Purpose: To evaluate the clinical outcomes of endovascular treatment for ruptured vertebral artery dissecting aneurysms (VADAs), with a focus on endovascular protocols tailored to different anatomical subtypes. Materials and Methods: We retrospectively analyzed 44 consecutive patients with ruptured VADAs treated from December 2014 to October 2024. Treatment strategies were guided by aneurysm location: parent artery occlusion (PAO) was used for lesions in non-dominant VAs, while stent-assisted coiling (SAC) reconstruction was used for aneurysms in dominant VAs. Patients were stratified by modified Rankin Scale (mRS) scores at 3-month follow-up (favorable: mRS 0–2; unfavorable: mRS 3–6). Results: All procedures were technically successful, including 12 single SAC, 13 overlapping SAC, and 19 with PAO (2 involving posterior inferior cerebellar artery preservation). Immediate complete occlusion was achieved in 50.0% of single SAC cases, 76.9% overlapping SAC, and 100% in the PAO group. Six (13.6%) procedure-related complications occurred, including 2 hemorrhagic and 4 ischemic events. Thirty patients (68.2%) had favorable outcomes, and the unfavorable outcomes group showed a higher incidence of ischemic events (P=0.012). An initial poor Hunt–Hess grade (≥IV) was an independent risk factor for unfavorable outcomes (odds ratio 6.35, 95% confidence interval 1.24–32.59; P=0.027). Angiographic follow-up was performed for 34 aneurysms, with complete occlusion achieved in 32 (94.1%); the remaining 2 patients were retreated. Conclusion Endovascular management is safe and effective for ruptured VADAs. Anatomical stratification—PAO for non-dominant VA lesions and SAC for dominant VA aneurysms—may help achieve favorable outcomes.

Objective To explore the mechanism of Kangliu Zengxiao Jiandu Prescription(KLJD)in enhancing the efficacy of cisplatin chemotherapy in non-small cell lung cancer(NSCLC)through network pharmacology and in vivo/in vitro experiments.Methods Components of KLJD were screened via the TCMSP database to identify active components and potential targets.Lung cancer-related genes were obtained from the GeneCards and OMIM databases.GO and KEGG pathway enrichment analysis was performed on drug-disease intersection targets using the Metascape database;molecular docking was performed between core target proteins and main active components.A Lewis lung cancer mouse model was established,and intervened with KLJD and cisplatin.Organ indexes and tumor inhibition rate were counted,and Western blot and RT-PCR were used to detect the expressions of key pathway target proteins and mRNA;A549 and H1299 cells were intervened with KLJD,and Western blot was used to detect key target protein expressions.Results Network pharmacology identified 74 active components and 20 key targets of KLJD,primarily involved in biological processes such as cell proliferation and inflammatory response,and pathways in cancer and PI3K/AKT signaling pathway;molecular docking revealed stable binding between EGFR and major compounds.Animal experiments demonstrated that,compared with the model group,the KLJD group showed significantly higher tumor inhibition rate(P<0.01)and downregulation of EGFR,AKT and PI3K protein and mRNA expression in tumor tissues(P<0.05).Compared with the cisplatin group,the combination group exhibited significantly enhanced tumor inhibition rate(P<0.01),elevated thymic and splenic indices(P<0.01),and decreased EGFR,PI3K and AKT protein and mRNA expressions(P<0.01).Cell experiments showed that KLJD concentration-dependently inhibited A549 and H1299 cell proliferation(IC50:14.72 mg/mL and 14.68 mg/mL,respectively).Combined with cisplatin,KLJD synergistically down-regulated EGFR PI3K and AKT protein expressions(P<0.01).Conclusion KLJD effectively enhances cisplatin's chemotherapeutic efficacy in NSCLC by inhibiting the EGFR/PI3K/AKT pathway while improving immune organ function.Its mechanism likely involves multi-target regulation,including suppression of tumor proliferation,promotion of apoptosis,and modulation of the immune microenvironment.

