Bronchial asthma （BA） is a common chronic inflammatory airway disease characterized by airway hyperresponsiveness and reversible airflow limitation. Lung macrophages （LMs）， as important effector cells of the innate immune system， play an important role in recognizing and engulfing pathogens， clearing harmful particles， and regulating immune responses. LMs can be polarized to M1 （pro-inflammatory） or M2 （anti-inflammatory） in different immune environments and participate in promoting or inhibiting inflammatory response， as well as lung parenchyma injury and repair （airway remodeling）， playing a key role in the BA occurrence and development. Regulating the polarization balance of macrophages can not only inhibit the inflammatory response in the airway and reduce airway hyperresponsiveness， but also improve airway remodeling and immune regulation， reduce airway mucus secretion， and alleviate the clinical BA symptoms. Traditional Chinese medicine and its active ingredients， especially polysaccharides and saponins， can regulate the polarization balance of M1/M2 macrophages. Traditional Chinese medicine compounds can balance the secretion of anti-inflammatory and pro-inflammatory factors by staging treatment and targeting the polarization state of M1/M2 macrophages， inhibit inflammatory response in the airway， reduce airway remodeling， and improve the BA symptoms. This paper summarized the research progress on the regulation of M1/M2 macrophage polarization by traditional Chinese medicine and its active ingredients， aiming to provide scientific evidence for the precise targeted therapy of BA.

Bronchial asthma （BA） is a common chronic inflammatory airway disease characterized by airway hyperresponsiveness and reversible airflow limitation. Lung macrophages （LMs）， as important effector cells of the innate immune system， play an important role in recognizing and engulfing pathogens， clearing harmful particles， and regulating immune responses. LMs can be polarized to M1 （pro-inflammatory） or M2 （anti-inflammatory） in different immune environments and participate in promoting or inhibiting inflammatory response， as well as lung parenchyma injury and repair （airway remodeling）， playing a key role in the BA occurrence and development. Regulating the polarization balance of macrophages can not only inhibit the inflammatory response in the airway and reduce airway hyperresponsiveness， but also improve airway remodeling and immune regulation， reduce airway mucus secretion， and alleviate the clinical BA symptoms. Traditional Chinese medicine and its active ingredients， especially polysaccharides and saponins， can regulate the polarization balance of M1/M2 macrophages. Traditional Chinese medicine compounds can balance the secretion of anti-inflammatory and pro-inflammatory factors by staging treatment and targeting the polarization state of M1/M2 macrophages， inhibit inflammatory response in the airway， reduce airway remodeling， and improve the BA symptoms. This paper summarized the research progress on the regulation of M1/M2 macrophage polarization by traditional Chinese medicine and its active ingredients， aiming to provide scientific evidence for the precise targeted therapy of BA.

ObjectiveTo investigate the effect and mechanism of long intergenic non-coding RNA02086 （LINC02086） overexpression mediated macrophage polarization on the proliferation， migration and invasion of gastric cancer cells. MethodsThe expression levels of LINC02086 in the human gastric epithelial cell line GES-1 and human gastric cancer cell lines HCG-27， NCI-N87， and AGS were determined by qRT-PCR. Human acute monocytic leukemia cells （THP-1） were induced to differentiate into M0 macrophages using phorbol 12-myristate 13-acetate （PMA）. HGC-27 cells were infected with either LINC02086 overexpression lentivirus （OE-LINC02086） or its negative control lentivirus （Vector）， and the culture supernatants were collected as conditioned medium （CM1）. M0 macrophages were co-cultured with the infected HGC-27 cells， and the resulting supernatants were designated as conditioned medium 2 （CM2）. M0 macrophages were treated with CM1 alone or in combination with Wnt/β-catenin pathway inhibitor IWR-1， forming the Vector+CM1， OE-LINC02086+CM1， and OE-LINC02086+CM1+IWR-1 groups， respectively. Flow cytometry was used to detect mannose receptor C-type 1 （CD206） expression， and qRT-PCR was employed to measure mRNA levels of interleukin-10 （IL⁃10）， transforming growth factor-β （TGF⁃β）， vascular endothelial growth factor （VEGF）， and chemokine ligand 22 （CCL22）. Western blot was performed to evaluate protein expression of CD206， VEGF， and key components of the Wnt/β-catenin pathway—Wnt family member 3a （Wnt3a）， glycogen synthase kinase-3β （GSK-3β）， and β-catenin. HGC-27 cells were treated with CM2 alone or combined with IWR-1， establishing the Vector+CM2， OE-LINC02086+CM2， and OE-LINC02086+CM2+IWR-1 groups. CCK-8 assay was used to evaluate cell proliferation， and Transwell assays were conducted to assess migration and invasion capabilities. ResultsCompared with GES-1 cells， the expression levels of LINC02086 were upregulated in HCG-27， NCI-N87， and AGS cells （P < 0.05）， with the smallest increase observed in HCG-27 cells. Compared with Vector+CM1 group， the level of CD206 and the expression levels of IL⁃10， TGF⁃β， VEGF and CCL22 mRNA in macrophages stimulated by OE-LINC02086+CM1 increased （P<0.05）. Meanwhile， the expression levels of Wnt3a and β-catenin proteins in cells increased （P<0.05）， and the expression level of GSK-3β protein decreased （P<0.05）. However， co-treatment with IWR-1 markedly reversed the promoting effects of LINC02086 overexpression on the expression of M2 polarization markers， including CD206， IL⁃10， and TGF⁃β mRNA， in macrophages （P<0.05）， as well as its activation of the Wnt/β-catenin signaling pathway （P<0.05）. Compared with Vector+CM2 group， HGC-27 cells infected with OE-LINC02086+CM2 had increased proliferation activity and increased number of migration and invasion cells （P<0.05）. However， the combined intervention of IWR-1 significantly reversed the promotion of LINC02086 overexpression on the proliferation， migration and invasion of HGC-27 cells （P<0.05）. ConclusionLINC02086 overexpression promotes the proliferation， migration and invasion of gastric cancer cells by activating Wnt/β-catenin pathway to mediate M2 polarization of macrophages.

