ObjectiveTo observe the effect of M1 bone marrow-derived macrophages （M1-BMDM） with Wnt5a knockdown on liver fibrosis and regeneration in a rat model of liver cirrhosis， and to investigate its gain-of-function effect compared with unmodified M1-BMDM. MethodsPrimary bone marrow-derived macrophages were isolated from rats and were polarized to M1 phenotype to construct M1-BMDM^Wnt5a-KD cells. A rat model of liver cirrhosis induced by CCl₄/2-AAF was established， and at the end of week 8， rats were randomly divided into model group， M1-BMDM group， M1-BMDM Wnt5a-knockdown empty vector group （M1-BMDM^KD-EV group）， and M1-BMDM Wnt5a-knockdown group （M1-BMDM^Wnt5a-KD group）， with 6 rats in each group. On the first day of week 9， the rats in each group were given a single injection of the corresponding cells via the caudal vein， along with an intraperitoneal injection of a CCR2 inhibitor. Six rats without any treatment were used as normal control group. Samples were collected at the end of week 12 to assess liver histopathology， serum liver function parameters， hepatic stellate cell activation， and the expression levels of mature hepatocyte markers. A one-way analysis of variance was used for comparison of continuous data between multiple groups， and the least significant difference t-test was used for further comparison between two groups. ResultsCompared with the model group， all cell treatment groups had significant alleviation of liver inflammatory response and significant reductions in the activities of alanine aminotransferase and aspartate aminotransferase （AST） in serum （all P<0.01）， and the M1-BMDM^Wnt5a-KD group had a significantly lower serum level of AST than the M1-BMDM group （P<0.05）. The semi-quantitative analysis based on immunohistochemical staining showed that compared with the model group， all cell treatment groups had a significant reduction in the percentage of CD68-positive area （all P<0.05）， and compared with the M1-BMDM^KD-EV group， the M1-BMDM^Wnt5a-KD group had a significant reduction in the percentage of CD68-positive area and a significant increase in the percentage of CD163-positive area （both P<0.05）. Compared with the model group， all cell treatment groups had significant reductions in the mRNA expression levels of CD68 and tumor necrosis factor-α （all P<0.05） and the protein expression level of CD68 （all P<0.01）； compared with the M1-BMDM^KD-EV group， the M1-BMDM^Wnt5a-KD group had significant increases in the protein and mRNA expression levels of CD163 （both P<0.05）， significant reductions in the protein and mRNA expression levels of CD68 （both P<0.05）， and a significant reduction in the protein expression level of tumor necrosis factor-α （P<0.01）. Sirius Red collagen staining and alpha-smooth muscle actin （α-SMA） immunohistochemical staining showed that compared with the model group， all cell treatment groups had significant alleviation of liver collagen deposition and α-SMA-positive area， with the most significant changes in the M1-BMDM^Wnt5a-KD group， and compared with the M1-BMDM^KD-EV group， the M1-BMDM^Wnt5a-KD group had significantly smaller Sirius Red-positive area and α-SMA-positive area and a significantly lower content of hydroxyproline in liver tissue （all P<0.05）. Compared with the M1-BMDM^KD-EV group， the M1-BMDM^Wnt5a-KD group had significant reductions in the protein and mRNA expression levels of α-SMA and the mRNA expression level of COL-I and TGF-β （all P<0.05）. Compared with the model group， all cell treatment groups had a significant increase in the protein expression level of HNF-4α in liver tissue （all P<0.05）， and the M1-BMDM^Wnt5a-KD group had significantly higher protein and mRNA expression levels of HNF-4α and hepatocyte specific antigen than the M1-BMDM^KD-EV group （both P<0.05）. The M1-BMDM^Wnt5a-KD group had a significantly higher serum level of albumin than the M1-BMDM^KD-EV group （P<0.01）. Immunofluorescence co-staining showed that compared with the model group， all cell treatment groups had a significant increase in the number of cells stained positive for HNF and HNF-4α and Ki67 （all P<0.01）， and the M1-BMDM^Wnt5a-KD group had a significantly higher number of such cells than the M1-BMDM^KD-EV group （P<0.05）. ConclusionInhibition of Wnt5a expression enhances the therapeutic effect of M1-BMDM on rats with liver cirrhosis induced by CCl₄/2-AAF， which provides new ideas for enhancing the anti-cirrhotic effect of M1-BMDM through genetic modification.

