Objective To explore the impact of number of positive regional lymph nodes (nPRLN) in N1 stage on the prognosis of non-small cell lung cancer (NSCLC) patients. Methods Patients with TxN1M0 stage NSCLC who underwent lobectomy and mediastinal lymph node dissection from 2010 to 2015 were screened from SEER database (17 Regs, 2022nov sub). The optimal cutoff value of nPRLN was determined using X-tile software, and patients were divided into 2 groups according to the cutoff value: a nPRLN≤optimal cutoff group and a nPRLN>optimal cutoff group. The influence of confounding factors was minimized by propensity score matching (PSM) at a ratio of 1 : 1. Kaplan-Meier curves and Cox proportional hazards models were used to evaluate overall survival (OS) and lung cancer-specific survival (LCSS) of patients. Results A total of 1316 patients with TxN1M0 stage NSCLC were included, including 662 males and 654 females, with a median age of 67 (60, 73) years. The optimal cutoff value of nPRLN was 3, with 1165 patients in the nPRLN≤3 group and 151 patients in the nPRLN>3 group. After PSM, there were 138 patients in each group. Regardless of before or after PSM, OS and LCSS of patients in the nPRLN≤3 group were superior to those in the nPRLN>3 group (P<0.001). N1 stage nPRLN>3 was an independent prognostic risk factor for OS [HR=1.52, 95%CI (1.22, 1.89), P<0.001] and LCSS [HR=1.72, 95%CI (1.36, 2.18), P<0.001]. Conclusion N1 stage nPRLN>3 is an independent prognostic risk factor for NSCLC patients in TxN1M0 stage, which may provide new evidence for future revision of TNM staging N1 stage subclassification.

[摘 要] 目的：探讨核仁小RNA（snoRNA）71A通过TLR3/PD-L1通路对食管鳞状细胞癌（ESCC）细胞增殖、迁移及侵袭能力的影响。方法：qPCR检测52例ESCC患者的配对肿瘤组织、癌旁组织，以及人ESCC细胞中SNORA71A的表达情况。将反义寡核苷酸（SNORA71A-ASO-29、SNORA71A-ASO-102和NC-ASO）或小干扰RNA（siTLR3、siTLR3-NC）分别转染至人ESCC TE-1细胞，分别记为SNORA71A-ASO1组、SNORA71A-ASO2组、NC-ASO组及siTLR3组、siNC组。另外将过表达质粒pcDNA3.1-SNORA71A和pcDNA3.1空载体质粒分别转染至TE-1细胞，分别记为SNORA71A组和Vector组。细胞功能学实验（MTS实验、划痕愈合实验，以及Transwell侵袭实验）评估各组细胞在敲低或过表达SNORA71A后增殖、迁移和侵袭能力的变化。高通量转录组测序筛选SNORA71A下游作用靶基因，基因本体论（GO）和京都基因与基因组百科全书（KEGG）功能富集分析预测SNORA71A下游作用靶基因可能参与的生物学过程和信号通路。qPCR检测测序筛选出的下游作用靶基因TLR3在ESCC组织以及细胞中的表达。同时，qPCR和WB检测TE-1细胞在敲低或过表达TLR3后PD-L1 mRNA和蛋白质表达变化。细胞功能学实验检测TLR3敲低对SNORA71A所促进的TE-1细胞恶性生物行为（增殖、迁移、侵袭）的影响。结果：在52例ESCC患者的肿瘤组织以及ESCC细胞中SNORA71A表达均呈高水平（P < 0.01或P < 0.05）。敲低SNORA71A抑制TE-1细胞增殖、迁移和侵袭（P < 0.01或P < 0.05），过表达SNORA71A则促进TE-1细胞增殖、迁移和侵袭（P < 0.01或P < 0.05）。高通量转录组测序筛选到TLR3为SNORA71A下游作用靶基因。TLR3在ESCC组织以及TE-1细胞中呈低表达（P < 0.01或P < 0.05）。TLR3正向调控PD-L1 mRNA和蛋白质表达（P < 0.01或P < 0.05）。细胞功能学实验中，TLR3可以部分削弱SNORA71A对PD-L1表达的调控（P < 0.01）。结论：SNORA71A通过调控TLR3/PD-L1通路调节TE-1细胞增殖、迁移和侵袭。