Objective To construct and validate the efficacy of a risk prediction model for pneumothorax after CT-guided percutaneous pulmonary puncture biopsy(CT-PCNB)based on nomograms.Methods A total of 246 patients who underwent CT-PCNB examination in the hospital from October 2020 to October 2023 were selected and divided into training set(n=144)and validation set(n=102)using a random sampling method.In the training set,univariate and multivariate logistic regression analyses were performed to identify risk factors for pneumothorax after CT-PCNB.A nomogram model was constructed based on the identified risk factors,and its accuracy was validated using the validation set.Results Multifactorial logistic regression analysis showed that age≥60 years,concomitant underlying lung disease,lesion diameter<2 cm,distance from lesion to pleura≥10 mm,puncture through interlobular pleura,and≥2 pleural punctures were the risk factors for pneumothorax after CT-PCNB in the training set(P<0.05).A nomogram model was constructed based on these six factors.The ROC curve results for the training set showed an AUC of 0.852,sensitivity of 84.50%,and specificity of 67.50%.The nomogram model was validated using the validation set,with ROC curve results showing an AUC of 0.845,sensitivity of 83.00%,and specificity of 69.50%.There was no statistically significant difference between the predicted and actual values in both the training and validation sets(χ2=1.803,1.225;P>0.05),indicating clinical validity.Conclusion The nomogram model constructed based on the risk factors for pneumothorax after CT-PCNB has high predictive efficacy and is clinically meaningful.

Objective:To investigate the effects and its related mechanism of placenta-derived mesenchymal stem cells(PMSCs)on the lipopolysaccharides(LPS)damaged astrocytes.Methods:Primary astrocytes were isolated from the cerebral cortex of neonatal rats.The expression of glial fibrillary acidic protein(GFAP)was identified using immu-nofluorescence staining to evaluate the purity of the primary astrocytes.PMSCs were cocultured with LPS-treated astro-cytes.The expression levels of factors related to inflammation including interleukin-1β(IL-1β),inducible nitric oxide synthase(iNOS),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),arginase-1(Arg-1),S100 calcium-bind-ing protein A10(S100A10),and TGF-β/Smad signaling pathway-related proteins such as transforming growth factor beta 1(TGF-β1),transforming growth factor beta type I receptor(TβRⅠ),transforming growth factor beta type II re-ceptor(TβRⅡ),phospho-Smad2 and phospho-Smad3(p-Smad2,p-Smad3)in astrocytes from each group were detec-ted using real time RT-PCR or Western blot techniques.Results:Astrocytes at the third passage exhibited an 80%pos-itivity rate for GFAP.After treated with 10 μg/ml LPS,the astrocytes expression levels of pro-inflammatory factors IL-1β,iNOS,IL-6,and TNF-α were significantly increased(P<0.05),while their expression levels of the anti-inflam-matory factors of Arg-1 and S100A10 were significantly decreased(P<0.05).Meanwhile,their expression levels of TGF-β/Smad signaling pathway related proteins of TGF-β1,TβRⅠ,TβRⅡ,p-Smad2 and Smad3 were increased(P<0.05).After the LPS damaged astrocytes were cocultured with PMSCs,their expression levels of pro-inflammatory factors IL-1β,iNOS,IL-6,and TNF-α were significantly decreased(P<0.05),while their expression levels of the anti-inflammatory factors of Arg-1 and S100A10 were significantly increased(P<0.05).Also,their expression levels of TGF-β/Smad signaling pathway related proteins of TGF-β1,TβRⅠ,TβRⅡ,p-Smad2,and Smad3 were decreased(P<0.05).Conclusion:PMSCs may inhibit the activation of A1 astrocytes through the TGF-β/Smad signaling path-way,by which reducing the astrocytic activation.

Jaws and alveolar defects present significant challenges in reconstructive surgery and implant restoration.Calcium phos-phate(CaP)bioceramics are commonly used as bone substitute and play a crucial role in repairing bone defects.Recent studies have shown that T cells play an important regulatory role in bone regeneration.The studies on CaP bioceramics and T cells,including their subpopulations,in bone regeneration,and the mechanisms through which CaP bioceramics regulate the behavior of T cells has been re-viewed.

