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.

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.

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.

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.

Objective To investigate the effect of Simo decoction on intestinal motility in rats with slow transit constipation（STC） by regulating the Takeda G protein-coupled receptor 5（TGR5）/transient receptor potential ankyrin 1（TRPA1） signaling pathway. Methods Sprague-Dawley rats were given compound diphenoxylate suspension by gavage to establish a model of STC，and then they were randomly divided into model group，low-dose（1.8 g/kg） Simo decoction group，high-dose（3.6 g/kg） Simo decoction group，and high-dose（3.6 g/kg） Simo decoction+SBI-115（TGR5 inhibitor，55.4 mg/kg） group，with 10 rats in each group； another 10 rats were given an equal volume of normal saline by gavage and were selected as control group. After treatment with Simo decoction and SBI-115，the rats in each group were measured in terms of the time to first black stool defecation，the number and weight of feces granules within 6 hours，small intestine charcoal powder propulsion rate，and colonic smooth muscle contractibility； HE staining was used to observe colon pathomorphology； immunohistochemical staining was used to measure the expression level of 5-hydroxytryptamine receptor 3（5-HT3R） in colon tissue； ELISA was used to measure the levels of 5-hydroxytryptamine（5-HT） and the inflammatory factors interleukin-6（IL-6） and interleukin-1β（IL-1β） in colon tissue； Western blotting was used to measure the expression of TGR5/TRPA1 pathway proteins in colon tissue. Results Compared with the control group，the model group had marked pathological damage of colon tissue，significant increases in the time to first black stool defecation and the levels of IL-6 and IL-1β in colon tissue（P<0.05），and significant reductions in the number and weight of feces granules within 6 hours，small intestine charcoal powder propulsion rate，colonic smooth muscle contractibility，positive expression of 5-HT3R in colonic tissue，5-HT level，and the protein expression levels of TGR5 and TRPA1（P<0.05）. Compared with the model group，the low- and high-dose Simo decoction groups had alleviation of the pathological damage of colon tissue，significant reductions in the time to first black stool defecation and the levels of IL-6 and IL-1β in colon tissue（P<0.05），and significant increases in the number and weight of feces granules within 6 hours，small intestine charcoal powder propulsion rate，colonic smooth muscle contractibility，positive expression of 5-HT3R in colonic tissue，5-HT level，and the protein expression levels of TGR5 and TRPA1（P<0.05），and high-dose Simo decoction showed a stronger effect. SBI-115 could weaken the effect of high-dose Simo decoction on various indicators of STC rats. Conclusion Simo decoction can inhibit colitis in STC rats by promoting the activation of TGR5/TRPA1 signaling，increase the levels of 5-HT and its receptor 5-HT3R in rat colon tissue，and alleviate pathological damage of colon tissue，thereby enhancing the contractibility of colon smooth muscle and intestinal motility and alleviating the symptoms of constipation.

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.

Intestinal barrier function is very important for overall health. Under physiological conditions，intestinal barrier can effectively prevent the internal environment from being affected by harmful substances and ensure the stability of the internal environment. When the internal environment of the body is damaged by various factors，the intestinal barrier function can be impaired，leading to increased intestinal permeability and thus a series of pathological changes such as intestinal flora shift and endotoxin absorption. By searching，sorting，and summarizing relevant literature，the authors found that there are many methods for detection and evaluation of intestinal barrier function. Indicators measured using blood，urine，stool，or intestinal tissue samples have been used to evaluate intestinal barrier function both in vivo and in vitro. This paper summarizes the methods of intestinal barrier function evaluation，and analyzes the advantages and disadvantages of each evaluation method，in order to provide a reference for the subsequent research in this field.

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.

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 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 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 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 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 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.

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 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 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.

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.

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.

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.

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.

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.