Diabetic kidney disease（DKD） is a chronic kidney structural and functional disorder caused by diabetes. With the global prevalence of diabetes continuing to rise， DKD has gradually become a major cause of chronic kidney disease and end-stage renal disease（ESRD）， posing a serious threat to patients' quality of life and long-term health outcomes. Studies have shown that apoptosis plays a pivotal role in the development and progression of DKD， with its mechanisms involving abnormal activation of multiple signaling pathways such as Toll-like receptor 4（TLR4）/nuclear transcription factor-κB（NF-κB）/B-cell lymphoma-2（Bcl-2）/cysteinyl aspartate-specific proteinase（Caspase）-3， protein kinase R-like endoplasmic reticulum kinase（PERK）/eukaryotic initiation factor 2α（eIF2α）/activating transcript factor 4（ATF4）/CCAAT enhancer-binding protein homologous protein（CHOP）， phosphatidylinositol 3-kinase（PI3K）/protein kinase B（Akt）/glycogen synthase kinase-3β（GSK-3β）， Janus kinase 2（JAK2）/signal transducer and activator of transcription 3（STAT3）， adenosine monophosphate-activated protein kinase（AMPK）/mammalian target of rapamycin（mTOR） and silent information regulator 1（SIRT1）/tumor suppressor protein 53（p53）， thereby accelerating renal pathological damage in DKD. Extensive evidence-based medical studies have confirmed that traditional Chinese medicine（TCM）， leveraging its unique therapeutic advantages of multi-target， multi-component and multi-pathway approaches， has demonstrated remarkable efficacy and favorable safety profiles in treating DKD. Recent studies have demonstrated that active components of TCM can specifically target and modulate key effectors in apoptotic signaling pathways. Meanwhile， traditional compound formulations exert synergistic effects through multiple approaches such as replenishing deficiency and activating blood circulation， detoxifying and dredging collaterals， tonifying kidney essence， and removing stasis and purging turbidity， thereby comprehensively regulating critical pathological processes including endoplasmic reticulum stress and mitochondrial apoptosis pathways. This combined therapeutic approach of molecular targeting and holistic regulation provides novel strategies for delaying the progression of DKD. Based on this， this paper provides an in-depth analysis of key apoptotic signaling pathways and their regulatory mechanisms， while systematically summarizing recent research advances regarding the therapeutic effects of TCM active components， compound formulations， and proprietary Chinese medicines on DKD through modulation of these pathways， with particular emphasis on their underlying molecular mechanisms. These findings not only elucidate the modern scientific connotation and theoretical basis of TCM in treating DKD but also establish a solid theoretical and practical foundation for promoting the wider clinical application and further research of TCM in the field of DKD treatment.

ObjectiveTo investigate the status and influencing factors of the continuity of care needs in patients with ruptured intracranial aneurysm hemorrhage. MethodsFrom January, 2022 to April, 2025, 121 patients with ruptured intracranial aneurysm hemorrhage admitted to the Fourth Affiliated Hospital of Anhui Medical University were selected. A questionnaire survey was conducted using general information questionnaire and continuity of care needs questionnaire. Multiple linear regression analysis was used to analyze the influencing factors of continuity of care needs. ResultsA total of 121 questionnaires were distributed, with 115 returned (95.04%). The scores of continuity of care needs were with an average score of (100.54±6.97). Statistically significant differences were observed in scores of continuity of care needs among patients with different ages, education levels, primary family caregivers, preoperative Hunt-Hess grades, number of comorbid diseases, whether they received postoperative rehabilitation training and availability of nearby healthcare services (|F| > 8.104, |t| > 2.651, P < 0.05). Multiple linear regression analysis showed that education level, primary family caregiver, preoperative Hunt-Hess grade, number of comorbid diseases and availability of nearby healthcare services were all influencing factors for the continuity of care needs in patients with ruptured intracranial aneurysm hemorrhage (|t| > 1.703, P < 0.05). ConclusionThe need for continuous care in patients with ruptured intracranial aneurysms is influenced by factors such as educational level, primary family caregivers, preoperative Hunt-Hess grade, number of comorbid diseases and accessibility to nearby healthcare services. Medical staff should comprehensively consider patients' specific conditions and actual needs to provide targeted continuous care services.