Objective To compare the performance of 7 Chinese-developed GenAI models (DeepSeek, Wenxin Yiyan, Tongyi, Doubao, Kimi, Hunyuan, and iFLYTEK Spark) in responding to common diseases of the pediatric genitourinary system and to explore their potential applications.Methods A total of 80 questions covering basic disease information, diagnosis, treatment, and prognosis related to “hypospadias, hydronephrosis, and cryptorchidism” were developed as prompts.The models were tested under 3 modes:“quick thinking, ”“deep thinking, ” and “deep thinking + internet access.” The results were evaluated in a blinded review by two pediatric urologists.The responses were graded into 4 levels—A, B, C, and D—based on accuracy, completeness, and relevance.The proportions of responses rated as A and A+B were statistically analyzed and compared across the different models/modes.Results The “deep thinking” mode of DeepSeek demonstrated the best performance, with 88% of responses rated as A and 96% rated as A+B.DeepSeek (deep thinking + internet access), Doubao (quick thinking), Hunyuan (deep thinking), and Doubao (deep thinking + internet access) followed closely, also showing excellent response capabilities.Among the top 5 models/modes, significant differences were observed in the proportion of Alevel responses (P＜0.05), while differences in the proportion of A+B-level responses were not statistically significant (P＞0.05).Conclusion Certain Chinese-developed GenAI models, represented by DeepSeek (deep thinking), demonstrate significant application potential.However, they still cannot consistently provide recommendations rated at the A+B level (recommended grade or higher) with 100% accuracy.In clinical practice, both doctors and patients should view GenAI as an auxiliary tool for education and information acquisition rather than as a final decision-making authority.All information must be reviewed and confirmed by professional physicians.

Lung cancer constitutes the most prevalent and lethal malignant tumor in China. Approximately 85% of lung cancer diagnoses correspond to the non-small cell histological subtype [non-small cell lung cancer (NSCLC)]. Despite surgery being the mainstay for early-stage disease, postoperative recurrence remains high and adjuvant chemotherapy offers limited benefit. In recent years, targeted therapy has demonstrated substantial advantages in driver mutation-positive NSCLC. To this end, the Lung Cancer Medical Education Committee of the Chinese Medical Education Association developed guidelines based on a systematic review of evidence through November 2025, using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach and a modified Delphi method. Focusing on epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK), and addressing ROS proto-oncogene 1 (ROS1), B-Raf proto-oncogene serine/threonine kinase (BRAF) V600E mutation, and mesenchymal-epithelial transition factor (MET) exon 14 (METex14) skipping, the guideline covers molecular testing, neoadjuvant/adjuvant therapy, perioperative strategies, minimal residual disease monitoring, and postoperative surveillance. It defines testing requirements, specifies stage-directed and subtype-specific treatments, and standardizes minimal residual disease monitoring. These recommendations emphasize precision and feasibility to improve survival and quality of life.

Objective: To investigate the implementation and evaluate the effectiveness of health management services for patients with type 2 diabetes mellitus (T2DM) in Urumqi City from 2017 to 2021, so as to provide the reference for enhancing T2DM patients management. Methods: Data on the rates of record establishment, health management and standardized management for T2DM patients, and blood glucose control rate in managed patients in Urumqi City from 2017 to 2021 were collected through the quarterly reports on basic public health service management from the Weining Health Platform System. The trends in the four management indicators, and the differences between urban and rural areas were analyzed. Results: The rates of record establishment, health management and blood glucose control rate in managed patients in Urumqi City were 46.94%, 38.37% and 59.92%, respectively, showing upward trends from 2017 to 2021 (all P<0.05). The rate of standardized management was 75.89%, showing a downward trend (P<0.05). The rate of record establishment was higher in urban areas than in rural areas (47.76% vs. 40.56%, P<0.05). The rates of standardized management and blood glucose control in managed patients were lower in urban areas than in rural areas (75.18% vs. 81.46%, 58.93% vs. 67.64%, both P<0.05). The rate of health management was 38.39% in urban areas and 38.24% in rural areas, with no statistically significant difference (P>0.05). The trends in the rates of record establishment, health management and standardized management in both urban and rural areas were consistent with those in the overall population. Conclusions From 2017 to 2021, the rates of record establishment, health management and blood glucose control in managed patients in Urumqi City showed upward trends, while the rate of standardized management exhibited a downward trend. There were urban-rural differences in the rates of record establishment, standardized management and blood glucose control in managed patients.

