objective To investigate the correlation between upper limb grip strength and total body bone mineral density （BMD） using public data. Methods During the 2011-2012 and 2013-2014 cycles of National Health and Nutrition Examination Surveys，a total of 5148 participants with grip strength，BMD，and multiple potential confounding factors were identified，and baseline levels were calculated after weighting. R language survey package was used for the multiple linear regression analysis to investigate the correlation between grip strength and BMD，and then stratified analysis was performed based on sex and age. The rcssci package was used for curve fitting to analyze the curve relationship between the two indicators. Results A total of 5 148 participants（2 493 male participants and 2 655 female participants） were included in this study. The overall grip strength was （77.48±0.40） kg，with a value of （93.98±0.45） kg for male participants and （59.71±0.24） kg for female participants； overall left upper limb grip strength was （37.75±0.21） kg，with a value of （28.89±0.12） kg for female participants and （45.98±0.24） kg for male participants； overall right upper limb grip strength was （39.73±0.20） kg，with a value of （30.83±0.13） kg for female participants and （48.00±0.23） kg in male participants. Overall left grip strength values of body mass index was 46.87±0.33，with a value of 53.65±0.46 for male participants and 39.56±0.26 for female participants（P<0.000 1）； overall right grip strength values of body mass index was 49.37±0.33，with a value of 56.01±0.47 for male participants and 42.21±0.26 for female participants； overall mean grip strength index was 48.12±0.33，with a value of 54.83±0.46 for male participants and 40.89±0.26 for female participants； overall BMD was （1.11±0.00） g/cm²，with a value of （1.15±0.00） g/cm² in male participants and （1.08±0.00） g/cm² in female participants. After exclusion of confounding factors，grip strength showed a significant positive correlation with total BMD（P<0.000 1），and in addition，age was negatively correlated with BMD. Black race（with Mexican descent as reference），college graduation or above（with the participants not graduated from high school as reference），body height，and body mass index（BMI） were positively correlated with BMD. Stratified analysis showed that age，sex，and BMI had interaction with BMD. The curve fitting results showed that there was only a linear relationship between grip strength and BMD（P<0.001），but there was an L-shaped curve relationship between grip strength index（mainly of the left side） and BMD. With the increases in grip strength and grip strength index，BMD increased in a linear and L-shaped curve（BMD increased slowly with the increase in grip strength index），with a variation range of 0.1 g/cm². Conclusion Grip strength of both upper limbs and grip strength index（mainly of the left side） are positively correlated with BMD，and BMD shows a linear relationship with grip strength and an L-shaped curve relationship with grip strength index. The results of this study further support the correlation between grip strength and BMD and provide important empirical data for understanding the impact of grip strength on BMD，which has important significance for further research on the regulatory mechanism of BMD and the prevention and treatment of osteoporosis.

Objective To investigate the flow cytometry cell sorting regimen for M1 macrophages and the association between M1 macrophage polarization and nonalcoholic fatty liver disease（NAFLD）. Methods High-fat diet（HFD） was used to establish a mouse model of NAFLD. Twelve C57BL/6 mice were randomly divided into control group（normal diet） and HFD group using a random number table and were fed for 24 weeks. Metabolic markers including blood glucose and blood lipids were measured；quantitative real-time PCR was used to measure the factors associated with M1 macrophages in mice；HE staining was used to observe liver pathology. The Percoll gradient centrifugation method was used to collect liver Kupffer cells，and flow cytometry was used to measure M1 macrophages in mouse liver（sorting regimen：FSC-A/SSC-A for grouping and removing red blood cells and impurities in the liver；FITC CD45（+）/PE-cy7 CD11c^low for grouping leukocytes；APC CD115（+）/Percp cy5.5 CD11b^high for the screening of monocytes；Apc-cy7 F4/80^low/PE Ly-6C^high for separating M1 macrophages）. Results Compared with the control group at week 24，the HFD group had significant increases in the indicators of body weight [（28.35±1.71） g vs. （38.43±4.41） g，P<0.001），liver weight [（1.03±0.18） g vs. （1.85±0.41） g，P=0.003），fasting blood glucose [（10.23±1.58） mmol/L vs. （7.07±0.58） mmol/L，P˂0.001）]，insulin [（18.62±3.84） pg/mL vs. （28.84±8.3） pg/mL，P˂0.001）]，triglyceride [（2.97±0.67） mmol/L vs. （4.05±0.99） mmol/L，P=0.01）]，cholesterol[（0.23±0.06） mmol/L vs. （0.55±0.17） mmol/L，P<0.001）]，alanine aminotransferase [5.67（3.16，9.23） U/L vs. 35.86（19.68，58.33） U/L，P=0.003]，and aspartate aminotransferase [53.14（38.18，64.40） U/L vs. 155.10 （113.60，192.20） U/L，P<0.001]，and there was a significant increase in M1 macrophage polarization in NAFLD mice [42.00%（26.50，45.50） vs. 9.95%（3.1，12），P=0.003]. There were significant increases in the mRNA levels of IL-β，IL-6，F4/80，and TNF-α in the liver of mice induced by HFD. Conclusion The flow cytometry sorting regimen can be used to measure M1 macrophages in the liver. Significant aggravation of inflammatory response is observed in NAFLD，and M1 macrophage polarization is positively correlated with the onset of NAFLD.