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 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 investigate the feasibility and safety of intracardiac echocardiography（ICE） combined with total three-dimensional（T3D） technique in zero-fluoroscopy individualized transseptal puncture. Methods A total of 112 patients with atrial fibrillation who underwent radiofrequency ablation in Yongchuan Hospital Affiliated to Chongqing Medical University from April 2021 to March 2024 were enrolled，and according to the method for transseptal puncture，they were randomly divided into ICE+T3D group with 56 patients and ICE group with 56 patients. The two groups were analyzed in terms of baseline data，time to atrial reconstruction，time to coronary sinus electrode placement，frequency of ICE probe adjustment during transseptal puncture，duration of transseptal puncture，pretreatment time before ablation，incidence rate of complications，and the duration and dosage of X-ray exposure. Results There were no significant differences in baseline data between the two groups. Compared with the ICE group，the ICE+T3D group had a significantly lower frequency of ICE probe adjustment during transseptal puncture（1.70±0.63 vs. 5.34±1.71，P<0.001） and the duration of transseptal puncture（3.66±1.09 min vs. 4.90±1.92 min，P<0.001）. Compared with the ICE group，the ICE+T3D group had significantly longer time to atrial reconstruction（22.44±3.13 min vs. 12.34±2.12 min，P<0.001） and pretreatment time before ablation（49.41±3.52 min vs. 37.65±4.04 min，P<0.001）. In the ICE+T3D group，43（76.8%） patients achieved zero radiation during pretreatment before ablation，and 13 patients received X-ray due to the difficulty in catheter placement； compared with the ICE group，the ICE+T3D group had a significantly shorter duration of X-ray exposure（1.68±0.72 min vs. 3.14±1.95 min，P=0.010） and a significantly lower dosage of X-ray exposure（6.28±2.78 mGy vs. 23.85±21.32 mGy，P=0.004）. During the stage of transseptal puncture，all patients in the ICE+T3D group achieved zero radiation，while 45 patients（80.4%） in the ICE patients received X-ray. In terms of complications，there were no life-threatening complications such as cardiac tamponade，perforation of the aorta by mistake，and embolization in either group，while there was one case（1.8%） of vascular complications in each group. Conclusions ICE combined with T3D after integration and improvement is a safe and reliable procedure for zero-fluoroscopy individualized transseptal puncture.

As the population ages，the incidence of diabetes continues to climb. Diabetic peripheral neuropathy （DPN） occurs in about half of diabetic patients. DPN is characterized by the loss of peripheral nerve function from distal to proximal，with the main symptom of diffuse and persistent spontaneous intractable pain，which is one of the most common chronic complications of diabetes. DPN has a high mortality rate and poor prognosis，and the pathogenesis is not fully clear. The current focus of clinical treatment for DPN is to alleviate the clinical symptoms，as well as to control blood glucose and reduce the risk of adverse cardiovascular events. This study investigated the pathogenesis，diagnosis，and treatment of DPN and summarized the latest research progress to provide new ideas for clinical diagnosis and treatment of DPN.

Osteoporotic vertebral compression fractures（OVCFs） are common orthopedic conditions that can lead to spinal pain and deformity，which greatly affects the quality of life of patients. Currently，there are various treatment methods for OVCFs，but there is still a lack of standards for optimal treatment modalities. Therefore，this article introduces the current treatment methods and characteristics of epidemiology for OVCFs，in order to improve the awareness of this disease among clinicians and provide a reference for selecting more appropriate treatment regimens. Conservative treatment measures，such as bracing and analgesia，are the basic treatment measures for OVCFs，and anti-osteoporosis drugs play a crucial role in management. Minimally invasive procedures，including percutaneous vertebroplasty and percutaneous balloon kyphoplasty，remain the primary surgical interventions，and traditional open surgeries are also an important part of treatment，such as anterior spinal fusion，combined anterior and posterior spinal fusion，posterior spinal fusion with three-column osteotomy，and posterior spinal fusion with vertebroplasty. Furthermore，surgeons should focus on the accumulation of related surgical techniques and skills during surgery to effectively address the challenges and complications associated with surgical interventions. Finally，scientific and appropriate treatment methods should be selected for patients，in order to improve long-term treatment outcomes and increase the degree of satisfaction among patients.

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.

Female infertility is mostly associated with oocyte senescence，which is mainly caused by advanced maternal age and long waiting time before fertilization. These two different physiological processes exhibit similar epigenetic alterations，particularly in histone acetylation. Establishing an association between histone modification and human health and diseases is of great importance for intervening in disease development，developing novel clinical treatment regimens，and ultimately achieving disease cure. Therefore，this article elaborates on the changes in the profile of histone acetylation modifications associated with oocyte senescence and summarizes the potential targets for epigenetic therapy.

