Objective: To investigate the biological effects of carvacrol on rats with stomach-heat and stomach-cold and its regulation on transient receptor potential(TRP) channels in rats with stomach-heat, and to study the cold and heat properties of carvacrol and its possible mechanism. Methods: According to the random number method, 100 SD rats were divided into stomach-heat blank group, stomach-heat model group, Coptidis Rhizoma group, stomach-heat low-dose and high-dose carvacrol group, stomach-cold blank group, stomach-cold model group, Baked ginger group, stomach-cold low-dose group and high-dose carvacrol group, 10 rats in each group. The rat model of stomach-heat was established by intragastric administration of pepper aqueous solution (0.80 g/kg) and anhydrous ethanol, and the rat model of stomach-cold was established by intragastric administration of water extract of Anemarrhena asphodeloides and sodium hydroxide (10.40 g/kg). On the day of modeling, the rats in the Baked ginger group were given Baked ginger decoction (0.78 g/kg), and the rats in the Coptidis Rhizoma group were given Coptidis Rhizoma decoction (0.43 g/kg).The stomach-cold and stomach-heat low-dose group of carvacrol was given carvacrol emulsion (40 mg/kg), high-dose group was given carvacrol emulsion (80 mg/kg).All rats of the blank and model groups were given the equal volume of emulsion prepared by 5% dimethyl sulfoxide, 1% Tween 80, 1% polyethylene glycol 400, and 93% normal saline, once a day, for 7 days. The general condition of rats was observed and the body mass was recorded. The pathological morphology of gastric tissue was observed by hematoxylin-eosin staining. The changes of material and energy metabolism, cyclic nucleotide (cAMP), thyroid hormone and gastrointestinal hormone in each group were determined by enzyme-linked immunosorbent assay. The expression levels of transient receptor potential vanilloid subtype 1 (TRPV1), transient receptor potential channel M8 (TRPM8) and uncoupling protein-1 (UCP1) in rats with gastric fever were detected by Western blotting. Results: Compared with the stomach-heat blank group, the body mass of rats in the stomach-heat model group decreased at the fifth and seventh day (P<0.05). The contents (or ratio) of hepatic glycogen (HGlyc), total cholesterol (TC), triglyceride (TG), and vasoactive intestinal peptide (VIP) were decreased (P<0.05), and Na+ -K+ -ATPase, Ca2+ -Mg2+ -ATPase, cytochrome C oxidase (COX), NADH dehydrogenase (ND), cyclic adenosine phosphate (cAMP), cAMP/cyclic guanosine phosphate (cGMP), triiodothyronine (T3), thyroxine (T4), gastrin (GAS), motilin (MTL), and α-amylase (α-AMS) all increased (P<0.05). Compared with the stomach-heat model group, the body mass of rats in the Coptidis Rhizoma group decreased at the third, fifth, and seventh day, the contents (or ratio) of HGlyc, TC, TG, VIP and α-AMS were increased, and Na+ -K+ -ATPase, COX, ND, cAMP, cAMP/cGMP, T3, T4, and GAS all decreased (P<0.05). The body mass of rats in the stomach-heat low-dose carvacrol group decreased at the seventh day. The contents (or ratio) of HGlyc, TC, and VIP were increased, Na+ -K+ -ATPase, COX, ND, cAMP, cAMP/cGMP, T3, T4, and MTL all decreased, the expression of TRPV1 and UCP1 in gastric tissue decreased, while TRPM8 increased (P<0.05) in rats of the stomach-heat low-dose and high-dose carvacrol groups. Compared with the stomach-cold blank group, the body mass of rats in the stomach-cold model group decreased at the third, fifth, and seventh day, the contents (or ratio) of HGlyc, TC, TG, α-AMS, and VIP all increased, while Na+ -K+ -ATPase, Ca2+ -Mg2+ -ATPase, COX, ND, cAMP, cAMP/cGMP, T3, T4, GAS, and MTL all decreased (P<0.05). Compared with the stomach-cold model group, the body mass of rats in the Baked ginger group was increased at the seventh day, and the contents (or ratio) of HGlyc, VIP, and α-AMS all decreased, while Na+ -K+ -ATPase, COX, ND, cAMP/cGMP, T3, T4, GAS, and MTL all increased (P<0.05). The contents of HGlyc, cAMP, α-AMS, and VIP of rats in the stomach-cold low and high-dose carvacrol group all decreased (P<0.05). TG in the stomach-cold low-dose carvacrol group was increased. TC, Ca2+ -Mg2+ -ATPase, and cGMP all increased, while cAMP/cGMP decreased (P<0.05) in the high-dose carvacrol group. Conclusion In this study, the rat model of stomach-cold and stomach-heat were successfully established by using cold and heat factors. The result showed that carvacrol had a certain inhibitory effect on body mass, material energy metabolism, cyclic nucleotide level, thyroid hormone and gastrointestinal function in rats with stomach-heat, indicating that the drug was cold. Carvacrol′s cold medicinal property could be biologically explained by TRPV1 activation, UCP1 induction, and TRPM8 suppression.