Objective To investigate the phenomenon of hippocampal ferroptosis and its change in a rat model of chronic constriction injury（CCI） of the sciatic nerve，as well as the association between hippocampal ferroptosis and emotional disorders induced by neuropathic pain. Methods A total of 32 male Sprague-Dawley rats were randomly divided into Sham group，CCI group，CCI+F group，and CCI+E group，with 8 rats in each group. The rats in the CCI+F group and the CCI+E group were given intraperitoneal injection of Ferrostatin-1（10 mg/kg） and Erastin（10 mg/kg），respectively，since day 7 after surgery for two consecutive days. Mechanical withdrawal threshold（MWT），paw withdrawal latency（PWL），and open field test（OFT） were measured before surgery and on days 7 and 14 after surgery. On day 14 after surgery，the rats were sacrificed to collect hippocampal tissue；Western blot was used to measure the levels of GPX4，xCT，and FTH1；related kits were used to measure the expression levels of MDA and GSH；HE staining，Nissl staining，and immunofluorescent staining were performed；transmission electron microscopy was used to observe the structural changes of the mitochondria. Results In terms of behavioristics，compared with the Sham group，the CCI group had significant reductions in MWT and PWL on day 7 after surgery（P<0.001），with further reductions from day 7 to day 14 after surgery（P<0.001）；compared with the CCI group，the CCI+F group had significant increases in MWT and PWL on day 14 after surgery（P<0.001），and the CCI+E group had no significant change in MWT and a significant reduction in PWL（P<0.01）. In terms of the OFT test，compared with the Sham group，the CCI group had significant reductions in total distance and number of central squares crossed （P<0.001） and a significant increase in immobility time（P<0.001）；compared with the CCI group，the CCI+F group had significant increases in total distance and number of central squares crossed and a significant reduction in immobility time，while the CCI+E group had no significant changes in these indices. In terms of biochemical results，compared with the Sham group，the CCI group had significant reductions in GPX4，xCT，and FTH1（P<0.01），a significant increase in MDA，and a significant reduction in GSH；compared with the CCI group，the CCI+F group had significant increases in GPX4，xCT，and FTH1（P<0.05），a significant reduction in MDA（P<0.001），and a significant increase in GSH（P<0.01），and the CCI+E group had significant reductions in xCT and FTH1，with no significant changes in MDA and GSH. In terms of morphology，compared with the Sham group，the CCI group had damage and necrosis of hippocampal neurons，significant reductions in Nissl bodies and c-Fos level（P<0.05），and significantly damaged mitochondrial cristae on day 14 after surgery；compared with the CCI group，the CCI+F group had intact structures of hippocampal neurons，significant increases in Nissl bodies and c-Fos（P<0.05），and relatively intact mitochondria，while there were no significant differences in c-Fos and Nissl bodies between the CCI+E group and the CCI group. The pairwise linear correlation analysis of PWL，MWT，GPX4，OFT，and c-Fos on day 14 after surgery showed a significantly positive correlation between any two indicators（P<0.01）. Conclusion Peripheral nerve injury triggers ferroptosis in the hippocampus and causes anxiety and depression，thereby aggravating ferroptosis and accelerating the development of central hyperalgesia.

