Serving as cerebral macrophages， microglial cells are meticulously regulated by the microenvironment of the central nervous system.In response to various environmental and cellular stresses， microglial cells are rapidly activated and exhibit either pro-inflammatory or anti-inflammatory phenotypes to maintain brain tissue homeostasis， and during this process， significant changes are observed in glucose metabolism of microglial cells. Aerobic glycolysis is the primary energy source for pro-inflammatory microglial cells， while oxidative phosphorylation is the energy source for anti-inflammatory microglial cells.This article systematically elaborates on glucose metabolism and glucose metabolic reprogramming pathways in microglial cells， as well as their role in central nervous system diseases. In addition， this article also discusses the potential of targeting glucose metabolic reprogramming in microglial cells for the treatment of related diseases.

Objective:To evaluate the efficacy and safety of ophthalmic viscosurgical device (OVD)-assisted non-gas dependent pars plana vitrectomy (PPV) combined with an inverted internal limiting membrane (ILM) flap for the treatment of idiopathic macular hole (IMH).Methods:A retrospective cohort study. From June 2023 to February 2024, 33 patients (33 eyes) diagnosed with IMH in Department of Ophthalmology of Changshu Second People’s Hospital were included in the study. Best corrected visual acuity (BCVA) and optical coherence tomography (OCT) examinations were performed on all affected eyes before surgery. BCVA examination was conducted using the international standard visual acuity chart, and the results were converted into the logarithm of the minimum angle of resolution (logMAR) visual acuity. The minimum diameter of the hole was measured using OCT. All affected eyes received standard 25G PPV treatment through the three channels of the flat part of the ciliary body. According to the surgical methods, they were divided into two groups: the OVD-assisted non-gas-dependent PPV combined with internal limiting membrane inversion and coverage treatment group (OVD group, 17 cases and 17 eyes) and the heavy water-assisted gas-dependent PPV combined with internal limiting membrane inversion and coverage treatment group (heavy water group, 16 cases and 16 eyes). Postoperatively, patients in the OVD group were not required to maintain a strict specific position, whereas those in the heavy water group needed to remain in a prone position for one week. The follow-up time points after the operation were 1 week, 1 month and 3 months. The main observation indicators included BCVA, intraocular pressure, hole closure rate and closure morphology of the two groups, as well as the occurrence of complications. The independent sample t test was used for comparison between groups. Pearson correlation analysis was used for the correlation between BCVA at 3 months after surgery and the minimum diameter of the surgical hole and BCVA before surgery. Results:Three months after the operation, the rate of hole closure in the OVD group and the heavy water group was 17 (100.0%, 17/17) and 15 (93.8%, 15/16) eyes, respectively. There was no statistically significant difference in the hole closure rate ( χ2=1.090) and closure type ( Z=?0.780) between the two groups ( P>0.05). Compared with before the operation, the logMAR BCVA at each time point after the operation in the OVD group and the heavy water group was significantly improved ( F=2.353, 1.375; P<0.05). One week after the operation, the BCVA in the OVD group was significantly better than that in the heavy water group ( t=-3.760, P<0.01). In terms of intraocular pressure, compared with the baseline value before the surgery, there was a statistically significant difference in the OVD group one week after the surgery ( Z=?3.454, P<0.05). There were statistically significant differences in the heavy water group at 1 week, 1 month and 3 months after the operation ( Z=?5.066, ?3.423, ?2.739; P<0.05). After the operation, one eye in the heavy water group had high intraocular pressure, which returned to normal after combined treatment with intraocular pressure-lowering drugs. No ocular or systemic complications occurred in the OVD group. The results of the correlation analysis showed that postoperative BCVA was correlated with the minimum diameter of the surgical hole and BCVA before the surgery ( r=0.543, 0.658; P<0.05). Conclusions:The treatment of IMH with OVD-assisted non-gas-dependent PPV combined with internal limiting membrane flip coverage has a good effect. It helps promote the early recovery of macular morphology and visual function after surgery, and at the same time can avoid the maintenance of forced position and reduce perioperative risks.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