BACKGROUND: Immune checkpoint inhibitors (ICIs) have been included in various neoadjuvant therapy (NAT) regimens for non-small cell lung cancer (NSCLC). However, due to the relatively short period for the use of ICIs in NAT, patients' clinical outcomes with different regimens are uncertain. Our study aims to examine the efficacy of neoadjuvant immunotherapy (NAIT) for NSCLC patients and compare the overall survival (OS) and event-free survival (EFS) of patients receiving different NAT regimens. METHODS: This study retrospectively included 308 NSCLC patients treated with different NAT regimens and subsequent surgery in National Cancer Center between August 1, 2016 and July 31, 2022. Kaplan-Meier survival analysis and Cox proportional hazards regression analysis were conducted to evaluate the prognosis of patients. RESULTS: With a median follow-up of 27.5 months, the 1-year OS rates were 98.8% and 96.2%, and the 2-year OS rates were 96.6% and 85.8% in patients of the NAIT and neoadjuvant chemotherapy (NACT) group, respectively (hazard ratio [HR], 0.339; 95% confidence interval [CI], 0.160-0.720; P = 0.003). The 1-year EFS rates were 96.0% and 88.0%, and the 2-year EFS rates were 92.0% and 77.7% for patients in the NAIT and NACT groups, respectively (HR, 0.438; 95% CI, 0.276-0.846; P = 0.010). For patients who did not achieve pathological complete response (pCR), significantly longer OS ( P = 0.012) and EFS ( P = 0.019) were observed in patients receiving NAIT than those receiving NACT. Different NAT regimens had little effect on surgery and the postoperative length of stay (6 [4, 7] days vs . 6 [4, 7] days, Z = -0.227, P = 0.820). CONCLUSIONS NAIT exhibited superior efficacy to NACT for NSCLC, resulting in longer OS and EFS. The OS and EFS benefits were also observed among patients in the NAIT group who did not achieve pCR.
Humans ; Carcinoma, Non-Small-Cell Lung/mortality* ; Male ; Female ; Lung Neoplasms/mortality* ; Middle Aged ; Immune Checkpoint Inhibitors/therapeutic use* ; Neoadjuvant Therapy/methods* ; Retrospective Studies ; Aged ; Adult ; Kaplan-Meier Estimate ; Treatment Outcome ; Immunotherapy/methods*

Objective:To compare the dosimetric characteristics of three fractionated stereotactic radiotherapy techniques,i.e.,tomo-therapy(TOMO),volumetric-modulated arc therapy(VMAT),and CyberKnife(CK),in the treatment of intracranial oligometastases,and to assess their dose distribution,treatment efficiency,and difference in dose delivered to organs at risk(OARs).Methods:A retro-spective analysis was performed for the clinical data of 54 patients with intracranial oligometastases who underwent fractionated stereo-tactic radiotherapy in The First Affiliated Hospital of Army Medical University in 2021-2023.Varian Eclipse 16.1 Physician Worksta-tion was used to perform tumor target volume delineation,and MANTEIA AccContour 3.2 software was used to perform the delineation of OARs,such as brainstem,spinal cord,and optical nerves.The delineated structures and images were transmitted to TOMO,CK,and Eclipse treatment planning systems to design three different radiotherapy treatment plans.Related key parameters were analyzed using the dose-volume histogram to evaluate the dosimetric characteristics of these three radiotherapy techniques,including conformity index(CI)of the target,dose homogeneity index(HI),beam-on time,the number of monitor units(MU),and the exposure dose of OARs.Results:All three treatment plans(TOMO,VMAT,and CK)met the requirements for prescribed dose.TOMO had a slightly better CI than VMAT and CK(1.05 vs.1.09 and 1.17,P<0.001).VMAT had a better HI than CK and TOMO(1.15 vs.1.28 and 1.46,P<0.001).In terms of execution efficiency,VMAT had a significantly shorter beam-on time than TOMO and CK(5 minutes,1 633 MU vs.10 minutes,8 932 MU and 39 minutes,5 191 MU,P<0.001).In terms of the exposure dose of OARs,CK provided the best protection for the lens,with a maximum dose of 15 cGy for the right lens and 17 cGy for the left lens,and TOMO had an advantage in dose control for the right cochlea,with a mean dose of 88 cGy,while VMAT had the best performance in limiting the dose for the spinal cord,with a maximum dose of 31 cGy(P<0.05).Conclusion:This study shows that TOMO,VMAT,and CK all meet the requirements for the prescribed dose and can effectively protect OARs in the treatment of in-tracranial oligometastases.In clinical practice,the most appropriate technique should be selected based on the features of lesions and treatment goals to achieve individualized treatment.