Objective To investigate the cytometric bead array（CBA） method in measuring the expression levels of human cytokine profiles in patients with sepsis，and to explore the clinical application value of different cytokines in the early diagnosis of sepsis and the prediction of mortality risk. Methods This study was conducted among 256 sepsis patients admitted to the intensive care unit （ICU），99 healthy individuals who underwent physical examination，and 99 non-sepsis patients admitted to the ICU，and the CBA method was used to measure the plasma levels of interleukin-2（IL-2），interleukin-4 （IL-4），interleukin-6（IL-6），interleukin-10 （IL-10），tumor necrosis factor-α（TNF-α），and interferon gamma（IFN-γ）. The Spearman and Mantel tests in R language were used for the routine correlation analysis and the correlation analysis between indicator sets，and the receiver operating characteristic（ROC） curve was plotted to assess the application value of each cytokine in the human cytokine profile in the early diagnosis of sepsis patients and the prediction of mortality risk. Results The sepsis patients had significantly higher plasma levels of IL-6 and IL-10 in the human cytokine profile than the healthy controls and the non-sepsis patients admitted to the ICU. IL-6 had an area under the ROC curve（AUC） of 0.868（95%CI=0.835-0.901，P<0.000 1） in the early diagnosis of sepsis，while IL-10 had an AUC of 0.831（95%CI= 0.793-0.869，P<0.000 1）. The correlation analysis of the indicator sets using the Mantel test showed a significant correlation between IL-6 and C-reactive protein in the sepsis mortality group（r=0.101，P=0.001），as well as a significant correlation between IL-10 and neutrophil count（r=0.132，P=0.001）. All cytokines in the human cytokine profile had an AUC of <0.70 in predicting 28-day mortality rate. Conclusion Human cytokines measured by the CBA method have varying degrees of efficacy in the early diagnosis of sepsis. While IL-6 and IL-10 can offer valuable evidence for the early clinical diagnosis of sepsis，they have comparable efficacy to other cytokines in predicting mortality risk

Multiplex single-cell proteomics technology has become a hot topic in biomedical research，among which imaging mass cytometry（IMC） completely solves the serious problem of cross-color between fluorophores and makes up for the lack of tissue spatial information in single-cell sequencing technology. This technique can label dozens of targets simultaneously on a single tissue section，obtain their expression levels and cell localization at the single-cell level，perform in-depth cell phenotypic in situ analysis，and visually depict single-cell proteome maps from the temporal and spatial levels，and due to its unique technical advantages，it has become a powerful tool in the field of tumor research. This article elaborates on the technical principle of IMC and summarizes the advances in the application of IMC in cell phenotype identification，biomarker detection，tumor immunomodulatory determination，tumor heterogeneity differentiation，clinical prognosis guidance，and response prediction by analyzing recent cases，so as to promote the further integration of tumor spatial omics with existing technologies.

Objective To investigate the feasibility of improving quality of life through outcome self-reporting and clinical intervention based on the Ureteral Stent Symptom Questionnaire（USSQ） for patients with upper tract urolithiasis. Methods We enrolled 106 patients with upper urinary tract calculi from June 2023 to June 2024 who underwent ureteral stent placement at The First Affiliated Hospital of Chongqing Medical University. We applied the USSQ to monitor the patients’ outcomes through their self-reports，and used the data to inform clinical interventions. The feasibility of this USSQ-based approach for improving patients’ quality of life was evaluated. Results The main symptoms after ureteral stent placement were pain and hematuria，while frequency，urgency，fever，and sexual problems were less common. The USSQ score was highest on the third day after operation，and thereafter declined in all the dimensions. except the additional problem. After intervention，the total USSQ score （57.5±10.1 vs. 51.6±8.9，t=2.981，P=0.004） and urinary symptom score （30.8±5.3 vs. 26.7±5.6，t=3.478，P<0.001） were significantly decreased. USSQ-based outcome self-reporting and clinical intervention could reduce symptom scores and improve patients’ quality of life. Conclusion USSQ-based outcome monitoring and management are feasible and effective for improving the quality of life of patients with upper tract urolithiasis.