ObjectiveTo investigate the status and influencing factors of the continuity of care needs in patients with ruptured intracranial aneurysm hemorrhage. MethodsFrom January, 2022 to April, 2025, 121 patients with ruptured intracranial aneurysm hemorrhage admitted to the Fourth Affiliated Hospital of Anhui Medical University were selected. A questionnaire survey was conducted using general information questionnaire and continuity of care needs questionnaire. Multiple linear regression analysis was used to analyze the influencing factors of continuity of care needs. ResultsA total of 121 questionnaires were distributed, with 115 returned (95.04%). The scores of continuity of care needs were with an average score of (100.54±6.97). Statistically significant differences were observed in scores of continuity of care needs among patients with different ages, education levels, primary family caregivers, preoperative Hunt-Hess grades, number of comorbid diseases, whether they received postoperative rehabilitation training and availability of nearby healthcare services (|F| > 8.104, |t| > 2.651, P < 0.05). Multiple linear regression analysis showed that education level, primary family caregiver, preoperative Hunt-Hess grade, number of comorbid diseases and availability of nearby healthcare services were all influencing factors for the continuity of care needs in patients with ruptured intracranial aneurysm hemorrhage (|t| > 1.703, P < 0.05). ConclusionThe need for continuous care in patients with ruptured intracranial aneurysms is influenced by factors such as educational level, primary family caregivers, preoperative Hunt-Hess grade, number of comorbid diseases and accessibility to nearby healthcare services. Medical staff should comprehensively consider patients' specific conditions and actual needs to provide targeted continuous care services.

Hepatitis D virus （HDV）， as a defective virus， relies on the envelope protein of hepatitis B virus （HBV） to complete replication and transmission. Chronic hepatitis B （CHB） patients comorbid with HDV infection may experience significant acceleration of liver disease progression and a significantly higher risk of serious complications such as liver cirrhosis and hepatocellular carcinoma （HCC） compared with the patients with CHB alone， which poses a serious threat to the life and health of patients. At present， the coverage rate of HDV screening needs to be improved， and some patients with HBV/HDV co-infection have not been found in time. Therefore， strengthening the understanding of HDV among clinicians， expanding the scope of HDV screening， identifying patients with infection in a timely manner， and performing standardized antiviral therapy and long-term follow-up management are of great significance for improving the prognosis of patients， reducing disease burden， improving the quality of life of patients， and achieving the global goal of “eliminating viral hepatitis as a public health threat by 2030”.

ObjectiveTo observe the effect of Qishao capsules on renal injury in db/db mice with diabetic kidney disease （DKD），and explore its mechanism of protecting the kidney by inhibiting podocyte apoptosis. Methodsdb/m mice （7 mice） were used as the normal group，and db/db mice （35 mice） were randomly divided into a model group，a dapagliflozin group （0.001 g·kg^-1·d^-1），and low-，medium-，and high-dose groups of Qishao capsules （0.341 3，0.682 5，and 1.365 g·kg^-1·d^-1，respectively）. Drug intervention lasted for 8 consecutive weeks. After sampling，the serum renal function indicators ［creatinine（SCr），and urea nitrogen（BUN）］，fasting blood glucose （FBG），24 h urinary protein quantification （24 h-UTP）， and other indicators of the mice were measured. The pathological tissue morphology of the kidney was observed by periodic acid-silver methenamine （PASM） and Masson's trichrome （Masson） staining. Immunohistochemical detection of cysteine-dependent aspartate-specific protease （Caspase）-3 and B-cell lymphoma 2 （Bcl-2） was performed. Western blot was used to detect the protein expression of Caspase-8，Caspase-7，Caspase-3， and other molecules. Terminal deoxynucleotidyl transferase dUTP nick End labeling （TUNEL） staining was used to observe apoptosis in renal tissue. Immunofluorescence staining of Wilms tumor suppressor gene-1 （WT-1） was used to observe podocyte injury. Real-time polymerase chain reaction （Real-time PCR） was employed to detect Caspase-8 and Caspase-3 mRNA expression in the kidneys of experimental mice. Data analysis was conducted using statistical software GraphPad Prism 10. ResultsCompared with the normal group，the model group showed significantly increased 24 h-UTP，SCr，BUN，and FBG （P<0.01）. Additionally， PASM staining of renal tissue showed increased glycogen deposition，glomerular hypertrophy，and thickening of the basement membrane. Masson staining showed collagen fiber proliferation in renal tissue. Transmission electron microscopy showed thickening of the renal tissue basement membrane and fusion or loss of foot processes in the model group. The immunohistochemical results showed that Caspase-3 in the kidneys of the mice in the model group significantly increased （P<0.01），while the Bcl-2 protein expression level decreased significantly （P<0.01）. The number of TUNEL positive cells in renal tissue significantly increased （P<0.01）. The positive expression of WT-1 in podocytes was significantly reduced （P<0.01）. Western blot analysis showed significant upregulation of Caspase-8，Caspase-7，and Caspase-3 protein expression in renal tissue （P<0.01）. The mRNA expression levels of Caspase-8 and Caspase-3 in the kidneys increased significantly （P<0.01）. Compared with the model group，the Qishao capsules groups can significantly reduce the levels of 24 h-UTP，SCr，BUN，and FBG （P<0.01）. The pathological damage of renal tissue and podocyte injury were improved to some extent. Immunohistochemistry in the kidney showed a significant decrease in Caspase-3 （P<0.01） and a significant increase in Bcl-2 protein expression level （P<0.01）. Additionally， there were a significant decrease in the number of TUNEL positive cells in renal tissue （P<0.01），a significant increase in WT-1 positive expression in podocytes （P<0.01），marked downregulation of Caspase-8，Caspase-7，and Caspase-3 protein expression in renal tissue （P<0.05，P<0.01），and a significant decrease in Caspase-8 and Caspase-3 mRNA expression levels （P<0.01）. ConclusionQishao capsules can inhibit podocyte apoptosis by regulating the expression of Caspase-8，Caspase-7， and Caspase-3，thereby improving the diabetic renal injury in db/db mice.

