ObjectiveAge-related macular degeneration （AMD） is one of the leading causes of low vision and blindness in people over 50 years old， and dry AMD （dAMD） is one type for which there is currently no clear treatment. On the basis of the diagnosis and clinical characteristics of dAMD in traditional Chinese and Western medicine， this paper evaluated the fitting degrees of existing animal models of dAMD with clinical characteristics according to the evaluation methods of animal models， and put forward suggestions and prospects. MethodsLiterature on animal models of dAMD was searched against database， and the characteristics of the models were assigned according to the diagnosis criteria of diseases and syndromes of traditional Chinese and Western medicine， and the fitting degrees of the models with clinical characteristics were analyzed and evaluated. ResultsAt present， the animal models of dAMD are mainly established targeting complement factors， chemokines， oxidative damage， lipid/glucose metabolism， and natural strains. Most of the models can simulate the major pathological changes of dAMD， showing the fitting degree of 25%-50% with clinical characteristics in Western medicine. However， the evaluation of traditional Chinese medicine （TCM） syndromes， especially the evaluation of secondary syndromes， is missing， and the models present low fitting degrees with the clinical characteristics in TCM. ConclusionExisting animal models of dAMD are mostly established under the guidance of Western diagnostic standards， which reproduce the main disease characteristics of Western medicine and lack observation of TCM syndromes. Future studies can pay attention to the intervention factors and evaluation systems of spleen deficiency Qi deficiency and liver-kidney Yin deficiency syndrome and build the animal model of dAMD with integration of disease and syndrome based on clinical characteristics of traditional Chinese and Western medicine.

ObjectiveAge-related macular degeneration （AMD） is one of the leading causes of low vision and blindness in people over 50 years old， and dry AMD （dAMD） is one type for which there is currently no clear treatment. On the basis of the diagnosis and clinical characteristics of dAMD in traditional Chinese and Western medicine， this paper evaluated the fitting degrees of existing animal models of dAMD with clinical characteristics according to the evaluation methods of animal models， and put forward suggestions and prospects. MethodsLiterature on animal models of dAMD was searched against database， and the characteristics of the models were assigned according to the diagnosis criteria of diseases and syndromes of traditional Chinese and Western medicine， and the fitting degrees of the models with clinical characteristics were analyzed and evaluated. ResultsAt present， the animal models of dAMD are mainly established targeting complement factors， chemokines， oxidative damage， lipid/glucose metabolism， and natural strains. Most of the models can simulate the major pathological changes of dAMD， showing the fitting degree of 25%-50% with clinical characteristics in Western medicine. However， the evaluation of traditional Chinese medicine （TCM） syndromes， especially the evaluation of secondary syndromes， is missing， and the models present low fitting degrees with the clinical characteristics in TCM. ConclusionExisting animal models of dAMD are mostly established under the guidance of Western diagnostic standards， which reproduce the main disease characteristics of Western medicine and lack observation of TCM syndromes. Future studies can pay attention to the intervention factors and evaluation systems of spleen deficiency Qi deficiency and liver-kidney Yin deficiency syndrome and build the animal model of dAMD with integration of disease and syndrome based on clinical characteristics of traditional Chinese and Western medicine.

BACKGROUND:Extracellular vesicles are secreted into the extracellular milieu by a wide range of cell types,including tumor cells,under different physiological and pathophysiological conditions,where a wide range of biological signals and cell-to-cell signaling exists.Tumor-derived extracellular vesicles may exacerbate cancer progression,survival,invasion,and promote angiogenesis. OBJECTIVE:To review the research progress of extracellular vesicles in the diagnosis and treatment of oral squamous cell carcinoma. METHODS:Literature search was performed by the first author in PubMed,WanFang,CNKI and other databases with the keywords"EVs,oral squamous cell carcinoma,diagnosis and treatment,biopsy,tissue engineering"in Chinese and English.Finally,63 articles were included for analysis. RESULTS AND CONCLUSION:(1)In oral squamous carcinoma saliva biopsies,extracellular vesicles play a crucial role in the progression of oral squamous cell carcinoma by acting as an information transfer tool between tumor cells and the surrounding microenvironment,carrying a wide range of biomolecules including soluble proteins,lipids,DNA,and RNA.These tiny vesicles not only play a key role in tumor growth and spread,but also provide important information about the biological properties of the tumor.(2)Saliva biopsy,as a non-invasive diagnostic method,can open up new possibilities for early diagnosis and targeted treatment of oral squamous cell carcinoma by analyzing the extracellular vesicles therein.(3)It has been found that bioactive molecules,such as microRNAs(miRNAs)and specific proteins,contained within extracellular vesicles can serve as biomarkers for oral squamous carcinoma and improve the accuracy of early diagnosis.Specific proteins in extracellular vesicles such as EHD2,CAVIN1,PF4V1,and CXCL7 show potential as novel predictive biomarkers.(4)In addition,this paper highlights the potential application of extracellular vesicles in the treatment of oral squamous carcinoma.Through engineering modifications,extracellular vesicles can serve as a new generation of nanoscale drug delivery systems to enhance the efficiency and specificity of targeted tumor therapy.(5)Future studies will further explore the effect and mechanism of extracellular vesicles in oral squamous cell carcinoma,which is expected to improve patients'survival and quality of life.