Objective To investigate the effects of Codonopsis pilosula polysaccharide on the proliferation and cell cycle progression of human keloid fibroblasts，and the possible molecular mechanisms. Methods The 3-（4，5-Dimethylthazol-2-yl）-2，5-diphenyltetrazolium bromide assay was used to determine the effect of C. pilosula polysaccharide on cell survival rate and select the concentration of C. pilosula polysaccharide. The clone-forming ability of keloid fibroblasts was determined by plate cloning experiment. The cell cycle distribution and apoptosis were determined by flow cytometry. Western blot was used to analyze proliferating cell nuclear antigen，cyclin D1，collagen I，collagen Ⅲ，and the phosphorylation levels of phosphatidylinositol 3-kinase and protein kinase B. Results When the concentration of C. pilosula polysaccharide was less than 80 μmol/L，there was no obvious toxic effect on keloid fibroblasts. In this experiment，C. pilosula polysaccharide was added at the concentrations of 10，20，and 40 μmol/L. Compared with the 0 μmol/L group，the clone-forming ability of keloid fibroblasts decreased in the 10，20，and 40 μmol/L groups； cell cycle was arrested at the G₀/G₁ phase； the expression of proliferating cell nuclear antigen，cyclin D1，collagen Ⅰ，and collagen Ⅲ was down-regulated； cell apoptosis was increased； the phosphorylation levels of PI3K and AKT decreased （P<0.05）. Conclusion Codonopsispilosula polysaccharide can inhibit the proliferation and cell cycle progression of keloid fibroblasts，and the molecular mechanisms may be related to the inhibition of the PI3K/AKT signal pathway.

Objective To establish lung adenocarcinoma cell lines with stable knockdown of the expression of encoding Misshapen/NIK-related kinase（MINK1）and analyze the effects of stable MINK1 knockdown on cell proliferation，migration，and cisplatin treatment. Methods In lung adenocarcinoma A549 and PC-9 cells，cell lines with stable MINK1 knockdown were constructed based on the pLKO.1-shRNA lentiviral expression system. The knockdown efficiency was detected at the mRNA and protein levels using qRT-PCR and Western blot. CCK-8 and Transwell assays were used to assess the effects of stable MINK1 knockdown on cell proliferation and migration. Flow cytometry was used to detect changes in cell cycle and apoptosis. The sensitivity of cells with stable MINK1 knockdown to cisplatin treatment was analyzed. The level of DNA damage in cells was detected by immunofluorescence staining of the DNA damage marker γH2AX. Results qRT-PCR and Western blot showed that shRNA significantly downregulated the expression of MINK1. Proliferation and migration were reduced in lung adenocarcinoma cells with stable MINK1 knockdown. MINK1 knockdown significantly enhanced the cytotoxic effect of the chemotherapy drug cisplatin on cancer cells and induced an increase in the level of DNA damage. Conclusion Lung adenocarcinoma cell lines with stable MINK1 knockdown were successfully established using A549 and PC-9 cells. Stable MINK1 knockdown can inhibit cancer cell proliferation and migration and may reduce the drug resistance of lung cancer cells by regulating the DNA damage repair process.

Alzheimer’s disease（AD） is a neurodegenerative disease with highly heterogeneous pathological and clinical manifestations，and it is the most common cause of dementia. This heterogeneity poses challenges for diagnosis，treatment，and evaluating novel pharmacological efficacy. This review summarizes the latest progress in the major clinical subtypes of AD based on clinical manifestations，genetic，and pathological features. Early-onset and late-onset AD clinical subtypes may share the same symptoms but differ in etiology，age of onset，mode of presentation，disease progression，and associated comorbidities. Typical and atypical AD differ significantly in clinical manifestations，pathological features，and diagnostic criteria. Research on AD subtypes based on imaging and omics data has also made considerable progress. This review also outlines the molecular pathological heterogeneity of AD. A deep understanding of these heterogeneities is crucial for diagnosis，the formulation of pharmacological treatment strategies，and clinical management.

