Liver cancer has high prevalence and mortality rates around the world， and its development and progression are closely associated with the interaction between the tumor microenvironment and tumor-associated macrophages （TAMs）. TAMs play a significant role in immune suppression， immune escape， cell proliferation， invasion， metastasis， and drug resistance in liver cancer. Traditional Chinese medicine （TCM）， with its unique therapeutic concepts and methods， has shown great potential in regulating TAMs and improving the prognosis of liver cancer. This article reviews the role and molecular mechanisms of TCM in regulating TAMs for the treatment of liver cancer， discusses the key role of TAMs in the progression of liver cancer， and analyzes the impact of Chinese medicinal components on the recruitment， polarization， and activity of TAMs and the expression of related factors based on TCM theory. Studies have shown that TCM can regulate the polarization state of TAMs， promote the formation of M1-type antitumor macrophages， and inhibit the activity of M2-type tumor macrophages， thereby playing a role in inhibiting the proliferation of liver cancer cells， promoting apoptosis， inhibiting angiogenesis， and enhancing immune response. In addition， this article also summarizes the molecular targets and mechanisms of action of TCM monomers， compound prescriptions， and novel preparations in the treatment of liver cancer， such as inhibiting the secretion of cytokines by TAMs， regulating signaling pathways， and affecting metabolic pathways， in order to provide a scientific basis for the application of TCM in liver cancer treatment and offer new ideas for immunotherapy for liver cancer.

Stem-leaf saponins from Panax notoginseng (SLSP) comprise numerous PPD-type saponins with diverse pharmacological properties; however, their role in Parkinson's disease (PD), characterized by microglia-mediated neuroinflammation, remains unclear. This study evaluated the effects of SLSP on suppressing microglia-driven neuroinflammation in experimental PD models, including the 1-methyl-4-phenylpyridinium (MPTP)-induced mouse model and lipopolysaccharide (LPS)-stimulated BV-2 microglia. Our findings revealed that SLSP mitigated behavioral impairments and excessive microglial activation in models of PD, including MPTP-treated mice. Additionally, SLSP inhibited the upregulation of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX2) and attenuated the phosphorylation of PI3K, protein kinase B (AKT), nuclear factor-κB (NFκB), and inhibitor of NFκB protein α (IκBα) both in vivo and in vitro. Moreover, SLSP suppressed the production of inflammatory markers such as interleukin (IL)-1β, IL-6, and tumor necrosis factor alpha (TNF-α) in LPS-stimulated BV-2 cells. Notably, the P2Y2R agonist partially reversed the inhibitory effects of SLSP in LPS-treated BV-2 cells. These results suggest that SLSP inhibit microglia-mediated neuroinflammation in experimental PD models, likely through the P2Y2R/PI3K/AKT/NFκB signaling pathway. These novel findings indicate that SLSP may offer therapeutic potential for PD by attenuating microglia-mediated neuroinflammation.
Animals ; Panax notoginseng/chemistry* ; Saponins/pharmacology* ; Microglia/immunology* ; Mice ; NF-kappa B/immunology* ; Signal Transduction/drug effects* ; Proto-Oncogene Proteins c-akt/immunology* ; Phosphatidylinositol 3-Kinases/genetics* ; Male ; Parkinson Disease/immunology* ; Mice, Inbred C57BL ; Disease Models, Animal ; Plant Leaves/chemistry* ; Neuroinflammatory Diseases/drug therapy* ; Humans

Currently,electroencephalogram(EEG),functional near-infrared spectroscopy(fNIRS),and functional magnetic resonance imaging have been widely studied and applied to neuropsychiatric disorders.In recent years,the devices which can realize the simultaneous acquisition of EEG and fNIRS has been developed and gradually applied in the studies on neuropsychiatric disorders.The review provides an introduction of the techniques of synchronized detection and data analysis for EEG-fNIRS,summarizes the analysis methods and new findings of the recent studies of stroke,epilepsy,and other neuropsychiatric disorders using EEG-fNIRS,and also discusses the future research directions.

Objective This study aims to provide an in-depth analysis of the effectiveness of blood pressure control and the influencing factors in elderly hypertensive patients in urban areas of Beijing,providing scientific support for developing more precise and effective home pharmaceutical intervention strategies.Methods Pharmacists conducted home visits and administered questionnaires to systematically investigate elderly hypertensive patients aged 60 and above in the urban areas of Beijing from February to June 2023.Binary logistic regression was used to identify key factors affecting blood pressure control.Results A total of 575 questionnaires were collected with 560 valid responses,achieving an effective recovery rate of 97.39%.Among the respondents,233 were male(41.61%)and 327 were female(58.39%),with a median age of 69.The proportion of patients with qualified blood pressure control was 33.39%(187 cases).Logistic regression analysis further revealed that smoking,the presence of comorbidities,and multiple comorbid conditions significantly impacted the control rate(P<0.05).Conclusion The blood pressure control rate among elderly hypertensive patients in urban areas of Beijing remains low.It is recommended to develop more targeted home pharmaceutical intervention measures for patients who smoke and have multiple comorbidities to enhance blood pressure control outcomes.

