Objective:To analyze the efficacies of unilateral biportal endoscopy(UBE)and percutaneous endoscopic transforaminal discectomy(PETD)in treatment of lumbar disc herniation(LDH),and to explore the optimal selection of minimally invasive surgical approaches for the The LDH patients.Methods:A retrospective analysis was performed on the clinical data of 64 LDH patients who underwent surgery at Liwan Central Hospital of Guangzhou City in Guangdong Province,between January 2020 and June 2024.The surgical approaches were determined through physician-patient communication,and the patients were divided into UBE group(n=30)and PETD group(n=34).The materials of patients were recorded including gender,age,body mass index(BMI),percentages of affected segments,course of disease,duration of hospitalization,operation duration,intraoperative blood loss,numbers of intraoperative fluoroscopy,total incision length,and time to full weight-bearing(WB).The therapeutic outcomes were evaluated using Oswestry disability index(ODI),Visual Analog Scale(VAS)scores for low back pain and leg pain,MacNab criteria,and spinal canal areas at the affected segment.the postoperative complications of the patients in two groups were analyzed.Results:There were no statistically significant differences in age,gender composition ratio,BMI,course of disease,and percentages of affected segments of the patients between UBE group and PETD group(P＞0.05).Compared with PETD group,the intraoperative blood loss,total incision length,and time to full WB of the patients in UBE group were significantly increase(P＜0.01),while the number of intraoperative fluoroscopy time was decreased(P＜0.01).Compared with pre-operation,the ODI scores and VAS scores for low back and leg pain of the patients at final follow-up in both groups were decreased(P＜0.01),and the spinal canal areas at the affected segments of the patients were increased(P＜0.01).At final follow-up,compared with PETD group,the ODI score and VAS scores for low back and leg pain of patients in UBE group were decreased(P＜0.01),while the spinal canal areas at the affected segments of the patients was increased(P＜0.01).According to MacNab criteria,the percentages of excellent and good had no significant difference between two groups(P＞0.05).The incidence of complication showed no statistical difference between two groups(P＞0.05).Conclusion:Both UBE and PETD yield satisfactory outcomes in the treatment of single-segment LDH.PETD is less invasive and permits earlier time to full WB,whereas UBE provides more extensive decompression and superior long-term efficacy.The surgical approach selection should be individualized based on specific factors in the clinic.

OBJECTIVE To explore the clinical risks and monitoring essentials associated with tonifying Chinese patent medicine. METHODS The varieties of tonifying Chinese patent medicines listed in the National Basic Drug List （2024 edition） were counted. Package inserts were collected using software such as “Dingxiangyuan” and then classified and organized according to criteria such as “drug name”“ingredients”“contraindications”“precautions”“drug interactions”. The names of traditional Chinese medicine （TCM） decoction pieces were standardized in accordance with the Chinese Pharmacopoeia （2020 edition） and other relevant standards； literature was reviewed to compile information on TCM decoction pieces that required caution/were contraindicated in special populations， as well as tonifying Chinese patent medicines and their related clinical applications. Then， a database for tonifying Chinese patent medicines was ultimately established by relying on the hospital’s internal information system， so as to conduct an in-depth exploration of the clinical usage risks and key monitoring points of tonifying Chinese patent medicines. RESULTS A total of 222 tonifying traditional Chinese medicines were evaluated. Contraindications or requirements for cautious use were identified in 91 （40.99%） for hepatic or renal impairment， 9 （4.05%） for hypertension， and 8 （3.60%） for pediatric patients， and 109 （49.10%） were designated as contraindicated or requiring caution for athletes. CONCLUSIONS Although tonifying Chinese patent medicines are indicated for deficiency patterns， their use is accompanied by measurable clinical risk， especially in individuals with hepatic or renal compromise who are prone to adverse reactions.