Objective To study the correlations of neutrophil-lymphocyte ratio（NLR） and platelet-lymphocyte ratio（PLR） with arteriovenous fistula（AVF） stenosis in hemodialysis（HD） patients. Methods Data were collected from 625 patients who underwent arteriovenous fistula hemodialysis at the Department of Nephrology，Affiliated Hospital of North Sichuan Medical College between January 2021 and June 2022. Of these，395 eligible patients with complete information were selected as subjects of study. The 245 patients with AVF stenosis were designated as group 1 and the 150 patients without AVF stenosis were designated as group 2. The routine biochemical parameters and complete blood count were recorded for all patients. Results ①Compared with patients in group 2，those in group 1 showed significantly higher NLR（5.07（4.00，6.66） vs. 3.46（2.63，4.15），P<0.001），PLR（169.52（127.56，227.11） vs. 125.66（89.31，165.31），P<0.001），and C-reactive protein（Hs-CRP）（1.90（0.80，2.99） vs. 0.82（0.42，1.27），P<0.001）. ②Multivariate logistic regression analysis，which was corrected for age，sex，body mass index，AVF anastomosis，puncture method，and diabetes，showed that NLR（OR=2.195，95%CI=1.674～2.878，P<0.001），PLR（OR=1.008，95%CI=1.002~1.012，P=0.007），and Hs-CRP（OR=2.170，95%CI=1.607~2.751，P<0.001） were independent risk factors for AVF stenosis in HD patients. ③Receiver operating characteristic curve analysis showed that the area under the NLR curve（0.799，95%CI=0.756～0.838，P<0.001），PLR（0.694，95%CI=0.646～0.740，P<0.001），and Hs-CRP（0.717，95%CI=0.670～0.761，P<0.001） could be used to predict AVF stenosis. Their optimal critical values for prediction were 4.08，122.49，and 1.62，respectively. Their combination showed improved prediction effect（AUC 0.870，95%CI=0.833~0.901，P<0.001），high sensitivity（79.18%），and high specificity（81.33%）. Conclusion NLR，PLR，and Hs-CRP were independent risk factors and predictors of AVF stenosis，and their combination has higher predictive value.

目的：为了明确渝西地区居民体检非酒精性脂肪肝（non-alcoholic fatty liver disease,NAFLD）的检出率状况及其影响因素。方法：根据NAFLD的临床诊断标准及超声检测结果，以2020年1月1日至2023年11月30日在重庆医科大学附属永川医院体检中心接受健康体检的人群为研究对象。采用t检验、交叉列表（卡方）检验、多因素logistic回归分析等方法，明确健康体检者NAFLD的检出率及其影响因素。结果：健康体检者NAFLD的检出率为23.64%（12 872/54 067）。男性的检出率（39.22%）显著高于女性（15.91%）(χ²=2 197.112,P<0.001);50～59岁群体的NAFLD检出率最高（33.18%）;60岁以前，NAFLD的检出率会随着年龄的增加而增加，而60岁以后的检出率则会降低（χ²=367.554,P<0.001），表明渝西地区NAFLD的检出状况总体呈现年轻化的发展态势。体质指数（body mass index,BMI）为超重（39.39%）和肥胖（71.40%）群体的NAFLD检出率也明显高于消瘦（0.23%）和正常（9.68%）群体（χ²=7 644.383,P<0.001）。多因素logistic回归分析结果显示，健康体检者的性别、年龄、BMI、空腹血糖（fasting blood glucose,FBG）、收缩压（systolic blood pressure,SBP）、舒张压（diastolic blood pressure,DBP）、甘油三酯（triglycerides,TG）、尿酸（uric acid,UA）、高密度脂蛋白胆固醇（high-density lipoprotein cholesterol,HDL-C）、低密度脂蛋白胆固醇（low-density lipoprotein cholesterol,LDL-C）均是NAFLD检出率的危险因素（P<0.05），而总胆固醇（total cholesterol,TC）不是NAFLD检出率的危险因素。结论：渝西地区18岁以上健康体检者群体的NAFLD的检出率为23.64%,50～59岁是NAFLD的高发时期，男性、超重、肥胖是高危和易发群体，FBG、SBP、DBP、TG、UA、HDL-C、LDL-C均是导致NAFLD的危险因素，TC不是NAFLD的危险因素。