Centric relation(CR)was used in the complete dentures for edentulous jaws firstly.Then,CR was gradual-ly applied in the clinical diagnosis and treatment of dentate jaws.Regarding the application of CR in dentate jaws,there are many doubts about its rationality.For instance,should CR be the core of diagnosis and treatment of temporomandibu-lar disorders?Should CR be used as the jaw position of establishing occlusion in occlusal reconstruction?Should CR serve as the target jaw position in orthodontic treatment?Meanwhile,varieties of CR clinical applications are objective.According to the existing evidence,this paper summarizes the applicable conditions of several main clinical situations with little controversy.We preliminarily put forward the decision tree for the clinical application of CR,which can be used as a reference in clinical practice.

Objective To investigate the correlation between uterine globulin associated protein 1(UGRP1)and Fas mediated apoptosis pathway in hashimoto thyroiditis(HT).Methods The expression of UGRP1 in thyroid cells of normal people and HT patients was detected by immunohistochemistry(IHC).FRTL-5 cells were transfect-ed by plasmids in vitro,and control group,UGRP1 group,Fas group were established respectively.Real-time fluo-rescent quantitative reverse transcription PCR(RT-qPCR)was used to detect the expression of Fas and UGRP1 mRNA in each group.Results UGRP1 expression was positive in thyroid cells of HT patients and negative in that of normal people.There were no significant differences between control group and UGRP1 group in Fas gene ex-pression(1.085 0±0.124 9 vs 1.021 0±0.113 9).Compared with the control group,the expression of UGRP1 gene increased significantly in Fas group(P＜0.000 1,5.807 0±0.323 2 vs 0.752 7±0.076 0).Conclusion The high expression of UGRP1 in HT may be related to apoptosis pathway mediated by Fas.

Objective To conduct a systematic review of relevant literature to understand the current status and influencing factors of telehealth readiness of clinical medical staff.Methods The Chinese and English databases of CNKI,Wanfang database,VIP,SinoMed,Pubmed,Embase,Cochrane Library,CINAHL,Web of Science were searched by computer.The Chinese and English literatures on the current status and influencing factors of remote health care readiness among medical staff personnel were collected.The search time was from the establishment of the database to July 12th,2023,and the literature was screened and evaluated.After data extraction and integration of the literature,descriptive analysis is conducted.Results 18 articles were ultimately included,involving 12 298 medical staff members.Research shows that the readiness of clinical medical staff for telehealth is currently at a moderate level and not optimistic.The relevant influencing factors are:medical staff factors,including general demography factors,willingness of medical care services,innovative self-efficacy,understanding and participation of telehealth care mode,and electronic information ability;organizational factors:including telemedicare policies,telemedicare training,sufficient human resource working environment and atmosphere,hospital level and type.Conclusions The readiness of clinical medical staff for remote health care is at a moderate level,but their willingness to participate in remote health care is high.It is recommended to construct a scientific and feasible remote health care training program for medical staff in the future to improve the quality of hospital services.