Objectives:To compare the efficacy and imaging parameters of lateral lumbar interbody fusion(LLIF)combined with anterolateral screw fixation(AF)or bilateral pedicle screw fixation(BPSF)in the treatment of lumbar degenerative disease(LDD).Methods:A retrospective study was conducted on 100 patients with single-segment LDD who underwent LLIF-AF or LLIF-BPSF treatment at the First Affiliated Hospital of Kunming Medical University between December 2019 and December 2021.The patients were divided into the AF group(50 cases)and the BPSF group(50 cases).There was no statistical difference in the general informa-tion such as gender,age,and body mass index(BMI)between the two groups(P＞0.05).The perioperative data(length of hospital stay,operative time,intraoperative blood loss);Pre-operative,postoperative 7d,postoperative 6 months' visual analog scale(VAS)scores for low back and leg pain,Oswestry disablity index(ODI),imaging parameters such as disc height(DH),foraminal height(FH),cross-sectional area(CSA),as well as surgical complications were collected and analyzed,and the risk factors for intervertebral subsidence and non-fusion of fusion device were explored.Results:AF group was better than BPSF group in operative time,intraoperative blood loss,and hospital stay[125.0±26.6min vs 221.6±52.2min,25.0mL(20.0-50.0mL)vs 100.0mL(90.0-150.0mL),12.5±4.8d vs 14.9±4.6d],and the differences were statistically significant(P＜0.05).For the low back and leg pain VAS scores and ODI,as well as DH,FH,and CSA,the postoperative 7d and 6 months'values were signiticantly improved than before operation in both groups(P＜0.05),while no statistically significant differences were found between groups at the same time points(P＞0.05).Intervertebral subsidence occurred in 12 patients in each group,and there was no statistically significant difference between the two groups.There were statistically significant differences in BMI and QCT between the AF and BPSF groups of patients with subsidence of the intervertebral space and those without subsidence at 6 months after operation;There were statistically significant differences in QCT between the two groups of patients with non-fusion and fusion of the fusion device;BMI≥28kg/m2 and QCT＜80mg/cm3 were the independent risk factors for intervertebral subsidence in AF group,but not in the BPSF group;QCT＜80mg/cm3 was the independent risk facors for non-fusion of fusion device in both AF and BPSF groups.Conclusions:LLIF combined with AF or BPSF are both reliable methods for treating LDD.For patients with a high body weight of BMI≥28kg/m2 or decreased bone density of QCT＜80mg/cm3,BPSF internal fixation can provide stronger mechanical stability to the spine,reducing the incidence of postoperative disc space collapse or fusion device non-union;On the contrary,AF internal fixation has shorter operative time and hospital stay,less intraoperative blood loss,which can be considered as a priority.

Objective To elucidate the role of miR-155-5p in diabetic retinopathy(DR)and its potential mechanism.Methods Twelve peripheral blood samples were collected from the Ophthalmology Department of the First Affiliated Hospital of Jinzhou Medical University.Among them,six blood samples from healthy individuals were set as the control group,and the other six blood samples from DR patients were set as the DR group.Reverse transcription-polymerase chain reaction(RT-PCR)was used to verify the expression levels of miR-155-5p in two groups of blood samples.The effects of miR-155-5p on cell proliferation,apoptosis,autophagy,and inflammation related proteins[including P62,LC3B,NOD-like receptor protein 3(NLRP3),IL-1β,and pro-caspase-1]were observed using a high glucose(100 mmol·L-1)-induced DR cell model.Some ARPE-19 cells were intervened with the miR-155-5p inhibitor or its negative control inhibitor(i.e.,NC-inhibitor),and then they were divided into the HG+miR-155-5p-inhibitor group and the HG+NC-inhibitor group.Cells cul-tured in a glucose-free medium were set as the Control group.Some ARPE-19 cells were treated with miR-155-5p-mimics or their negative control inhibitors(i.e.,NC-mimics),and then they were classified into the HG+miR-155-5p-mimics group and the HG+NC-mimics group.Dual luciferase reporter gene analysis revealed the interaction between miR-155-5p and si-lent information regulator 1(SIRT1).Cells in the HG+miR-155-5 p-mimics and HG+NC-mimics groups were co-transfected with SIRT1-3'UTR-WT and SIRT1-3'UTR-MUT,respectively.The expression levels of luciferase in both groups of cells were detected.The recovery experiment verified that miR-155-5p affected autophagy and inflammatory responses in DR model cells by regulating SIRT1 expression.Cells co-transfected with miR-155-5p-mimics and pcDNA3.1-SIRT1 overexpres-sion plasmids were included in the HG+miR-155-5p-mimics+SIRT1 group.Cells transfected only with miR-155-5p-mimics or their negative control inhibitors were included in the HG+miR-155-5p-mimics group and the HG+NC-mimics group,re-spectively.Cell proliferation,apoptosis,and the expression levels of apoptosis and autophagy related proteins were detec-ted in each group.Results The expression level of miR-155-5p in the DR group was higher than that in the control group(t=-8.078,P＜0.001).Compared with the HG+NC-inhibitor group,the HG+miR-155-5p-inhibitor group showed en-hanced cell proliferation ability,decreased miR-155-5p level,and weakened apoptosis(all P＜0.001).Compared with the HG+NC-mimics group,the HG+miR-155-5p-mimics group showed decreased cell proliferation ability,increased miR-155-5p levels,enhanced apoptosis,lowered levels of the autophagy protein P62,and elevated levels of the autophagy protein LC3B and inflammatory proteins NLRP3,IL-1 β,and pro-caspase-1(all P＜0.01).Compared with those in the HG+NC-mimics group,the expression levels of SIRT1 mRNAs and proteins in the HG+miR-155-5p-mimics group decreased(both P＜0.001).The luciferase activity in the HG+miR-155-5p-mimics group decreased after the transfection with SIRT1-3'UTR-WT(P＜0.001).Compared with the HG+miR-155-5p-mimics group,the HG+miR-155-5p-mimics+SIRT1 group showed enhanced cell proliferation,decreased miR-155-5p levels,weakened apoptosis,elevated levels of SIRT1 and P62 proteins,and reduced levels of LC3B and inflammatory proteins NLRP3,IL-1 β,and pro-caspase-1(all P＜0.05).SIRT1 was identified as a downstream target of miR-155-5p.Conclusion MiR-155-5p inhibits the proliferation of DR model cells by targeting SIRT1,thus promoting the apoptosis,autophagy,and inflammatory response of retinal epithelial cells.