AIM: To explore the risk factors for postoperative anterior chamber exudation in cataract patients and construct a nomogram prediction model.METHODS: Retrospective study. From July 2019 to October 2024, 450 patients(467 eyes)with age-related cataract who underwent surgery in our hospital were collected as the study subjects. They were randomly grouped into a modeling group(315 cases, 327 eyes)and a validation group(135 cases, 140 eyes)roughly estimated at a 7:3 ratio using the random number table method. Both groups were separated into a non-exudative group and an exudative group based on whether anterior chamber exudation occurred after surgery. Clinical basic data was collected; multivariate Logistic regression was applied to analyze the influencing factors of anterior chamber exudation in patients with age-related cataract after surgery; R software was applied to draw a nomogram prediction model of anterior chamber exudation in patients with age-related cataract after surgery; the calibration curve and Hosmer Lemeshow(H-L)test were applied to evaluate the calibration of the column plot model in predicting the occurrence of anterior chamber exudation in patients with age-related cataract after surgery; ROC was applied to evaluate the efficacy of anterior chamber exudation in patients with age-related cataract after surgery.RESULTS:The clinical characteristics of the modeling group and the validation group were comparable. The high myopia, history of uveitis, preoperative intraocular pressure, lens nuclear grade, intraoperative cumulative dissipated energy, and intraoperative posterior capsular rupture of the lens were the influencing factors for postoperative anterior chamber exudation in patients with age-related cataract(all P<0.05). The results of the modeling group verifying the occurrence of anterior chamber exudation in patients with age-related cataract after surgery showed that the area under the ROC curve(AUC)was 0.986(95% CI: 0.966-0.996), the H-L test was χ2=6.494, P=0.592, indicating that the risk of anterior chamber exudation in patients with age-related cataract after surgery predicted by model had good consistency with actual risks, the AUC of postoperative anterior chamber exudation in patients with age-related cataract based on external validation was 0.982(95% CI: 0.960-0.994); and the H-L test suggested that the risk of anterior chamber exudation in CAT patients after surgery predicted by model had good consistency with actual risks(χ2=6.117, P=0.634).CONCLUSION:High myopia, history of uveitis, preoperative intraocular pressure, lens nuclear grade, intraoperative cumulative dissipated energy, and intraoperative posterior capsular rupture of the lens are risk factors for postoperative anterior chamber exudation in patients with age-related cataract; the nomogram prediction model constructed based on this has high predictive value, and can provide reference for individualized prevention of anterior chamber exudation in patients with age-related cataract after surgery.