Objective:To compare the antiosteoporosis effect of conventional treatment and conventional treatment combined with Denosumab after percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures (OVCF).Methods:A retrospective cohort study was conducted to analyze the clinical data of 211 patients with OVCF admitted to the Second Affiliated Hospital of Soochow University from September 2020 to September 2022. All the patients were female, aged 56-90 years [(71.4±8.1)years]. The bone mineral density T-score of the lumbar spine was (-2.6±1.0)SD before operation. Fracture segments included T 1-T 9 in 45 patients, T 10-L 2 in 146, and L 3-L 5 in 69. Of all, 174 patients were treated with single-segment surgery, 25 with two-segment surgery and 12 with surgery involving three or more segments. According to the wishes of the patients, 107 patients were treated with daily oral administration of calcium and active Vitamin D after PKP (conventional treatment group) and 104 patients with Denosumab combined with the conventional treatment after PKP (Denosumab therapy group). The bone mineral density T-scores of the lumbar spine of the two groups were compared before surgery and at the last follow-up. The visual analogue scale (VAS) and Oswestry disability index (ODI) before surgery, at 3 days, 6 months after surgery, and at the last follow-up were evaluated and the refracture rate after surgery was detected. Possible adverse effects after medication during anti-osteoporosis treatment were observed in two the groups. Results:All the patients were followed up for 12-24 months [(13.5±2.0)months]. Before surgery, the bone mineral density T-score of the lumbar spine was (-2.7±1.1)SD in the Denosumab therapy group and (-2.5±0.8)SD in the conventional treatment group ( P>0.05). At the last follow-up, the bone mineral density T-score of the lumbar spine was (-2.1±1.1)SD in the Denosumab therapy group, significantly higher than (-2.5±0.9)SD in the conventional treatment group ( P<0.05). In the Denosumab therapy group, the bone mineral density T-score of the lumbar spine at the last follow-up was significantly increased compared to that before surgery ( P<0.01), while there was no significant difference in the conventional treatment group ( P<0.05). Before surgery and at 3 days after surgery, the VAS scores and ODI values were (8.5±0.9)points, (2.8±0.8)points, 48.7±4.8 and 25.6±4.0 in the Denosumab therapy group, which was not statistically different from those in the conventional treatment group [(8.5±1.3)points and (2.8±0.9)points, 47.9±7.0 and 25.9±3.7] ( P>0.05). At 6 months after surgery and at the last follow-up, the VAS scores and ODI values were (2.2±0.8)points, (1.7±0.8)points, 24.2±3.6 and 23.2±4.1 in the Denosumab therapy group, significantly lower than those of the conventional treatment group [(2.8±0.9)points, (2.8±1.1)points, 26.4±3.2 and 27.3±4.0] ( P<0.01). The VAS scores at each time point after surgery in both groups decreased significantly compared with those before surgery ( P<0.05). The VAS scores continued to decrease after surgery in the Denosumab therapy group ( P<0.05), while no significant difference was found among those at different time points in the conventional treatment group ( P>0.05). The ODI values at each time point after surgery in both groups significantly decreased compared to those before surgery ( P<0.05). The ODI values continued to decrease after surgery in the Denosumab therapy group ( P<0.05), while in the conventional treatment group, no significant difference was found between those at 6 months after surgery and those at 3 days after surgery ( P>0.05) and they were improved at the last follow-up compared with those at 3 days after surgery ( P<0.05). The refracture rate after surgery was 6.7% (7/104) in the Denosumab therapy group, significantly lower than 16.8% (18/107) in the conventional treatment group ( P<0.05). No serious complications were observed during the antiosteoporosis period in either group. Conclusion:Compared with daily oral administration of Calcium and active Vitamin D after PKP, the conventional treatment combined with Denosumab after PKP can effectively increase the bone density, relieve pain continuously, improve functional restoration, and reduce the risk of refracture in OVCF patients.

Objective:To investigate the risk factors of postoperative recurrence of parastomal hernia repair.Methods:The clinical and follow-up data of 128 patients undergoing parastomal hernia repair at the the Central Hospital of Wuhan, Tongji Medical College of Huazhong University of Science and Technology from Jan 1, 2013 to Dec 31, 2022 was analyzed retrospectively.Results:Postoperative recurrence was confirmed in 32 patients during follow-up, and the recurrence rates were 13.8% , 24.8% and 25.0% at 1',3' and 5 years .Univariate analysis showed that body mass index (BMI) , chronic obstructive pulmonary disease (COPD), type of stoma, prophylactic stoma displacement, and surgical options were the risk factors for recurrence after parastomal hernia repair. Multiple Logistic regression analysis showed that BMI, COPD, prophylactic stoma displacement, and surgical options were independent risk factors for the recurrence after parastomal hernia ( P< 0.05). Conclusion:The occurrence of hernia recurrence after parastomal hernia repair is closely related to patients' BMI, COPD, prophylactic stoma displacement and the surgical options.

Objective To explore the application of MRI in the differential diagnosis of high-and low-risk thymoma.Methods The data of patients with pathologically confirmed thymoma were collected bidirectionally,and the differences in clinical data,MRI image characteristics of lesions,signal characteristics and apparent diffusion coefficient(ADC)values were compared and analyzed between high-and low-risk thymoma according to the pathological subtype.The receiver operating characteristic(ROC)curve analysis was used to screen out meaningful features,then the diagnostic efficacy and combined prediction probability of indicators were evaluated.Results There was no significant difference in clinical data(P＞0.001).The morphology of high-risk lesions was mainly irregular,while that of low-risk lesions was mainly regular.The edges of high-risk lesions were mostly not smooth,and the edges of low-risk lesions were mostly smooth.The enhancement degree of high-risk lesions was higher than that of low-risk lesions,and the ADC value was lower than that of low-risk lesions,with statistical significance(P＜0.001),in which the ADC value area under the curve(AUC)was higher than other indicators(AUC=0.968),and the combined prediction probability of indicators was the highest(AUC=0.981).Conclusion MRI shows great potential application value in preoperative differential diagnosis of high-and low-risk thymoma.