Objective:To explore the differences in bacterial communities within tissues during the process of oral mucosal carcinogenesis, and analyze the relationship between the high-abundance species Prevotella intermedia (Pi) and the occurrence and development of oral mucosal carcinogenesis. Methods:Fresh tissue samples were collected from patients diagnosed with oral leukoplakia (OLK), oral squamous cell carcinoma (OSCC), and healthy controls (HC) at Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, from January 2022 to November 2024, following strict inclusion criteria. Bacterial DNA was extracted from these specimens, and the 2bRAD sequencing for microbiome (2bRAD-M) was employed to analyze and compare the α and β diversity, as well as the community composition of bacteria within tissues, aiming to identify specifically expressed bacteria. Subsequently, paraffin-embedded clinical specimens were collected: 15 cases in the OLK group (including 4 cases of simple hyperplasia, 6 cases of mild dysplasia, and 5 cases of moderate to severe dysplasia), 12 cases in the OSCC group, and 5 cases in the HC group. A 4-nitroquinoline N-oxide (4NQO)-induced OLK progression mouse model was also constructed. Mice were randomly divided into three groups using a random number table, with six in each group. The negative control group was given distilled water to drink; Group 1 was given distilled water containing 4NQO to drink until week 12, while Group 2 was given distilled water containing 4NQO to drink until week 22. After the mice were sacrificed, their tongue tissue were collected and fixed. Fluorescence in situ hybridization (FISH) with specific probes was used to validate the presence of Pi in human and mouse tissue sections, analyzing the correlation between histopathological grading and the invasion depth of Pi.Results:The 2bRAD-M microbial analysis revealed that the relative abundance of Pi in OSCC tissues (10.80%) was significantly higher than in the HC group (0.50%) ( P=0.001) and OLK group (0.70%) ( P=0.002). FISH probe detection showed that the fluorescence intensity of Pi in human OSCC tissues [123.50 (101.00, 142.30)] was higher than in the HC group [0.00 (0.00, 28.50)], simple hyperplasia OLK [0.00 (0.00, 35.25)], and mild dysplasia OLK [24.50 (0.00, 55.50)] groups, with statistically significant differences respectively ( P=0.002, P=0.003, P=0.005). However, there was no significant difference compared to moderate to severe dysplasia OLK [56.00 (28.00, 62.50)] ( P=0.210). The fluorescence area of Pi in human OSCC tissues [8 615.00 (7 439.00, 11 084.00)] was significantly larger than in the HC group [0.00 (0. 00, 45.00)], simple hyperplasia OLK group [0.00 (0.00, 81.00)], mild dysplasia [49.00 (0.00, 151.00)], and moderate to severe dysplasia groups [1 450.00 (454.00, 2 892.00)], with highly significant differences ( P<0.001). There was a significant correlation between the invasive depth of Pi and the degree of histopathological grading ( P<0.001). In mice, the fluorescence intensity of Pi in OSCC tissues [120.00 (110.00, 127.00)] was significantly higher than in the HC group [0.00 (0.00, 12.25)] ( P<0.01), but showed no significant difference compared with the OLK group [50.00 (0.00, 58.00)] ( P>0.05). The fluorescence area of Pi in mice OSCC tissues [11 020.00 (6 790.00, 12 102.00)] was significantly larger than in the HC group [0.00 (0.00, 56.75)] and the OLK group [0.00 (0.00, 751.50)] ( P=0.006, P=0.043). There is a significant correlation between the depth of invasion of Pi and the degree of histopathological grading ( P<0.01). Conclusions:This study suggests that Pi in oral mucosal tissue may be a potential biomarker for early detection of OSCC and play an important role in the carcinogenesis process of oral mucosa.