Objective:To investigate the impact of the size of the liver tumor diameter on the prognosis of patients with hepatitis B-related hepatocellular carcinoma (HCC)-inducing acute-on-chronic liver failure (HBV-HCC/ACLF).Method:A retrospective cohort study was conducted. Clinical data of patients with hepatitis B-related acute-on-chronic liver failure (HBV-ACLF) diagnosed according to the Asia-Pacific Association for the Study of the Liver (APASLT) guidelines who were admitted to the Fifth Medical Center of PLA General Hospital between January 2016 and January 2021 were collected. The patients were enrolled in the HBV-HCC/ACLF group (116 cases) and the HBV-ACLF group (348 cases). General information, medical history, biochemical parameters, complications, and liver cancer status were collected. Clinical data and prognoses at 28 days and 12 months of follow-up were compared between the two groups. Factors influencing mortality in the HBV-HCC/ACLF group were analyzed to determine the prognostic significance of tumor diameter. The t test, χ 2 test, and multivariate logistic regression analysis were used to analyze factors influencing mortality. Receiver operating characteristic (ROC) curves were used to assess the sensitivity and specificity of tumor diameter for 28-day prognosis, and Kaplan-Meier curves were used for survival analysis. Result:There were statistically significant differences in the 28-day mortality rate [(55.17%, 64/116) vs. (38.51%, 134/348)] and 12-month mortality rate [(78.45%, 91/116) vs. (55.75%, 194/348)] between the HBV-HCC/ACLF group and the HBV-ACLF group ( P<0.05). The area under the ROC curve analysis for HBV-HCC/ACLF patients indicated that the tumor diameter was 0.707 (95% CI: 0.615-0.788). The survival group (52 cases) and the mortality group (64 cases) were divided into the HBV-HCC/ACLF group based on 28-day mortality. Univariate analysis showed that the levels of aspartate aminotransferase (AST), alkaline phosphatase, creatinine, alpha-fetoprotein, white blood cell count, international normalized ratio, model for end-stage liver disease score, acute kidney injury (AKI), the occurrence of infections and complications, and others were all significantly higher in the mortality group compared to the survival group ( P<0.05).The mortality group had a larger tumor diameter than the survival group ( P<0.01). The incidence of portal vein tumor thrombosis and distant liver cancer metastasis was also higher in the survival group ( P<0.01). The mortality group had a higher rate of HCC-related minimally invasive treatment within three months before ACLF diagnosis than the survival group ( P<0.01). AST levels, infection, size of tumor diameter, and minimally invasive treatment within three months before onset were independent risk factors for 28-day mortality in the HBV-HCC/ACLF group. The optimal significant value for tumor diameter affecting prognosis was 3.3 cm, with a sensitivity of 67.19% and a specificity of 73.08%. Patients with liver tumor diameters >3.3 cm had significantly lower 28-day survival rates than those with a tumor diameter ≤3.3 cm [(24.56%, 14/57) vs. (64.41%, 38/59)]. Eighty case analyses had the same findings in patients who had not previously received any therapy. Conclusion:Patients with HBV-HCC/ACLF had a high 28-day mortality rate, and the size of the tumor diameter is important in determining the 28-day prognosis.