Solanum nigrum is a traditional Chinese herb widely distributed in China. It is rich in active ingredients such as alkaloids and saponins， and has shown remarkable hepatoprotective effects and various mechanisms in the treatment of various liver diseases. It can prevent and treat chemical liver injury through anti-inflammatory， antioxidant， gut microbiota-regulating， and anti- fibrotic pathways. In the prevention and treatment of fatty liver disease， it can regulate lipid metabolism， inhibit lipogenesis， and promote fat degradation. It has potential antiviral activity against viral hepatitis. By inducing tumor cell apoptosis， arresting the cell cycle， and inhibiting tumor cell proliferation and metastasis and so on， it plays a role in the prevention and treatment of liver cancer. Clinically， S. nigrum has been used in the treatment of liver cancer and liver fibrosis after chronic hepatitis B， showing good efficacy and high safety. Future research should focus on further elucidating its mechanisms of action and promoting the development and application of new drugs， in order to benefit more patients with liver diseases.

With the widespread adoption of low-dose CT screening and the extensive application of high-resolution CT, the detection rate of sub-centimeter lung nodules has significantly increased. How to scientifically manage these nodules while avoiding overtreatment and diagnostic delays has become an important clinical issue. Among them, lung nodules with a consolidation tumor ratio less than 0.25, dominated by ground-glass shadows, are particularly worthy of attention. The therapeutic challenge for this group is how to achieve precise and complete resection of nodules during surgery while maximizing the preservation of the patient's lung function. The "watershed topography map" is a new technology based on big data and artificial intelligence algorithms. This method uses Dicom data from conventional dose CT scans, combined with microscopic (22-24 levels) capillary network anatomical watershed features, to generate high-precision simulated natural segmentation planes of lung sub-segments through specific textures and forms. This technology forms fluorescent watershed boundaries on the lung surface, which highly fit the actual lung anatomical structure. By analyzing the adjacent relationship between the nodule and the watershed boundary, real-time, visually accurate positioning of the nodule can be achieved. This innovative technology provides a new solution for the intraoperative positioning and resection of lung nodules. This consensus was led by four major domestic societies, jointly with expert teams in related fields, oriented to clinical practical needs, referring to domestic and foreign guidelines and consensus, and finally formed after multiple rounds of consultation, discussion, and voting. The main content covers the theoretical basis of the "watershed topography map" technology, indications, operation procedures, surgical planning details, and postoperative evaluation standards, aiming to provide scientific guidance and exploration directions for clinical peers who are currently or plan to carry out lung nodule resection using the fluorescent microscope watershed analysis method.

Objective To use imaging features of pulmonary nodules to predict the risk of lymph node metastasis in patients with cT1-stage non-small cell lung cancer (NSCLC), providing a reference for clinical decision-making. Methods A retrospective analysis was conducted on the imaging features and postoperative pathological results of cT1 NSCLC patients who underwent surgical treatment at Linyi People’s Hospital from July 2019 to July 2022. Patients were grouped and analyzed according to lymph node metastasis status. Results A total of 1 123 patients were included, comprising 471 males and 652 females, with a median age of 59 (52, 66) years. Comparative analysis revealed that sex, age, nodule location, nodule size on imaging, solid component size, consolidation tumor ratio (CTR), average CT value, and tumor proximity to the pleura all influenced lymph node metastasis. A nomogram was constructed, indicating that the probability of lymph node metastasis in cT1 NSCLC was positively correlated with solid component size, CTR, and average CT value of the pulmonary nodule, and negatively correlated with patient age. The area under the receiver operating characteristic curve was 0.929. Conclusion For cT1 NSCLC patients, the probability of lymph node metastasis can be predicted by measuring the solid component size, CTR, and average CT value of the pulmonary nodule, in conjunction with patient age. However, relying solely on pulmonary nodule imaging characteristics is insufficient to determine a specific lymph node dissection strategy.