Objective:To evaluate the clinical equivalence between a domestic calcipotriol/betamethasone dipropionate ointment and the originator product in the treatment of stable plaque psoriasis.Methods:A multicenter, randomized, double-blind, three-arm, parallel-group, active- and placebo-controlled study was conducted, and 449 patients aged 18 - 65 years with stable plaque psoriasis were enrolled from 25 hospitals (such as the First Affiliated Hospital of China Medical University). Eligible patients had a baseline physician's global assessment (PGA) score of ≥ 3 points, baseline body surface area (BSA) involvement of 5% - 30%, and a target lesion psoriasis area and severity index (TL-PASI) for plaque elevation of ≥ 3 points. Participants were randomly assigned in a 2:2:1 ratio to the test group ( n = 179), reference group ( n = 180), and placebo group ( n = 90), and applied the domestic calcipotriol/betamethasone dipropionate ointment, originator product, and ointment base respectively, once daily in the evening for 4 weeks. Efficacy and safety were assessed at weeks 1, 2, and 4. The primary efficacy endpoints were the treatment success rates and clinical success rates in each group at week 4. The per-protocol set (PPS) was used for the primary efficacy analysis, and the intention-to-treat (ITT) set for supplementary efficacy analysis. Equivalence between the test and reference preparations was tested using the Cochran-Mantel-Haenszel method adjusted for randomization strata. Superiority of the test and reference preparations over the placebo was also tested. Measurement data were compared among the 3 groups using analysis of variance or non-parametric tests, while treatment success rates, clinical success rates, and incidence rates of adverse reactions were compared using the chi-square test. Results:The ITT, PPS, and safety sets included 447, 420, and 448 patients, respectively. In the ITT set, patients were aged 43.6 ± 12.8 years, including 320 (71.6%) males and 127 (28.4%) females, and the disease duration was 11.21 ± 9.05 years; 316 (70.7%) had a PGA score of 3 points and 131 (29.3%) had a PGA score of 4 - 5 points. No significant differences in the baseline characteristics (including age, sex, disease duration and disease severity) were observed among the 3 groups (all P > 0.05). Based on the PPS analysis, the treatment success rates were 57.9% (99/171) in the test group, 50.3% (86/171) in the reference group, and 7.7% (6/78) in the placebo group, and the clinical success rates were 57.9% (99/171), 50.3% (86/171), and 10.3% (8/78), respectively; both the test and reference groups were superior to the placebo group in both treatment and clinical success rates (all P < 0.001) ; the rate differences for treatment success (90% confidence interval [ CI]: -1.3% - 16.4%) and clinical success (90% CI: -1.3% - 16.3%) between the test and reference groups were entirely within the pre-defined equivalence margin (-20% - 20%). Subgroup analyses by baseline PGA scores: for patients with a baseline PGA score of 3 points, the treatment success rates in the test, reference, and placebo groups were 60.8% (73/120), 52.1% (62/119), and 11.1% (6/54), respectively, and the corresponding clinical success rates were 61.7% (74/120), 53.8% (64/119), and 13% (7/54), respectively; the test and reference groups did not differ significantly in treatment or clinical success rates (both P > 0.05), but both showed higher success rates than the placebo group (all P < 0.001) ; the results of statistical comparisons among the 3 groups in patients with a baseline PGA score of 4 - 5 points were consistent with those observed in patients with a baseline PGA score of 3 points. The percentage reductions in PGA and TL-PASI scores from baseline to weeks 1, 2, and 4 showed significant differences among the 3 groups, which were significantly higher in the test and reference groups than in the placebo group (all P < 0.001), but did not differ between the test and reference groups (all P > 0.05). The primary adverse reactions were local skin reactions, such as pruritus, pain, and erythema. The incidence rates of adverse reactions were 8.9% (16/179) in the test group, 7.3% (13/179) in the reference group, and 7.8% (7/90) in the placebo group, with no significant difference among the 3 groups ( P > 0.05) . Conclusions:The domestic calcipotriol/betamethasone dipropionate ointment demonstrated clinical equivalence to the originator product in the treatment of stable plaque psoriasis, and the two agents exhibited comparable efficacy for patients with varying degrees of disease severity, and were comparable in the speed and degree of clinical improvement, with similar favorable safety profiles.