Objective:To investigate the clinical efficacy of minimally invasive bone plate technology combined with interlocking intramedullary nail fixation in the treatment of Schatzker type V-VI tibial plateau fractures.Methods:This study is a prospective randomized controlled trial involving 102 patients with Schatzker type V-VI tibial plateau fractures admitted to the First People's Hospital of Yuhang District from November 2020 to October 2023. The patients were randomly divided into a control group ( n = 48) and a study group ( n = 54) using the random number table method. The study group received treatment with minimally invasive plate technology combined with interlocking intramedullary nail fixation, while the control group underwent double bone plate fixation through medial and lateral knee incisions. Surgical outcomes and bone healing were compared between the two groups. All participants were followed up for 1 year after surgery, during which knee joint function was assessed at 1, 6, and 12 months using the Hospital for Special Surgery knee score and balance ability was evaluated using the Berg Balance Scale. The incidence of postoperative complications was also compared between the two groups. Results:The study group had significantly shorter surgical time [(69.38 ± 12.64) minutes], intraoperative blood loss [(165.20 ± 17.58) mL], and fracture healing time [(14.51 ± 3.02) weeks] compared with the control group [(91.24 ± 15.18) minutes, (222.19 ± 20.47) mL, (17.04 ± 4.11) weeks, t = 7.93, 15.13, 3.51, all P < 0.05]. At 1, 6, and 12 months after surgery, the Berg Balance Scale scores in the study group were (44.55 ± 4.01), (49.31 ± 3.67), and (53.11 ± 3.18), respectively. These scores were significantly higher than those in the control group [(40.27 ± 3.98), (45.65 ± 3.16), (48.26 ± 3.20), t = -5.40, -5.36, -7.65, all P < 0.05]. At 1, 6, and 12 months after surgery, the Hospital for Special Surgery knee scores in the study group were (68.29 ± 4.25), (76.37 ± 5.25), (83.31 ± 5.01) respectively. These scores were significantly higher than those in the control group [(63.57 ± 4.14), (72.08 ± 4.50), (80.05 ± 4.57), t = -5.67, -4.40, -3.42, all P < 0.05]. There was no significant incidence in the incidence of complications between the study and control groups [12.96% (7/54) vs. 18.75% (9/48), P > 0.05]. Conclusions:The use of minimally invasive bone plate technology combined with interlocking intramedullary nail fixation for the treatment of Schatzker type V-VI tibial plateau fractures has demonstrated significant short-term clinical results, including reduced intraoperative blood loss, shorter fracture healing time, and improved recovery of joint function after surgery.

Objective To explore the mechanism of Kangliu Zengxiao Jiandu Prescription(KLJD)in enhancing the efficacy of cisplatin chemotherapy in non-small cell lung cancer(NSCLC)through network pharmacology and in vivo/in vitro experiments.Methods Components of KLJD were screened via the TCMSP database to identify active components and potential targets.Lung cancer-related genes were obtained from the GeneCards and OMIM databases.GO and KEGG pathway enrichment analysis was performed on drug-disease intersection targets using the Metascape database;molecular docking was performed between core target proteins and main active components.A Lewis lung cancer mouse model was established,and intervened with KLJD and cisplatin.Organ indexes and tumor inhibition rate were counted,and Western blot and RT-PCR were used to detect the expressions of key pathway target proteins and mRNA;A549 and H1299 cells were intervened with KLJD,and Western blot was used to detect key target protein expressions.Results Network pharmacology identified 74 active components and 20 key targets of KLJD,primarily involved in biological processes such as cell proliferation and inflammatory response,and pathways in cancer and PI3K/AKT signaling pathway;molecular docking revealed stable binding between EGFR and major compounds.Animal experiments demonstrated that,compared with the model group,the KLJD group showed significantly higher tumor inhibition rate(P<0.01)and downregulation of EGFR,AKT and PI3K protein and mRNA expression in tumor tissues(P<0.05).Compared with the cisplatin group,the combination group exhibited significantly enhanced tumor inhibition rate(P<0.01),elevated thymic and splenic indices(P<0.01),and decreased EGFR,PI3K and AKT protein and mRNA expressions(P<0.01).Cell experiments showed that KLJD concentration-dependently inhibited A549 and H1299 cell proliferation(IC50:14.72 mg/mL and 14.68 mg/mL,respectively).Combined with cisplatin,KLJD synergistically down-regulated EGFR PI3K and AKT protein expressions(P<0.01).Conclusion KLJD effectively enhances cisplatin's chemotherapeutic efficacy in NSCLC by inhibiting the EGFR/PI3K/AKT pathway while improving immune organ function.Its mechanism likely involves multi-target regulation,including suppression of tumor proliferation,promotion of apoptosis,and modulation of the immune microenvironment.