Objective To investigate whether biochanin A （BCA） has a protective effect against dextran sodium sulfate（DSS）-induced ulcerative colitis（UC） in mice. Methods Thirty C57BL/6N mice were randomly divided into normal control group，DSS model group，sulfasalazine（SASP）-positive drug control group，and low/medium/high-dose（5 mg/kg，10 mg/kg，and 20 mg/kg） BCA groups. The mouse model of UC was induced by administering 2.5% DSS aqueous solution for 7 days. During the experimental period，both the normal control and model groups were given 0.5% carboxymethyl cellulose sodium solution daily by gavage. The positive control group was given 100 mg/kg SASP，while the BCA groups were given BCA suspensions at doses of 5 mg/kg，10 mg/kg，and 20 mg/kg. The administration lasted for 10 days. Body weight changes and fecal status of the mice were recorded every day； the colon was dissected，collected，and measured for its length. The colon was stained with Hematoxylin-Eosin for pathomorphological study. Quantitative polymerase chain reaction was used to determine the levels of tumor necrosis factor-α（TNF-α），interleukin-6（IL-6），and interleukin-10 （IL-10） in the colon. Immunofluorescence was used to determine the expression of tight junction proteins，zonula occluden-1 （ZO-1） and occludin，in the colon. Results It showed that 5 mg/kg and 10 mg/kg BCA significantly alleviated weight loss in mice with UC，while 5 mg/kg，10 mg/kg，and 20 mg/kg BCA reduced the disease activity index scores. Additionally，BCA showed similar effects to SASP in improving the structure and reducing the shortening of the colon in mice with UC. Compared with the model group，all BCA groups had significantly decreased TNF-α（P=0.024、P=0.060、P=0.003） and IL-6（P=0.002、P<0.001、P<0.001）and significantly increased IL-10（P=0.006、P=0.003、P<0.001），with varying degrees of up-regulated expression of tight junction proteins. Conclusion BCA can effectively alleviate DSS-induced symptoms，reduce intestinal damage，and protect the intestinal barrier in mice with UC.

Amino acids are essential nutrients for the survival of all cells in the body，and their metabolic processes are closely associated with tumor development and progression. The metabolic changes of the essential amino acid tryptophan have a significance impact on tumor microenvironment. Tryptophan is mainly metabolized to kynurenine （KYN） by indoleamine 2，3-dioxygenase and tryptophan 2，3-dioxygenase，and the accumulation of KYN and the deficiency of tryptophan cause alterations in the immune status in tumor microenvironment，which in turn affects tumor development and progression. Based on the current studies on tryptophan，this article systematically discusses the influence of abnormal tryptophan metabolism on tumors and the interventions targeting this pathway，in order to provide a reference for subsequent tumor therapy.

Objective To investigate the effects of dictyophora polysaccharides（DIP） on cognitive dysfunction induced by chronic alcohol exposure in rats. Methods Sixty male Sprague-Dawley（SD） rats were randomly divided into five groups（n=12）：control group （normal saline），DIP group［DIP_H，DIP administered by gavage at 300 mg/（kg·d） for 28 consecutive days］，alcohol group［EtOH，60% alcohol administered by gavage at 10 mg/（kg·d） for 28 consecutive days］，low-dose DIP treatment group［EtOH+DIP_L，60% alcohol administered at 10 mg/（kg·d） and DIP administered at 100 mg/（kg·d） by gavage，with an interval of 6 hours between doses，for 28 consecutive days］，and high-dose DIP treatment group［EtOH+DIP_H，60% alcohol administered at 10 mg/（kg·d） and DIP administered at 300 mg/（kg·d） by gavage，with an interval of 6 hours between doses，for 28 consecutive days］. On day 25 of gavage，water maze training was provided for the rats for 4 days. On day 29，a water maze test was performed to determine the memory and learning functions of the rats；HE staining was used to evaluate the edema and inflammation of the liver and brain tissues； presence of inflammatory cells and the expression of myelin basic protein（MBP） in brain tissue were measured using immunohistochemical staining； Western blot was used to measure the expression of 2，2-cyclic nucleotide-3-phosphodiesterase（CNP） in the hippocampal tissue；the structural integrity of the myelin sheath was evaluated using LuxoL fast blue（LFB） staining and transmission electron microscopy. Results Compared with the control group，the EtOH group showed a significantly increased escape latency，reduced expression of MBP，and decreased density of the myelin sheath. DIP intervention significantly improved cognitive dysfunction in rats，increased the expression of MBP and CNP，and reduced myelin damage. Conclusion At a dose of 300 mg/kg，DIP may ameliorate cognitive dysfunction induced by chronic alcohol exposure by protecting the structural and functional integrity of myelin sheaths.