Objective:To investigate the relationship between lumbar disc herniation and vertebral bone mineral density(BMD)of quantitative analysis of computed tomography(CT).Methods:Eighty patients with lumbar disc herniation who admitted to Beijing Tongzhou District Hospital of Integrated Traditional Chinese and Western Medicine from May 2022 to June 2024 were included in the case group,and 30 healthy volunteers who underwent physical examination in hospital were included in the healthy control group during the same period.The vertebral BMD of all subjects was quantitatively analyzed by CT.The data,lumbar BMD value,lumbar bone mass loss and osteoporosis distribution of the two groups were compared at baseline.Results:There were no significant differences in gender,age,body mass index(BMI)and abdominal circumference of baseline data between the case group and the healthy control group(P>0.05).The BMD value of the fourth lumbar vertebra(L4)in the case group was lower than that in the healthy control group,and the difference was statistically significant(t=1.991,P<0.05).There were no significant differences in BMD value and mean BMD(Lmean BMD)of the fifth lumbar vertebra(L5)between the case group and the healthy control group(P>0.05).There was no statistically significant difference in the lumbar BMD value of healthy control group between different genders(P>0.05),and there was significant difference in Lmean BMD between different genders in the case group(t=2.063,P<0.05),while there were no statistically significant difference in the L4 BMD and L5 BMD of the case group between different genders(P>0.05).The difference of Lmean BMD values of the persons with same gender(male,female)between the case group and the healthy control group were statistically significant(t=2.570,3.300,P<0.05).The ratio of normal lumbar bone mass in the case group was 48.75%,which was lower than that in the healthy control group(70.00%),and the difference was statistically significant(x2=3.974,P<0.05).The ratio of osteoporosis in the case group was 18.75%,which was higher than that in the healthy control group(3.33%),and the difference of that between two groups was significant(x2=4.172,P<0.05).There was no significant difference in the ratio of bone mass loss between the two groups(P>0.05).Conclusion:CT quantitative analysis shows that the vertebral BMD value of the patients with lumbar disc herniation is significantly lower than that of persons of the healthy control group,which indicates that the decrease of BMD value might be related to the occurrence of lumbar disc herniation.

Objective To investigate the factors influencing the persistence of residual low back pain following percutaneous vertebroplasty(PVP)in patients with osteoporotic vertebral fractures(OVF),in order to provide a scientific basis for clinical intervention strategies.Methods A retrospective analysis was conducted on data from 1 120 patients diagnosed with OVF who received PVP treatment between July 2020 and June 2025.Among them,61 patients who experienced residual low back pain in the early postoperative period(defined as 2 days to 1 month after surgery)with a postoperative visual analog scale(VAS)score greater than 3 points were selected as the observation group.An additional 61 control subjects were matched to the observation group at a 1∶1 ratio based on age(±5 years),gender,and preoperative bone mineral density(±0.5 standard deviation).Univariate and logistic regression analyses were subsequently performed to evaluate potential influencing factors.Results Univariate analysis revealed statistically significant differences between the two groups with respect to preoperative thoracolumbar fascia injury(TFI),MRI-detected liquefaction signals in the affected vertebrae,the number of involved vertebrae(≥2),and suboptimal bone cement distribution(P<0.05).Multivariate regression analysis confirmed that these factors were independent risk factors,with corresponding odds ratios(ORs)of 5.378,6.111,3.245,and 2.890(all P<0.05).The area under the curve(AUC)of the predictive model was 0.929,indicating a high level of predictive accuracy.Conclusion Preoperative TFI,MRI-demonstrated liquefaction signals in the affected vertebrae,the presence of multiple responsible vertebrae,and suboptimal bone cement distribution may contribute to an increased risk of early residual low back pain following PVP.

Non-small cell lung cancer(NSCLC)continues to exhibit a high incidence and mortality worldwide,posing a serious threat to human health.In recent years,the rapid advancement of immunotherapy has profoundly reshaped the therapeutic paradigm for NSCLC,particularly by improving long-term outcomes in the perioperative period.However,with its increasingly widespread clinical use during this period,several critical issues have emerged,including the precise identification of patients most likely to benefit,optimization of therapeutic strategies,evaluation of pathological value,formulation of adjuvant therapy strategies for patients with complete pathological response after surgery,and the management of immune-related adverse events.This review will systematically discuss these key challenges and aims to provide insights that may facilitate the standardized application of perioperative immunotherapy in NSCLC.

Non-small cell lung cancer(NSCLC)continues to exhibit a high incidence and mortality worldwide,posing a serious threat to human health.In recent years,the rapid advancement of immunotherapy has profoundly reshaped the therapeutic paradigm for NSCLC,particularly by improving long-term outcomes in the perioperative period.However,with its increasingly widespread clinical use during this period,several critical issues have emerged,including the precise identification of patients most likely to benefit,optimization of therapeutic strategies,evaluation of pathological value,formulation of adjuvant therapy strategies for patients with complete pathological response after surgery,and the management of immune-related adverse events.This review will systematically discuss these key challenges and aims to provide insights that may facilitate the standardized application of perioperative immunotherapy in NSCLC.