Objective:To investigate the role of ionizing radiation in regulating mitochondrial autophagy and epithelial mesenchymal transaction (EMT) in lung, in order to provide experimental evidence for further elucidating the pathogenesis and clinical treatment of radiation-induced pulmonary fibrosis (RIPF).Methods:Beas-2B cells were irradiated with 6 Gy X-rays, and their morphological changes were observed at 0, 12, 24 and 48 h after irradiation. The changes of mitochondrial autophagy and EMT-related proteins in PINK1/Parkin pathway were detected by Western blot assay. The changes of mitochondrial membrane potential were detected by JC-1 staining. TEM was used to observe the changes of cell ultrastructure 48 h after radiation. Beas-2B cells were then divided into control group, irradiation group (RI), RI + vector plasmid group (RI+ oeNC), RI+ PINK1 overexpression group (RI+ oePINK1), and the protein changes of FN1 and LC3 were detected by immunofluorescence. Flow cytometry was used to detect the change of reactive oxygen species (ROS) in each group. The changes of mitochondrial autophagy and EMT-related protein contents were detected by immunofluorescence, flow cytometry and Western blot, respectively.Results:After X-ray irradiation, the cell morphology of human epithelial cells Beas-2B was changed from irregular polygon to spindle shape along with the time increase after irradiation, showing EMT appearance. JC-1 staining showed that, along with the time after irradiation, the red fluorescence was weakened, and the green fluorescence was enhanced, so that the red/green fluorescence ratio was decreased. TEM observation indicated that the cell morphology changed to spindle shape and the number of autophagic lysosomes decreased significantly at 48 h after irradiation. Western blot assay showed that the protein expression levels of PINK1, Parkin and Beclin1 were significantly decreased, while the expression of p62 protein was significantly increased after irradiation. Moreover, the expressions of E-cad and CK19 were significantly decreased, while the expressions of N-cad and Vim were significantly increased ( t = 6.48, 3.72, 6.06, -18.71, P<0.05). Immunofluorescence assay showed that LC3 expression was increased and FN1 expression was decreased in the oePINK1 group ( t = 6.06, -21.49, -9.58, 3.58, P < 0.05). Flow cytometry assay showed that ROS in the oePINK1 group was significantly decreased ( t = -342.54, 88.01, 25.48, P<0.05). After PINK1 overexpression, the expression levels of PINK1, Parkin and Beclin1 were significantly increased, while the expression of p62 protein was significantly decreased ( t = -25.57, -8.76, -11.24, 34.81, P<0.05); meanwhile, the expressions of E-cad and CK19 were significantly increased, while the expressions of N-cad and Vim were significantly decreased ( t =-7.12, 12.04, 67.92, -7.64, P<0.05). Conclusions:X-ray irradiation promoted EMT and impaired mitochondrial function of Beas-2B cells, and weakened mitochondrial autophagy mediated by PINK1/Parkin pathway. Overexpression of PINK1 promoted mitochondrial autophagy, which improved mitochondrial function and effectively inhibited cell EMT, thus alleviating pulmonary fibrosis.

Objective:To evaluate the relationship between the mechanism of mild hypothermia-induced reduction of neuronal apoptosis during cerebral ischemia-reperfusion (I/R) and calcium/calmodulin-dependent protein kinase kinase 2 (CaMKK2)/adenosine monophosphate-activated protein kinase (AMPK) signaling pathway in rats.Methods:Forty SPF male Sprague-Dawley rats, aged 6-8 weeks, weighing 200-250 g, were divided into 5 groups ( n=8 each) using a random number table method: sham operation group (Sham group), cerebral I/R group (IR group), hypothermia + cerebral I/R group (HIR group), hypothermia + cerebral ischemia-reperfusion + solvent group (HIR-DMSO group) and hypothermia + ischemia-reperfusion + CaMKK2 inhibitor STO-609 group (HIR-STO609 group). A global cerebral I/R injury model was established using the four-vessel occlusion method. In HIR group, HIR-DMSO group, and HIR-STO609 group, an ice blanket was used to reduce the body temperature immediately after cerebral ischemia, bringing the core body temperature down to 32.5-33.5 ℃, and rewarming was carried out 4 h later. One hour before developing the model, STO-609 solution 4 μl was injected into the lateral ventricle in HIR-STO609 group, and the equal volume of dimethyl sulfoxide solution was given instead in HIR-DMSO group. At the end of reperfusion, the modified neurological severity score (mNSS) was performed. Then the rats were sacrificed under deep anesthesia, and the hippocampal tissues were taken to observe the pathological results of the hippocampal tissues (using HE staining and Nissl staining) and to determine the apoptosis rate of neurons (by TUNEL method) and expression of B-cell lymphoma 2(Bcl-2), Bcl-2-associated X (Bax), CaMKK2, phosphorylated AMPK (p-AMPK) and AMPK (by Western blot). Results:Compared with Sham group, the mNSS and apoptosis rate of neurons in the hippocampal tissues were significantly increased, the expression of Bax was up-regulated, the expression of Bcl-2, CaMKK2 and p-AMPK was down-regulated, and the ratio of p-AMPK/AMPK was decreased in IR group ( P<0.05). Compared with IR group, the mNSS and apoptosis rate of neurons in the hippocampal tissues were significantly decreased, the expression of Bax was down-regulated, the expression of Bcl-2, CaMKK2 and p-AMPK was up-regulated, and the ratio of p-AMPK/AMPK was increased in HIR group ( P<0.05). Compared with HIR group, the mNSS and apoptosis rate of neurons in the hippocampal tissues were significantly increased, the expression of Bax was up-regulated, the expression of Bcl-2, CaMKK2 and p-AMPK was down-regulated, the ratio of p-AMPK/AMPK was decreased ( P<0.05), and no significant change was found in the aforementioned parameters in HIR-DMSO group ( P>0.05). Conclusions:Mild hypothermia can inhibit neuronal apoptosis by up-regulating the CaMKK2/AMPK signaling pathway, thus reducing cerebral I/R injury in rats.