Objective:To investigate the association between anti-rituximab antibodies (ARA) and relapse after rituximab (RTX) therapy in children with frequently relapsing or steroid-dependent nephrotic syndrome (FRNS or SDNS).Methods:A retrospective cohort study was conducted. Clinical and laboratory data were collected from 48 FRNS or SDNS children treated with RTX in the Department of Pediatrics, General Hospital of Eastern Theater Command, between April 2024 and October 2024. Data included RTX dosing frequency, relapse events, peripheral CD20? B-cell counts, and ARA levels. With a 6-month observation period after the last RTX therapy, the children were divided into an ARA-positive group and an ARA-negative group based on ARA test results. Chi-square test, independent sample t-test, or Mann-Whitney U test were used to compare relapse rates and laboratory indicators between the two groups. The predictive value of ARA levels for relapse was evaluated using univariate receiver operating characteristic (ROC) curve analysis. Results:Among the 48 children (36 males, 12 females), the age of disease onset was 3.5 (2.0, 6.0) years, the ages at the first and last RTX treatments were 7.0 (5.0, 12.0) years and 9.5 (7.0, 13.0) years, respectively. The overall ARA positive rate was 29% (14/48). The relapse rate in the ARA-positive group was significantly higher than that in the negative group ( P<0.05). The ARA level was 0.01 (0.01, 5.88) μg/L, and all 12 children with ARA levels >5.88 μg/L relapsed. ROC curve analysis showed that ARA levels predicted relapse after RTX treatment in FRNS or SDNS children with an area under the curve (AUC) of 0.73, sensitivity of 0.50, specificity of 1.00, and an optimal cut-off value of 5.02 μg/L. All children received single-dose RTX therapy, with no significant difference in treatment frequency between the two groups ( P>0.05). At 3 months after the last rituximab therapy, CD20? B cell counts were significantly higher in the ARA-positive group ( P<0.05). During follow-up, 15% (7/48) of the children experienced infusion-related adverse reactions, with no significant difference in incidence between the two groups ( P>0.05). Conclusion:ARA is significantly associated with relapse in FRNS or SDNS children after RTX therapy.

Ischemic stroke(IS),caused by the interruption of cerebral blood flow,results in localized ischemia and hypoxia in the brain tissue.Its pathophysiological mechanisms are complex,involving disturbances in energy metabo-lism,oxidative stress,inflammation,and apoptosis.As the cell's powerhouse,mitochondria play a critical role in IS,and their dysfunction exacerbates neuronal injury.In recent years,tunneling nanotubes(TNTs),a novel form of intercellular communication,have gained increasing attention for their role in mediating the intercellular transfer of functional mito-chondria.Studies have shown that both stem cells and astrocytes can transfer healthy mitochondria to damaged neurons via TNTs,thereby restoring energy metabolism,reducing apoptosis,and alleviating neurological deficits.This review summa-rizes the current research on the mechanisms and biological functions of TNT-mediated mitochondrial transfer and discuss-es its potential therapeutic applications in IS,aiming to provide insight into IS treatment strategies.

Objective To identify genetic regulators of ionizing radiation(IR)sensitivity through clustered regularly interspaced short palindromic repeats(CRISPR)/CRISPR-associated nuclease 9(Cas9)genome-wide screening.Methods A specialized single guide RNA(sgRNA)library was developed targeting 987 stress-response regulatory genes identified through Kyoto Encyclopedia of Genes and Genomes(KEGG),Reactome and gene ontology(GO)databases,followed by construction of sgRNA plasmids and packaging into a lentiviral library.Using colon adenocarcinoma Caco-2 cells as a model system,the Cas9-stable transgenic line was established via lentiviral transduction and antibiotic selection.Library-transduced cells underwent puromycin selection,followed by γ-irradiation(dose optimized via preliminary experiments).Post-irradiation phenotypic selection was conducted after 14 days,with subsequent next-generation sequencing of surviving cell populations to identify enriched/depleted sgRNAs.Candidate genes were functionally validated through orthogonal assays:cell counting kit-8(CCK-8)proliferation analysis,clonogenic survival assays and flow cytometric quantification of reactive oxygen species(ROS)and apoptotic markers.Results The optimized screening platform identified 281 radiation response genes(165 radiosensitive and 116 radioprotective candidates).Functional validation revealed Bcl2-associated athanogene 3(BAG3)knockdown significantly enhanced radioresistance.Proliferation was increased 1.2-1.5 fold,clonogenic survival improved 1.5-2.0 fold,and ROS was reduced by 13％-25％coupled with 32％-73％apoptosis attenuation compared to control groups.Conclusion The integrated CRISPR/Cas9 screening platform effectively identifies novel radiation response regulators,as evidenced by the discovery of BAG3 as a critical radiosensitivity determinant.This high-throughput functional genomics approach provides a robust methodology for systematically mapping molecular determinants of cellular radiation response,with potential applications in both mechanistic studies and therapeutic target discovery.