Objective To investigate the accuracy of a model established based on machine learning and computed tomography（CT） radiomics features in predicting vertebral fragility fractures in patients with type 2 diabetes mellitus（T2DM）. Methods A retrospective analysis was performed for the CT images and clinical data of 140 patients，among whom there were 70 T2DM patients with newly diagnosed vertebral fragility fractures and 70 patients in the control group. The previous CT images and clinical data of 18 patients（16 T2DM patients with vertebral fragility fractures and 2 patients in the control group） were collected as an external validation set. The optimal features were screened by the univariate analysis，the Pearson correlation analysis，minimum redundancy maximum relevance algorithm，the binary logistic regression analysis，and the least absolute shrinkage and selection operator regression model，and then a predictive model was constructed by support vector machine，multi-layer perceptron，and eXtreme gradient boosting（XGBoost） classifiers. The area under the ROC curve（AUC） was used to evaluate the predictive performance of the model. Results A total of 1 037 radiomics features were extracted from the CT images of each patient and were then simplified into 14 radiomics features. Among the 17 clinical features，sex，age，and body mass index were independent factors for predicting outcome. XGBoost classifier showed the best performance，and the XGBoost model showed an AUC of 1.000，0.929，and 1.000，respectively，in the training set and an AUC of 0.954，0.862，and 0.969，respectively，in the test set. Conclusion The XGBoost model based on clinical and radiomics features can be used as a noninvasive tool for predicting vertebral fragility fractures in T2DM patients.

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.

Objective To explore the effects of transcription factor adenovirus E4 promoter-binding protein（E4BP4） in regulating pathological myocardial fibrosis through the adenosine monophosphate-activated protein kinase（AMPK）-transforming growth factor （TGF）-β1/Smad homolog 3（SMAD3） pathway. Methods A mouse model of myocardial fibrosis was established，and the expression of E4BP4 was determined in the model group and the sham-operation group. Primary cardiac fibroblasts were isolated，cultured，activated by angiotensin Ⅱ（Ang Ⅱ），and divided into the following groups：Ang Ⅱ+E4BP4 group （transfected with E4BP4 overexpression plasmids），Ang Ⅱ+siE4BP4 group （transfected with E4BP4 interfering plasmids），Ang Ⅱ group，and control group（without Ang Ⅱ treatment）. The fluorescence intensity of ɑ-smooth muscle actin（α-SMA） was determined by the immunofluorescence assay，the cell viability by the cell counting kit，the expression of E4BP4，α-SMA，collagen type Ⅰ（collagen Ⅰ），and collagen type Ⅲ（collagen Ⅲ） by polymerase chain reaction，and the protein expression of TGF-β1，AMPK，and SMAD3 by Western blot. Results Compared with the sham-operation group，the model group showed significantly increased myocardial fibrosis degree（38.46±1.21 vs. 3.39±0.39，t=-78.564，P=0.000） and E4BP4 protein expression（0.96±0.03 vs. 0.75±0.03，t=-11.480，P=0.000）. In vitro experiments found that the mean fluorescence intensity（0.05±0.01 vs. 0.42±0.03，F=677.591，P=0.000），cell viability（91.30±2.39 vs. 123.74±2.60，F=132.696，P=0.000），and the levels of α-SMA（1.26±0.09 vs. 3.59±0.86，F=52.274，P=0.000），collagen Ⅰ（1.16±0.11 vs. 3.79±0.89，F=55.336，P=0.000），collagen Ⅲ（1.23±0.13 vs. 2.92±0.36，F=119.929，P=0.000），TGF-β1（0.66±0.04 vs. 0.96±0.02，F=142.954，P=0.000），and p-SMAD3/SMAD3（0.81±0.03 vs. 1.37±0.02，F=739.609，P=0.000） in the Ang Ⅱ+siE4BP4 group were significantly lower than those in the Ang Ⅱ+E4BP4 group. The expression of p-AMPK/AMPK in the Ang Ⅱ+siE4BP4 group was significantly higher than that in the Ang Ⅱ+E4BP4 group（0.89±0.01 vs. 0.58±0.02，F=284.541，P=0.000）. Conclusion E4BP4 plays a crucial role in the regulation of fibrosis. Inhibition of E4BP4 expression exerts an anti-fibrotic effect by activating AMPK and inhibiting TGF-β1/SMAD3 pathway.