Objective:To investigate the role of ionizing radiation in regulating mitochondrial autophagy and epithelial mesenchymal transaction (EMT) in lung, in order to provide experimental evidence for further elucidating the pathogenesis and clinical treatment of radiation-induced pulmonary fibrosis (RIPF).Methods:Beas-2B cells were irradiated with 6 Gy X-rays, and their morphological changes were observed at 0, 12, 24 and 48 h after irradiation. The changes of mitochondrial autophagy and EMT-related proteins in PINK1/Parkin pathway were detected by Western blot assay. The changes of mitochondrial membrane potential were detected by JC-1 staining. TEM was used to observe the changes of cell ultrastructure 48 h after radiation. Beas-2B cells were then divided into control group, irradiation group (RI), RI + vector plasmid group (RI+ oeNC), RI+ PINK1 overexpression group (RI+ oePINK1), and the protein changes of FN1 and LC3 were detected by immunofluorescence. Flow cytometry was used to detect the change of reactive oxygen species (ROS) in each group. The changes of mitochondrial autophagy and EMT-related protein contents were detected by immunofluorescence, flow cytometry and Western blot, respectively.Results:After X-ray irradiation, the cell morphology of human epithelial cells Beas-2B was changed from irregular polygon to spindle shape along with the time increase after irradiation, showing EMT appearance. JC-1 staining showed that, along with the time after irradiation, the red fluorescence was weakened, and the green fluorescence was enhanced, so that the red/green fluorescence ratio was decreased. TEM observation indicated that the cell morphology changed to spindle shape and the number of autophagic lysosomes decreased significantly at 48 h after irradiation. Western blot assay showed that the protein expression levels of PINK1, Parkin and Beclin1 were significantly decreased, while the expression of p62 protein was significantly increased after irradiation. Moreover, the expressions of E-cad and CK19 were significantly decreased, while the expressions of N-cad and Vim were significantly increased ( t = 6.48, 3.72, 6.06, -18.71, P<0.05). Immunofluorescence assay showed that LC3 expression was increased and FN1 expression was decreased in the oePINK1 group ( t = 6.06, -21.49, -9.58, 3.58, P < 0.05). Flow cytometry assay showed that ROS in the oePINK1 group was significantly decreased ( t = -342.54, 88.01, 25.48, P<0.05). After PINK1 overexpression, the expression levels of PINK1, Parkin and Beclin1 were significantly increased, while the expression of p62 protein was significantly decreased ( t = -25.57, -8.76, -11.24, 34.81, P<0.05); meanwhile, the expressions of E-cad and CK19 were significantly increased, while the expressions of N-cad and Vim were significantly decreased ( t =-7.12, 12.04, 67.92, -7.64, P<0.05). Conclusions:X-ray irradiation promoted EMT and impaired mitochondrial function of Beas-2B cells, and weakened mitochondrial autophagy mediated by PINK1/Parkin pathway. Overexpression of PINK1 promoted mitochondrial autophagy, which improved mitochondrial function and effectively inhibited cell EMT, thus alleviating pulmonary fibrosis.