Objective:To construct a machine learning classification prediction model using planning-omics (planomics) features to predict the γ pass rate of intensity-modulated radiotherapy (IMRT) plan dose verification in fixed-field thoracic tumors, and evaluate the application of planomics in radiotherapy quality assurance.Methods:The fixed-field IMRT plans of 240 patients with chest tumors admitted to Department of Radiotherapy, Henan Cancer Hospital from August 2022 to March 2023 were retrospectively analyzed. All plans underwent dose verification using the electronic portal imaging system detector on the Varian accelerator to collect field dose data. The dose verification results were analyzed through Portal Dosimetry in the treatment planning system of Eclipse. The γ pass rate standard was set at 2%/2 mm with a 10% dose threshold. From the planning documents, 48 conventional planning features, 2476 planomics features, and the combination of the previous two feature sets were extracted. Subsequently, an auto-encoder classification model was constructed. To evaluate the classification efficacy of various feature sets, 20 random train-test divisions were conducted by calculating the area under the receiver operating characteristic curve (AUC) values along with the accuracy rates.Results:After the feature selection, 2 conventional features and 16 planomics features were finally selected. In the testing set, the AUC values for the model using combined features, planomics features, and conventional planned features were 0.802±0.030, 0.740±0.069, and 0.673±0.083, respectively. In contrast, in the training set, these AUC values were 0.844±0.074, 0.816±0.047, and 0.687±0.036, respectively. The accuracy rates were 0.752±0.083, 0.703±0.110, and 0.648±0.081 in the testing set, and 0.753±0.098, 0.751±0.075, and 0.624±0.054 in the training set for the combined, planomics, and conventional planning feature sets, respectively.Conclusions:For thoracic fixed-field adjusted radiotherapy planning, the machine learning method based on planomics features can be utilized to build a classification model for predicting the γ pass rate. Combining planomics features with conventional planned features can enhance the predictive performance of the classification models.

Objective:To evaluate the detection capability of the contrast-enhanced three-dimensional turbo spin-echo (CE-SPACE) sequence for brain metastases (BM), aiming to provide evidence for precise target delineation in stereotactic radiotherapy (SRT).Methods:A total of 123 BM patients who received radiotherapy at the Affiliated Cancer Hospital of Zhengzhou University from May to November 2024 were enrolled. All patients underwent contrast-enhanced (CE) MRI and CT scans in the same treatment position, with images rigidly registered in the Eclipse planning system. Two experienced radiation oncologists independently delineated BM lesions on CE-MPRAGE and CE-SPACE sequences in a blinded manner. Patients were divided into the delayed group (10 min, n=61) and a priority group (5 min, n=62) based on the time interval between gadolinium injection and CE-SPACE acquisition. The non-parametric Wilcoxon rank-sum test was used to compare the lesion counts and volume differences between the two imaging sequences. Point-biserial correlation analysis was performed to assess the correlation between the additional lesions identified by CE-SPACE and lesion volume. Results:The overall analysis demonstrated that CE-SPACE detected 421 BM lesions, achieving an 8.2% higher detection rate than CE-MPRAGE ( Z=3.78, P<0.001). In terms of lesion volume, the median BM lesions volume identified by CE-SPACE [0.30(0.07,1.53)cm 3] was 8.7% larger than that by CE-MPRAGE [0.23 (0.04, 1.34) cm 3] ( Z=12.88, P<0.001). CE-SPACE demonstrated superior sensitivity for lesions ≤ 0.06 cm3, with negative correlation between the number of additional lesions detected and lesion volume ( r=-0.104, P=0.034). Subgroup analysis revealed that in the delayed group, CE-SPACE detected significantly more lesions [median 2 (1, 3.5) vs. 2 (1, 3), P=0.002] and larger volumes [0.39 (0.08, 2.24) cm3 vs. 0.29 (0.05, 1.99) cm3, P<0.001] than CE-MPRAGE. In the priority group, CE-SPACE detected significantly larger lesion volumes [0.55 (0.09, 2.06) cm3 vs. 0.45 (0.08, 1.88) cm3, P<0.001], but no significant difference was observed in lesion counts between two sequences ( P=0.059). Conclusions:Three-dimensional CE-SPACE sequence offers superior detection sensitivity for small BM (≤ 0.06 cm3), providing crucial guidance for accurate target delineation in SRT.