ObjectiveZheng’s San Qi San (ZSQS) power, a classic traditional Chinese medicine (TCM) formula, is used for treating soft tissue injuries involving muscles, tendons, and ligaments. However, its underlying therapeutic mechanisms remain unclear. This study aimed to screen and identify pharmaceutically active ingredients and their candidate biomolecule targets, and further elucidate the molecular mechanism of ZSQS in the treatment of skeletal muscle injury. MethodsNetwork pharmacology was employed to construct “ZSQS-component-target”, “protein-protein interaction (PPI)” and “active ingredient-core protein-pathway” networks to predict the key active ingredients and potential core targets of ZSQS for skeletal muscle injury. The predicted results were then validated via microarray data from the GEO database. Molecular docking was then performed to assess the binding ability between the screened active ingredients of ZSQS and the candidate core targets. Moreover, liquid chromatography-mass spectrometry (LC-MS) was used for qualitative and quantitative analysis to verify the active components of the drug and ZSQS serum. Finally, an animal model of eccentric exercise-induced skeletal muscle injury and a myotube cell model of oxidative stress-induced injury were established to validate the effects of ZSQS and its interventional effects on the biological functions of critical targets, thereby demonstrating the potential therapeutic mechanism of ZSQS. ResultsAmong the 111 active components identified in ZSQS and their corresponding 204 targets related to the skeletal muscle injury repair process, 14 core targets (including AKT1) and 4 core active components (quercetin, luteolin, kaempferol, and β‑sitosterol) were screened out, while the corresponding metabolites of quercetin, luteolin and kaempferol were detected in the ZSQS serum. Among these targets, 5 candidate genes (IL-6, CASP3, HIF1A, STAT3, and JUN) overlapped with the differential expression screening results with GEO data, and IL-6 was confirmed to be enriched in the PI3K/AKT pathway. Combined with the prediction results of the AKT expression levels, these findings suggest that the phosphorylation level of AKT1 plays a core role in the therapeutic mechanism of ZSQS. Molecular docking analysis further revealed that the PH domain of AKT1 had high binding energy with all 4 core active components, as verified by LC-MS. Finally, animal model studies have shown the promoting effect of ZSQS administration on skeletal muscle injury repair and its possible antioxidant damage mechanism. Cell model studies further demonstrated that ZSQS-containing serum, core active ingredient combination therapy, and quercetin monomer could increase the phosphorylation level of AKT, promote the nuclear translocation of Nrf2, upregulate the expression of downstream antioxidant enzymes (SOD, GPx, and GR), and inhibit the expression of inflammatory factors (IL-6 and TNF-α), thereby alleviating oxidative stress and the inflammatory response. ConclusionZSQS alleviates skeletal muscle injury mainly by activating the AKT/Nrf2 signaling pathway, enhancing cellular antioxidant and anti-inflammatory capabilities. The results of this study provide a scientific basis for the clinical application and modernized development of ZSQS.