Objective:To explore the therapeutic effect of micro-flaps carrying sensory nerve in treatment of high-pressure injection injuries of the digit (HPIID).Methods:From January 2022 to June 2024, retrospective analysis of 7 patients who had HPIID were admitted to the Department of Hand Surgery Division 1, Norinco General Hospital. The patients were 5 males and 2 females with ages from 25 to 59 years. The digital injuries were: 3 index fingers, 2 middle fingers and 2 thumbs. All patients received debridement under microscope in primary surgery, with the defects at 1.5 cm×2.4 cm - 2.5 cm×5.5 cm in size after debridement. In stage Ⅱ surgery, 5 patients received the treatment of free fibular great toe flap carrying peroneal nerve of the great toe, with the flap size at 1.8 cm× 2.0 cm - 2.7 cm×4.0 cm. Two patients received the treatment of transfer of free fibular medial plantar flap carrying medial plantar nerve, with flap size at 1.9 cm×2.6 cm - 4.5 cm×5.7 cm. Donor sites were directly sutured in 5 patients, and 2 patients received skin grafting. Five patients received postoperative follow-up at outpatient clinic, 1 patient via telephone interview and 1 via WeChat review.Results:All 7 flaps survived and all wounds had primary healing. All donor and recipient sites and skin grafting sites healed primarily. Postoperative follow-up lasted for 4 to 9 months, with an average of 6.4 months. All the affected digits had satisfactory appearance and function, except 1 which was slightly slimmer than the healthy side. Range of motion of the affected digits was evaluated according to total active movement (TAM): 5 were in excellent and 2 in good. Sensory recovery of the digits was evaluated according to the British Medical Research Council (BMRC): 1 digit was at S 2, 2 at S 3 and 4 at S 4. One patient had two-point discrimination (TPD) at 9.0-15.0 mm, 2 at 6.0-10.0 mm, and 4 at 3.0-6.0 mm. Conclusion:For HPIID with a defect, surgical treatment with transfer of micro-flap carrying sensory nerve should be a preferred treatment option.

Objective To explore the predictive value of serum levels of CXC chemokine ligand 4(CXCL4),CXC receptor 3 chemokine(CXCR3)for postoperative cerebral vasospasm(CVS)in patients with ruptured intracranial aneurysms.Methods The clinical data of 106 patients with intracranial aneurysms rupture who under went craniotomy and clipping surgery at the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from October 2020 to December 2022 were collected.The incidence of CVS was observed.Serum CXCL4 and CXCR3 levels were compared at 1,3,7 days after surgery between patients without CVS and patients with CVS.Spearman correlation coefficient was used to analyze the relationship between serum CXCL4,CXCR3 levels and CVS degree.ROC curve was used to analyze the value of serum CXCL4 and CXCR3 levels in predicting postoperative CVS.Results Among 106 patients with ruptured intracranial aneurysms,a total of 38 cases(35.85%)developed CVS after surgery,and 68 cases(64.15%)did not develop CVS.There was no statistically obvious difference in preoperative serum levels of CXCL4 and CXCR3 between the CVS group and the non CVS group(t=0.104,0.141,all P>0.05).The serum levels of CXCL4 and CXCR3 in the non CVS group were lower than those before surgery 1,3,and 7 day after surgery,and the differences were statistically significant(q=14.867,17.525,24.384;16.274,20.251,34.237,all P<0.05).Compated with preoperative levels,the levels of serum CXCL4 and CXCR3 in the CVS group decreased on postoperative 1 and 7 days,and the differences were statistically significant(q=9.486,4.858;10.760,9.104,all P<0.05).Compared with the mild CVS group,the serum levels of CXCL4 and CXCR3 in the moderate and severe CVS groups were obviously increased(q=2.982,5.992;2.961,3.465),and the serum levels of CXCL4 and CXCR3 in the severe CVS group were higher than those in the moderate CVS group(q=3.564,4.036),and the differences were statistically significant(all P<0.05),respectively.Spearman results showed that serum levels of CXCL4 and CXCR3 were positively correlated with the severity of CVS(r=0.491,0.483,all P<0.05).The ROC curve results showed that the AUC of CXCL4 and CXCR3 combined in predicting postoperative CVS in patients with intracranial ruptured aneurysms was higher than that of CXCL4,CXCR3 alone,and the differences were statistically significant(Z=2.937,2.750,all P<0.05).Conclusion The serum levels of CXCL4 and CXCR3 in ruptured intracranial aneurysms patients with postoperative CVS are obviously elevated,and the combined detection of the two can effectively predict the occurrence of CVS.

The incidence of type 2 diabetes mellitus (T2DM) has been continuously rising, severely impacting health and increasing the medical burden. With the development of medical big data and artificial intelligence, research into constructing T2DM and its complications prediction models using machine learning methods based on multidimensional data such as genetic information, health records and laboratory testing data have increased, providing new ideas and means for the prevention and control of T2DM. This article reviewed the research progress in prediction models related to the risk of T2DM to understand the classification, modeling methods and applications by retrieving literature on T2DM and its complications prediction models from domestic and international databases including CNKI, Web of Science, and PubMed from 2003 to 2024, so as to provide the reference for early screening and intervention of T2DM.