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective To elucidate the role of miR-155-5p in diabetic retinopathy(DR)and its potential mechanism.Methods Twelve peripheral blood samples were collected from the Ophthalmology Department of the First Affiliated Hospital of Jinzhou Medical University.Among them,six blood samples from healthy individuals were set as the control group,and the other six blood samples from DR patients were set as the DR group.Reverse transcription-polymerase chain reaction(RT-PCR)was used to verify the expression levels of miR-155-5p in two groups of blood samples.The effects of miR-155-5p on cell proliferation,apoptosis,autophagy,and inflammation related proteins[including P62,LC3B,NOD-like receptor protein 3(NLRP3),IL-1β,and pro-caspase-1]were observed using a high glucose(100 mmol·L-1)-induced DR cell model.Some ARPE-19 cells were intervened with the miR-155-5p inhibitor or its negative control inhibitor(i.e.,NC-inhibitor),and then they were divided into the HG+miR-155-5p-inhibitor group and the HG+NC-inhibitor group.Cells cul-tured in a glucose-free medium were set as the Control group.Some ARPE-19 cells were treated with miR-155-5p-mimics or their negative control inhibitors(i.e.,NC-mimics),and then they were classified into the HG+miR-155-5p-mimics group and the HG+NC-mimics group.Dual luciferase reporter gene analysis revealed the interaction between miR-155-5p and si-lent information regulator 1(SIRT1).Cells in the HG+miR-155-5 p-mimics and HG+NC-mimics groups were co-transfected with SIRT1-3'UTR-WT and SIRT1-3'UTR-MUT,respectively.The expression levels of luciferase in both groups of cells were detected.The recovery experiment verified that miR-155-5p affected autophagy and inflammatory responses in DR model cells by regulating SIRT1 expression.Cells co-transfected with miR-155-5p-mimics and pcDNA3.1-SIRT1 overexpres-sion plasmids were included in the HG+miR-155-5p-mimics+SIRT1 group.Cells transfected only with miR-155-5p-mimics or their negative control inhibitors were included in the HG+miR-155-5p-mimics group and the HG+NC-mimics group,re-spectively.Cell proliferation,apoptosis,and the expression levels of apoptosis and autophagy related proteins were detec-ted in each group.Results The expression level of miR-155-5p in the DR group was higher than that in the control group(t=-8.078,P＜0.001).Compared with the HG+NC-inhibitor group,the HG+miR-155-5p-inhibitor group showed en-hanced cell proliferation ability,decreased miR-155-5p level,and weakened apoptosis(all P＜0.001).Compared with the HG+NC-mimics group,the HG+miR-155-5p-mimics group showed decreased cell proliferation ability,increased miR-155-5p levels,enhanced apoptosis,lowered levels of the autophagy protein P62,and elevated levels of the autophagy protein LC3B and inflammatory proteins NLRP3,IL-1 β,and pro-caspase-1(all P＜0.01).Compared with those in the HG+NC-mimics group,the expression levels of SIRT1 mRNAs and proteins in the HG+miR-155-5p-mimics group decreased(both P＜0.001).The luciferase activity in the HG+miR-155-5p-mimics group decreased after the transfection with SIRT1-3'UTR-WT(P＜0.001).Compared with the HG+miR-155-5p-mimics group,the HG+miR-155-5p-mimics+SIRT1 group showed enhanced cell proliferation,decreased miR-155-5p levels,weakened apoptosis,elevated levels of SIRT1 and P62 proteins,and reduced levels of LC3B and inflammatory proteins NLRP3,IL-1 β,and pro-caspase-1(all P＜0.05).SIRT1 was identified as a downstream target of miR-155-5p.Conclusion MiR-155-5p inhibits the proliferation of DR model cells by targeting SIRT1,thus promoting the apoptosis,autophagy,and inflammatory response of retinal epithelial cells.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.