Objective:To investigate the distribution of iodine in drinking water and the iodine nutrition status of key populations in Boxing County of Shandong Province, and to provide a basis for continuous elimination of iodine deficiency disorders and scientific iodine supplementation.Methods:In 2021, in the historical iodine deficiency towns (districts, referred to as towns) in Boxing County, one water sample of centralized water supply terminal water of each administrative village (neighborhood committee) was collected for water iodine testing. Using stratified cluster sampling method, the historical iodine deficiency areas in Boxing County were divided into 5 areas according to east, west, south, north and center. One town was randomly selected from each area, 20 pregnant women and 40 non-boarding students aged 8 - 10 from a primary school were randomly selected from each town. Thirty pregnant women and 100 students were selected from each of the two historical high iodine towns, and random urine samples were collected from the above-mentioned population for urinary iodine detection and analysis.Results:A total of 329 water samples were collected, and the median water iodine was 10.9 μg/L. Of these, 267 samples (81.2%) were < 40 μg/L, 33 samples (10.0%) were among 40 - 100 μg/L, and 29 samples (8.8%) were > 100 μg/L. A total of 410 urine samples were collected from children, and the median urinary iodine was 162.0 μg/L. The median urinary iodine of children in different towns was compared, and the difference was statistically significant ( H = 86.34, P < 0.001). A total of 109 urine samples were collected from pregnant women, and the median urinary iodine was 57.4 μg/L. The median urinary iodine of pregnant women in different towns were compared, and the difference was statistically significant ( H = 38.35, P < 0.001). Conclusions:The distribution of iodine in drinking water in Boxing County is complex, with areas with high iodine, iodine deficiency, and suitable iodine sources coexisting. Children's iodine nutrition is at an appropriate level, but pregnant women's iodine nutrition is at a deficiency level. Relevant departments should strengthen health promotion, and each region should formulate iodized salt supply strategies based on actual conditions. At the same time, special attention should be paid to the iodine nutrition status of pregnant women.

Objective To explore the safety of Yttrium-90 resin microsphere selective internal radiation therapy (⁹⁰Y-SIRT) on malignant liver tumors. Methods A retrospective analysis was conducted on 64 patients with malignant liver tumors who underwent ⁹⁰Y-SIRT from February 2023 to November 2024 at Weifang People’s Hospital. The clinical characteristics of the patients and the occurrence of adverse reactions after treatment were analyzed to assess the safety of ⁹⁰Y-SIRT. Results Among the 64 patients, there were 52 males (81.25%) and 12 females (18.75%); the average age was (56.29±11.08) years. Seven patients (10.94%) had tumors with maximum diameter of less than 5 cm, 38 patients (59.38%) had tumors with maximum diameter of 5-10 cm, and 19 patients (29.68%) had tumors with maximum diameter of greater than 10 cm. There were 47 cases (73.44%) of solitary lesions and 17 cases (26.56%) of multiple lesions; 53 cases (82.81%) were primary liver cancers and 11 cases (17.19%) were metastatic liver cancers. Of the 64 patients, 63 successfully completed the Technetium-99m macroaggregated albumin (^99mTc-MAA) perfusion test and received the ⁹⁰Y-SIRT; one patient received ⁹⁰Y-SIRT after the second ^99mTc-MAA perfusion test due to a work error. The most common adverse reactions included grade 1 alanine aminotransferase (ALT) elevation in 26 cases (40.62%) and grade 2 in 2 cases (9.37%), grade 1 aspartate aminotransferase (AST) elevation in 27 cases (42.18%) and grade 2 in 7 cases (10.93%); grade 1 nausea in 17 cases (26.56%) and grade 2 in 6 cases (9.37%); grade 1 abdominal pain in 12 cases (18.75%), grade 2 in 5 cases (7.81%), and grade 3 in 1 case (1.56%); grade 1 vomiting in 11 cases (17.18%), grade 2 in 5 cases (7.81%), and grade 3 in 1 case (1.56%). Conclusion The adverse reactions of ⁹⁰Y-SIRT for treating malignant liver tumors are mild, indicating good safety.