AIM: To investigate the correlation of serum leukocyte-derived chemotaxin 2(LECT2)and complement C1q/tumor necrosis factor-related protein 5(CTRP5)with diabetic retinopathy(DR).METHODS:A single-center cross-sectional analysis was conducted on 138 patients with type 2 diabetes mellitus(T2DM)admitted to our hospital from April 2023 to April 2025. According to the diagnostic results, they were divided into a non-DR group(60 cases)and a DR group(78 cases). The DR group was further divided into a proliferative DR(PDR)group(29 cases)and a non-proliferative DR(NPDR)group(49 cases). Pearson correlation analysis was used to assess the correlation of LECT2 and CTRP5 with glucose-lipid metabolism indicators. Logistic regression analysis was conducted to identify the influencing factors for the occurrence of DR in T2DM patients. ROC curve analysis was performed to evaluate the diagnostic value of serum LECT2 and CTRP5 for DR in T2DM patients.RESULTS: A comparison of general patient data between the two groups showed no significant differences. The DR group had higher serum levels of LECT2, CTRP5, total cholesterol(TC), triglycerides(TG), low-density lipoprotein cholesterol(LDL-C), and homeostatic model assessment of insulin resistance(HOMA-IR)than the non-DR group, while high-density lipoprotein cholesterol(HDL-C)was lower(all P<0.05). The serum levels of LECT2 and CTRP5 in the PDR group were higher than those in the NPDR group(all P<0.05). Serum LECT2 and CTRP5 positively correlated with TC, TG, LDL-C, and HOMA-IR, and negatively correlated with HDL-C(all P<0.001). Logistic results showed that duration of diabetes, TC, TG, LDL-C, HOMA-IR, LECT2, and CTRP5 were risk factors for DR occurrence in T2DM patients(all P<0.05). The ROC curve showed that the AUCs for serum LECT2, CTRP5 alone, and combined in diagnosing DR in T2DM patients were 0.830, 0.839, and 0.915, respectively. The AUC for the combined diagnosis was higher than that of LECT2 or CTRP5 alone according to the DeLong test(Z=2.818, 2.824, P=0.015, 0.012).CONCLUSION:Serum LECT2 and CTRP5 levels are closely related to the development of DR in T2DM patients, and joint detection has certain clinical value in diagnosing DR in T2DM patients.

AIM:To evaluate the efficacy and safety of trypsin irrigation in the treatment of lacrimal duct obstruction after Nd:YAG laser dacryoplasty.METHODS:This retrospective cohort study included 160 patients(160 eyes)with lacrimal duct obstruction who underwent Nd:YAG laser dacryocystoplasty at our institution. Based on the postoperative irrigation protocol, patients were allocated into two groups: the experimental group, which received lacrimal irrigation with a 25% trypsin solution once weekly for 4 wk postoperatively, and the control group, which received irrigation with normal saline on the same schedule. Patient data was obtained by reviewing electronic medical records, including baseline characteristics, surgical records, postoperative irrigation protocols, and follow-up outcomes at 1, 2, 4, and 6 mo post-surgery.RESULTS:The baseline characteristics were comparable between the two groups. At 1 mo postoperatively, the success rate in the experimental group was 90.0%, significantly higher than 71.3% in the control group(P<0.05). Preoperatively, the tear meniscus height in obstructed eyes was higher than in healthy eyes in all patients(all P<0.01). At 1 mo postoperatively, the tear meniscus height in obstructed eyes decreased significantly compared to preoperative levels(all P<0.01), and was lower in the experimental group than in the control group(P<0.01). The recurrence rates of obstruction at 2, 4, and 6 mo were 1.4%, 6.9%, and 5.6% in the experimental group, compared to 5.3%, 17.5%, and 12.3% in the control group, respectively. The total recurrence rate was significantly lower in the experimental group(13.9%)than in the control group(35.1%; P<0.05). No severe complications occurred in either group. Patient satisfaction with the treatment outcome was significantly higher in the experimental group than in the control group(P<0.01).CONCLUSION:Lacrimal irrigation with trypsin following Nd:YAG laser dacryocystoplasty demonstrates superior efficacy and a lower recurrence rate in the treatment of lacrimal duct obstruction. Trypsin shows promising application prospects for improving surgical success rate and reducing recurrence rate after laser treatment for lacrimal duct obstruction.