Objective To evaluate the prognostic value of ¹⁸F-fluorodeoxyglucose（FDG） positron emission tomography（PET）/computed tomography（CT） （¹⁸F-FDG PET/CT） metabolic parameters combined with clinical characteristics in treated patients with esophageal squamous cell carcinoma（ESCC）. Methods The clinical data of 75 patients （65 males and 10 females，age of 63.41±7.75 years） with pathologically confirmed ESCC in * Hospital from January 2015 to November 2021 were retrospectively analyzed. All patients underwent ¹⁸F-FDG PET/CT examination after treatment. The relevant parameters of ¹⁸F-FDG PET/CT were determined：whole body SUVmax（SUVmaxwb）； SUVmean and metabolic tumor volume（MTV） were measured with 40% SUVmax as the critical value，and whole body MTV（MTVwb） and whole body total lesion glycolysis（TLGwb） were calculated. Kaplan-Meier survival curves and Cox proportional hazards model were used to evaluate the relationship between PET parameters and overall survival（OS）. Results Fifty-two（69.3%） patients died. PET-positive patients exhibited a 6.029-fold increased risk of death compared with PET-negative patients（P<0.001），with the median survival time of 22.3 months and 43.2 months，respectively. PET-positive patients were categorized based on median parameters of PET：SUVmaxwb=11.09，MTVwb=27.07 cm³，and TLGwb=162.34 g. Kaplan-Meier survival curves and log-rank tests revealed the correlations of pathological classification，M stage，post-PET anti-tumor treatment，MTVwb，and TLGwb with OS. M stage emerged as an independent predictor for OS（hazard ratio=5.698，95%CI=1.791-18.123，P=0.003）. Patients positive for both PET imaging and serology had a 6.112-fold higher death risk compared with those negative for PET imaging（P<0.001）. Conclusion ¹⁸F-FDG PET/CT volume metabolism parameters are significant prognostic predictors for treated patients with ESCC，and patients positive for PET imaging and tumor markers are associated with a poor prognosis.

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 influencing factors for dysphagia in the elderly，to construct a predictive model for dysphagia，and to provide a theoretical basis for clinical practice. Methods In this case-control study，the patients with dysphagia who attended Department of Geriatrics in the first affiliated hospital of Chongqing Medical University from March 2016 to June 2023 were enrolled as case group，and the patients without dysphagia who attended the same department during the same period of time were enrolled as control group. The correlation analysis，least absolute shrinkage and selection operator（LASSO） regression，and multivariate logistic regression analysis were used to investigate the influencing factors for dysphagia；the 10-fold cross-validation Extreme Gradient Boosting（XGBoost） model was used to predict dysphagia，and the SHapley additive exPlanations（SHAP） method was used for model visualization. Results There were 1009 cases in the case group and 2125 cases in the control group. The correlation analysis and LASSO regression analysis identified 12 factors for the multivariate logistic regression analysis，and the results showed that sarcopenia，increasing age，children or caretakers as caregivers，frail health，poor oral health，poor self-care ability，depression，and cognitive impairment were risk factors for dysphagia（odds ratio［OR］>1，P<0.05），and female sex and participation in community activities were protective factors against dysphagia（OR<1，P<0.05）. The XGBoost model had a good predictive efficacy，with an accuracy rate of 0.795，a precision rate of 0.711，a sensitivity of 0.613，a specificity of 0.881，an F1 value of 0.661，and an area under the ROC curve of 0.855. The SHAP plot showed that the top five important characteristics were caregiver，oral score，frail health condition，activities of daily living，and cognitive function. Conclusion There are various influencing factors for dysphagia in the elderly，and the elderly patients with poor oral health，frailty，dependence on others for daily life，and cognitive impairment should be taken seriously in clinical practice. The XGBoost model has a good performance in predicting dysphagia in the elderly，which can provide a reference for clinical practice.