Objective To assay the salivary ANG-2 level of oral lichen planus(OLP)patients,and analyze its correlation with in-flammatory activity of OLP.Methods Eighty-nine OLP patients were included,and divided into four subgroups as non-erosive asymp-tomatic(NEA),non-erosive symptomatic(NES),minor-erosive(MIE)and major-erosive(MAE)groups.Fifteen healthy adults were recruited as controls.Whole unstimulated saliva was collected from each participant,and the salivary ANG-2 level was measured by chemiluminescence immunoassays(CLIA)for analysis.Normal oral mucosal tissue,non-erosive and erosive OLP tissues were collected to detect and analyze the expression of ANG-2 positive blood vessels by immunohistochemistry(IHC).Results The base-lines of age and gender between OLP and control groups showed no significant difference.Compared to controls,the salivary ANG-2 levels of OLP group,non-erosive and erosive OLP subgroups were significantly higher(P＜0.05),in which erosive OLP group was higher than non-erosive OLP group(P=0.022);NES subgroup was slightly higher than NEA(P=0.048),and there was no statistical significance between MIA and MEA subgroups(P=0.067).Spearman correlation analysis showed a positive correlation between sali-vary ANG-2 level and inflammation activity in OLP patients(r=0.314,P=0.003).The expression of ANG-2 in non-erosive OLP mu-cosal tissues slightly increased than normal oral mucosal tissue(P＞0.05),but there was no significant difference.The expression of ANG-2 in erosive OLP mucosal tissues significantly increased than normal oral mucosal tissue(P＜0.001)and non-erosive OLP group(P＜0.001).Conclusion There is a certain correlation between sali-vary ANG-2 level and inflammatory activity of OLP,indicating that salivary ANG-2 level is probable to be one of the inflammatory activity indicators to monitor the state-variation of OLP as a clinical non-inva-sive method.

Objective:To establish a deployment management mode for life-supporting equipment,so as to provide reference for healthcare institutions in deployment management for equipment in responding public health emergencies.Methods:The existed problems of healthcare institutions in facing public health emergencies were analyzed.Based on evidence-based practices from domestic and international healthcare institutions in responding public health emergencies,and combined with the experiences of West China Hospital of Sichuan University in preventing and treating epidemic infection of public health emergencies,a scheme of deployment management of life-supporting equipment,and an assessment scheme that precisely matched mode and equipment for supporting respiratory were formulated.The ventilator-related medical consumables was standardly managed.A deployment management mode for life-supporting equipment was constructed to conduct deployment management for the using 293 non-invasive ventilators and 112 high-flow non-invasive respiratory humidification devices in our hospital from December 26,2022,to January 20,2023.Results:During the period of deployment management for 293 non-invasive ventilators,a total of 7492 prescriptions of non-invasive ventilation were completed,and 3183 prescriptions of non-invasive(high-follow)ventilation of using 112 high-flow non-invasive respiratory humidification devices were completed at the same period,which better ensured the requirements of all patients in clinical treatment.The average turnaround time of equipment was shorted from 22.5 min before deployment management mode was implemented to 12.6 min after it was implemented.The accuracy rate of healthcare personnel was 100%in preparing medical consumables.Conclusion:The deployment management mode of life-supporting equipment can increase the use rate of limited life-supporting equipment at the maximum degree,and increase the turnover efficiency of equipment,and decrease turnover time and vacancy rate of equipment,and increase the accuracy rate of preparing medical consumables,and meet the requirement of clinical treatment under the premise of"overall deployment and coordinated management".