Objective To retrospectively analyze the impact of low-dose computed tomography (LDCT) parameter optimization on the diagnostic accuracy for pulmonary nodules and their radiation exposure, and to provide a basis for balancing diagnostic performance and radiation safety. Methods Data from 300 high-risk individuals who underwent pulmonary LDCT screening at Wuhan Hospital of Traditional Chinese Medicine between January 2023 and December 2024 were collected. Participants were divided into an optimized LDCT group (n = 150; 100 kV, 70-90 mA) and a traditional LDCT group (n = 150; 120 kV, 140-160 mA) based on scanning parameters. Baseline characteristics, radiation dose, image quality, and diagnostic accuracy were compared between the two groups. Key factors influencing diagnostic accuracy were analyzed. Results In the optimized group, the volume CT dose index, dose-length product, and effective dose decreased by over 40% (t = 37.492, 35.351, and 35.262, respectively, all P<0.001). Similarly, tube voltage and current decreased significantly (t = 14.582 and 28.653, respectively, both P<0.001), while scan time showed no significant change (t = 0.321, P = 0.760). The overall image quality score of the optimized group was slightly lower than that of the traditional group (4.21 ± 0.43 vs. 4.38 ± 0.39; t = 3.587, P<0.001), but remained within the good-to-excellent range. Both groups demonstrated high diagnostic confidence (4.25 vs. 4.41; t = 3.361, P = 0.001) and high inter-evaluator consistency as indicated by an intraclass correlation coefficient of 0.82. No significant differences were observed between the two groups in sensitivity (94.83% vs. 96.43%; Z = 0.393), specificity (91.30% vs. 90.22%; Z = 0.292), accuracy (92.78% vs. 93.33%; χ² = 0.031), and area under the receiver operating characteristic curve (0.931 vs. 0.938; Z = 0.202) (all P>0.05). Diagnostic performance for<6 mm nodules showed no significant difference (P = 0.778). Multivariable analysis identified nodule size, solid density, lobulated margins, and image quality score as independent predictors of diagnostic accuracy. Conclusion Optimized LDCT can significantly reduce radiation exposure (by over 40%) while maintaining diagnostic accuracy for pulmonary nodules, including small nodules, and good image quality, making it suitable for lung cancer screening in high-risk populations.

Objective To introduce an innovative technique, the "balance-shaped sternal elevation device" and its application in the subxiphoid uniportal video-assisted thoracoscopic surgery (VATS) for anterior mediastinal masses resection. Methods Patients who underwent single-port thoracoscopic assisted anterior mediastinal tumor resection through the xiphoid process at the Department of Thoracic Surgery, West China Hospital, Sichuan University from May to June 2024 were included, and their clinical data were analyzed. Results A total of 7 patients were included, with 3 males and 4 females, aged 28-72 years. The diameter of the tumor was 1.9-17.0 cm. The operation time was 62-308 min, intraoperative blood loss was 5-100 mL, postoperative chest drainage tube retention time was 0-9 days, pain score on the 7th day after surgery was 0-2 points, and postoperative hospital stay was 3-12 days. All patients underwent successful and complete resection of the masses and thymus, with favorable postoperative recovery. Conclusion The "balance-shaped sternal elevation device" effectively expands the retrosternal space, providing surgeons with satisfactory surgical views and operating space. This technique significantly enhances the efficacy and safety of minimally invasive surgery for anterior mediastinal masses, reduces trauma and postoperative pain, and accelerates patient recovery, demonstrating important clinical significance and application value.

OBJECTIVES: To develop a scale for evaluating responsive feeding behaviors among caregivers of children aged 0-24 months in China, and to examine its reliability and validity. METHODS: An initial item pool was constructed through literature review, expert panel discussions, and caregiver interviews. Items were screened and revised using expert consultation and item analysis. A total of 523 caregivers of children aged 0-24 months were randomly selected from urban community health service centers in Nanjing for a formal survey to assess the scale's reliability and validity. RESULTS: The scale comprised two age-specific subscales: 0-6 months (4 dimensions, 18 items) and 7-24 months (5 dimensions, 29 items). Cronbach's alpha values for the two subscales were 0.766 and 0.850, respectively; split-half reliability coefficients were 0.616 and 0.716. Content validity indices were 0.83 for the 0-6 months subscale and 0.86 for the 7-24 months subscale. Confirmatory factor analysis supported the structural validity of both subscales, with all fit indices within acceptable ranges. CONCLUSIONS The two age-specific subscales demonstrate good reliability and validity and can serve as practical tools for assessing caregivers' responsive feeding behaviors in children aged 0-24 months, suitable for clinical application and dissemination.
Humans ; Infant ; Caregivers/psychology* ; Male ; Female ; Feeding Behavior ; Child, Preschool ; Infant, Newborn ; Reproducibility of Results