Objective To investigate the risk factors for esophageal varices in patients with liver cirrhosis，to establish a predictive model，and to provide reasonable guidance for the prevention of early esophageal varices in patients with liver cirrhosis. Methods A retrospective analysis was performed for 1 113 patients with liver cirrhosis who attended the hospitals in Chongqing，China from December 2006 to May 2021. Recursive feature elimination（RFE） and four machine learning methods were used for the screening of features，and five machine learning predictive models were established by logistic regression，random forest，support vector machine（SVM），decision tree，and eXtreme Gradient Boosting（XGBoost）. The receiver operating characteristic（ROC） curve was used to evaluate the performance of each model，and the model with the best performance was used to investigate the risk factors for esophageal varices in patients with liver cirrhosis. SHAP plots were used to explain the impact of each risk factor on patients. Results The XGBoost model showed the best performance in predicting the risk of esophageal varices in patients with liver cirrhosis，with an area under the ROC curve of 0.872（95%CI=0.813-0.918）. SHAP plots showed that platelet count，diameter of the portal vein，cholinesterase，albumin，alanine aminotransferase，hemoglobin，prothrombin ratio，prothrombin time，and serum total protein were risk factors for esophageal varices in patients with liver cirrhosis. Conclusion This study shows that the XGBoost predictive model has a relatively high predictive value，and the risk factors obtained by this model have a certain guiding significance for the clinical prevention and treatment of early esophageal varices in patients with liver cirrhosis.

Cell pyroptosis is characterized by cellular swelling and the formation of ion non-selective pores，leading to the emergence of “pyroptotic body-like” vesicular protrusions，ultimately resulting in plasma membrane lysis and the release of inflammatory factors. Cell pyroptosis is mainly mediated by inflammatory cysteinyl aspartate specific proteinase（caspase），including the classical pyroptotic pathway mediated by caspase-1 and the non-classical pyroptotic pathway mediated by caspase-4/5/11. This process triggers downstream gasdermin to cause cell membrane perforation，thus leading to the release of cellular contents and numbers of inflammatory cytokines and inducing cell pyroptosis. In recent years，increasing evidence suggests that cell pyroptosis is involved in the progression of diabetic kidney disease（DKD） and may serve as a potential therapeutic target for DKD. This article provides a review of the relevant research on cell pyroptosis in the progression of DKD and summarizes the current understanding of the role of intrinsic renal cell pyroptosis in the pathogenesis of DKD and drug studies targeting cell pyroptosis，aiming to offer new insights for updating research on the mechanisms and treatment strategies of DKD.

Objective To investigate the inhibitory effect of Xiaojianzhong Granule（XJZG） on food allergy（FA） and related mechanisms in terms of gut microbiota，zonula occluden-1（ZO-1），and Occludin. Methods A total of 24 specific pathogen-free female BALB/c mice were randomly divided into normal group，model group，prevention group，and treatment group，with 6 mice in each group. The mice in the prevention group were given XJZG by gavage at a standard dose of 5.85 g/kg/day from 3 days before the first challenge till 4 hours before the last challenge；the mice in the treatment group were given XJZG at the double dose for 3 days based on the allergy score； the mice in the other groups were given an equal volume of distilled water by gavage. At the end of the experiment，allergy score and anal temperature were measured； flow cytometry was used to measure eosinophils and mast cells in mesenteric lymph nodes（MLNs）；toluidine blue staining was performed for mast cells in jejunal tissue； immunohistochemistry was used to measure the expression of ZO-1 and Occludin；16S rRNA sequencing was performed to analyze the microbiota in the intestinal content；high-performance liquid chromatography-mass spectrometry was used to measure the content of short-chain fatty acids（SCFAs） in jejunal lavage fluid. Results Compared with the model group，the prevention group and the treatment group had significant reductions in allergy score（P=0.000，P=0.000），anal temperature（P=0.002，P=0.000），the proportion of eosinophils and mast cells in MLNs（P<0.05），and mast cell infiltration in jejunal tissue（P=0.000，P=0.000）. Compared with the normal group，the model group had significant increases in the relative abundances of Erysipelaceae and Turicibacter，while the prevention group and the treatment group had disappearance of Erysipelaceae and Turicibacter and an increase in the relative abundance of Porphyromonadaceae. Compared with the normal group，the model group had a significant reduction in the content of propionate in jejunal lavage fluid（P=0.014），and compared with the model group，the prevention group had a significant increase in the content of propionate in jejunal lavage fluid（P=0.024），as well as a significant increase in the treatment group（P=0.008）. In the model group，the expression of ZO-1 was downregulated（P=0.010），and the expression of Occludin was significantly downregulated（P=0.002），while the expression of ZO-1 and Occludin returned to normal levels in the prevention group and the treatment group（P=0.001，P=0.013；P=0.025，P=0.015）. Conclusion XJZG can change the composition and abundance of gut microbiota，increase the concentration of SCFAs，upregulate the expression of ZO-1 and Occludin，promote the repair of intestinal barrier，and inhibit food allergy.