Objective To determine the role of stromal cell-derived factor-1/C-X-C chemokine receptor 4（SDF-1/CXCR4） signaling axis in atherosclerosis and to investigate its associated molecular mechanisms. Methods Forty ApoE^-/- mice were divided into five groups：control（CON） group，high-fat diet（HFD） group，empty virus（adeno-associated virus 9 enhanced green fluorescent protein，AAV9-eGFP） group，virus knockdown（adeno-associated virus 9-CXCR4-small interfering RNA，AAV9-CXCR4-siRNA） group，and pyrrolidine dithiocarbamate（PDTC） group. The CON group was fed normal chow and the remaining four groups were fed high-fat chow for 16 weeks. The PDTC group received intraperitoneal injections of 60 mg/kg PDTC twice/week starting from the fifth week. At 12 weeks，the AAV9-CXCR4-siRNA group and the AAV9-eGFP group received tail-vein injection of rAAV9-CXCR4-RNAi and negative control viruses，respectively，while the HFD group was injected with an equal amount of physiologic saline. The expression of enhanced green fluorescent protein（eGFP） was determined using confocal fluorescence microscopy. The area of atherosclerotic plaques was visualized by hematoxylin and eosin staining. Immunohistochemical staining and Western blot were used to detect the expression of CXCR4，nuclear factor kappa B p65 （NF-κB p65），phosphorylated nuclear factor-κB p65（NF-κB p-p65），interleukin-1β（IL-1β），and tumor necrosis factor-α（TNF-α）. Results Hematoxylin and eosin staining showed that atherosclerotic plaques were clearly present in all groups except the CON group，and plaques in the AAV9-CXCR4-siRNA group were significantly smaller than those in the AAV9-eGFP group. Plaques were significantly smaller in the PDTC group compared with the HFD group. In addition，the serum levels of SDF-1，IL-1β，and TNF-α were lower in the PDTC group compared with the HFD group. The serum levels of SDF-1，IL-1β，and TNF-α were lower in the PDTC group compared with the AAV9-eGFP group. Immunohistochemical staining showed that the expression levels of CXCR4 and SDF-1 were higher in the HFD and AAV9-eGFP groups than in the CON group. However，the expression levels of CXCR4（F=9.621，P=0.000） and SDF-1（F=20.102，P=0.000） were significantly reduced in the plaque region in the AAV9-CXCR4-siRNA group compared with the AAV9-eGFP group. In addition，Western blot showed that the expression levels of SDF-1（F=54.093，P=0.000） and CXCR4（F=28.485，P=0.000） were significantly reduced in the PDTC group compared with the HFD group. SDF-1 and CXCR4 expression levels were significantly lower in the AAV9-CXCR4-siRNA group compared with the AAV9-eGFP group（F=9.621，P=0.000；F=20.102，P=0.000）. Pearson correlation analysis showed that CXCR4 was positively correlated with the protein levels of NF-κb p65（r=0.762，P=0.000），NF-κb p-p65（r=0.795，P=0.000），IL-1（r=0.786，P=0.000），TNF-α（r=0.844，P=0.000），and SDF-1（r=0.815，P=0.000）. Conclusion Inhibition of the SDF-1/CXCR4 axis reduces the inflammatory response through the NF-κb signaling pathway，thereby attenuating the development and progression of atherosclerosis.