Hearing loss is the most prevalent disabling disease. Cochlear implantation（CI） serves as the primary intervention for severe to profound hearing loss. This consensus systematically explores the value of genetic diagnosis in the pre-operative assessment and efficacy prognosis for CI. Drawing upon domestic and international research and clinical experience, it proposes an evidence-based medicine three-tiered prognostic classification system（Favorable, Marginal, Poor）. The consensus focuses on common hereditary non-syndromic hearing loss（such as that caused by mutations in genes like GJB2, SLC26A4, OTOF, LOXHD1） and syndromic hereditary hearing loss（such as Jervell & Lange-Nielsen syndrome and Waardenburg syndrome）, which are closely associated with congenital hearing loss, analyzing the impact of their pathological mechanisms on CI outcomes. The consensus provides recommendations based on multiple round of expert discussion and voting. It emphasizes that genetic diagnosis can optimize patient selection, predict prognosis, guide post-operative rehabilitation, offer stratified management strategies for patients with different genotypes, and advance the application of precision medicine in the field of CI.
Humans ; Cochlear Implantation ; Prognosis ; Hearing Loss/surgery* ; Consensus ; Connexin 26 ; Mutation ; Sulfate Transporters ; Connexins/genetics*

Objective:To introduce a new design of super-micro flap for endoscopic ear surgery, and to evaluate the application effect of super-micro flap in endoscopic tympanoplasty. Methods:Between January, 2023 and March, 2024, 58 patients（64 ears） with tympanosclerosis underwent tympanoplasty with super-micro flap. Continuous irrigating mode endoscopic ear surgery（CIM-EES） was used to complete type Ⅱ or Ⅲ tympanoplasty with the tragus cartilage with followed up for 12 to 24 months. The operation time, postoperative efficacy and complications were statistically analyzed. Results:Of the 64 ears, 63 ears had primary healing of the tympanic membrane, and 1 ear had cartilage necrosis due to multi-drug resistant bacteria infection. The second operation was performed one year later, and the success rate of operation was 98.40%. The average operation time was （48.40±8.86） minutes. The average hearing threshold of 0.5 kHz to 4.0 kHz before operation was （59.63±10.62） dB HL, and the average air conduction threshold of 0.5 kHz to 4.0 kHz one year after operation was（38.79±10.91） dB HL, which was significantly improved compared with that before operation（P<0.01）. Bone conduction threshold also improved significantly （24.49±8.55） dB HL vs（21.88±7.58） dB HL（P<0.01）. No outer tympanic membrane healing and ear canal scar stenosis occurred. Conclusion:The design of super-micro flap can effectively solve the interference of flap floating during continuous irrigating mode in endoscopic ear surgery, relieve the difficulty of flap reposition, simplify the operation process, help to shorten the operation time, and reduce the possibility of circular scar stenosis of conventional free flap, which provides a new flap design option for endoscopic ear surgery.
Humans ; Tympanoplasty/methods* ; Endoscopy/methods* ; Surgical Flaps ; Male ; Female ; Adult ; Myringosclerosis/surgery* ; Middle Aged ; Treatment Outcome ; Tympanic Membrane/surgery* ; Adolescent ; Young Adult

Homo- or heterodimeric compounds that affect dimeric protein function through interaction between monomeric moieties and protein subunits can serve as valuable sources of potent and selective drug candidates. Here, we screened an in-house dimeric natural product collection, and panepocyclinol A (PecA) emerged as a selective and potent STAT3 inhibitor with profound anti-tumor efficacy. Through cross-linking C712/C718 residues in separate STAT3 monomers with two distinct Michael receptors, PecA inhibits STAT3 DNA binding affinity and transcription activity. Molecular dynamics simulation reveals the key conformation changes of STAT3 dimers upon the di-covalent binding with PecA that abolishes its DNA interactions. Furthermore, PecA exhibits high efficacy against anaplastic large T cell lymphoma in vitro and in vivo, especially those with constitutively activated STAT3 or STAT3^Y640F. In summary, our study describes a distinct and effective di-covalent modification for the dimeric compound PecA to disrupt STAT3 function.