Objective To compare the therapeutic effects of laparoscopic transabdominal preperitoneal repair(TAPP)and Bassini herniorrhaphy in the treatment of inguinal hernia.Methods 107 patients with inguinal hernia from January 2021 to December 2024 were selected and divided into the Bassini group(53 cases were repaired by Bassini herniorrhaphy)and the TAPP group(54 cases were repaired by TAPP)by random number table method.The surgical-related indicators,pain degree,stress index levels,quality of life,rehabilitation effect and incidence of complications of the two groups of patients were compared.Results The operation time of the Bassini group was significantly shorter than that of the TAPP group,the intraoperative blood loss was significantly more than that in the TAPP group,and the hospital stay was significantly longer than that in the TAPP group,the differences were statistically significant(P<0.05).The visual analogue scale(VAS)score of the two groups of patients after surgery showed a trend of first increasing and then decreasing.The VAS scores of the TAPP group at 3 and 7 days after surgery were significantly lower than those of the Bassini group,and the differences were statistically significant(P<0.05).The levels of cortisol and norepinephrine in both groups of patients 3 days after the operation were significantly higher than those before the operation,and the Bassini group was significantly higher than the TAPP group,the differences were statistically significant(P<0.05).The total effective rate of the TAPP group was 98.15%,significantly higher than that of the Bassini group(83.02%),and the difference was statistically significant(P<0.05).The Short Form 36(SF-36)score of the two groups of patients one month after the operation was significantly higher than that before the operation,and the TAPP group was significantly higher than the Bassini group,the differences were statistically significant(P<0.05).The incidence of complications in the TAPP group was 3.70%,significantly lower than 18.87%in the Bassini group,and the difference was statistically significant(P<0.05).Conclusion Compared with Bassini herniorrhaphy,TAPP can effectively shorten the hospital stay,reduce intraoperative blood loss,lower postoperative pain and stress response,improve the postoperative quality of life of patients,enhance rehabilitation effect and reduce the incidence of complications.It is worthy of clinical promotion and application.

Objective To evaluate the effect of optical body surface monitoring system(OSMS)in setup of intensity modulated radiotherapy(IMRT)for thoracic tumorsand to analyze its relationship with BMI.Methods Thesetup errors of CBCT and location CT with body membrane and the registration errors of OSMS and first body surface reference image without body membrane were obtained in 49 patients with thoracic tumor who received routine intensity modulated radiotherapy.The paired t-test was used to analyze the difference of registration errors between the two image guidance methods.Pearson′s correlation analysis was used to analyze the correlation between CBCT errors and OSMS errors,and Bland-Altman analysis was employed to evaluatethe agreement of the two errors.The correlation and consistency of the two registration errors in patients with different BMI index were analyzed.PTV external marginsby the two registration methods were calculated using Van Herk formula.Results The OSMS and CBCT groups demonstrated significant differences in setup errors in the ventrodorsal direction(P<0.05),while no significant differences were found in the left-right,head-foot translation directions,or RTN rota-tion directions(P>0.05).Although the two methods showed a significant correlation in setup errors(P<0.05),this correlation was only moderate in the head-foot and left-right directions(r=0.500,0.408),weak in the RTN rotation direction(r=0.339),and very weak in the ventrodorsal direction(r=0.152).The limits of agreement(LOA,95％CI)between the two methods were[-0.45,0.45]cm in the left-right direction,[-0.59,0.57]cm in the head-foot direction,and[-0.48,0.40]cm in the ventrodorsal direction,with(-2.08°～2.19°)in the RTN rotation direction.Different BMI levels influenced the results of the two registration methods,particularly in patients with a BMI of 18.5～23.9 kg/m2.In this group,OSMS and CBCT exhibited a strong correlation in the head-foot direction(r=0.731),a moderate correlation in the left-right direction(r=0.512),and weak correlations in the ventrodorsal and RTN rotation directions(r=0.345,0.267).The absolute difference in setup errors between the two imaging systems was 0.4～0.5 cm/2°.Using CBCT and OSMS image guidance,the margins in the left-right,head-foot,and ventrodorsal directions were[0.5 cm,0.7 cm,0.3 cm]for CBCT,and[0.5 cm,0.7 cm,0.5 cm]for OSMS.Conclusion In chest tumor patients with a BMI of 18.5～23.9 kg/m2,OSMS and CBCT image guidance methods show good correlation in the head-foot and left-right directions,but their limits of agreement exceed the clinically acceptable range.OSMS cannot yet replace CBCT for image guidance in chest tumor intensity-modulated radiotherapy.Further improvements to tumor motion surrogates are necessary to enhance the accuracy of OSMS image guidance.

Objective To compare the therapeutic effects of laparoscopic transabdominal preperitoneal repair(TAPP)and Bassini herniorrhaphy in the treatment of inguinal hernia.Methods 107 patients with inguinal hernia from January 2021 to December 2024 were selected and divided into the Bassini group(53 cases were repaired by Bassini herniorrhaphy)and the TAPP group(54 cases were repaired by TAPP)by random number table method.The surgical-related indicators,pain degree,stress index levels,quality of life,rehabilitation effect and incidence of complications of the two groups of patients were compared.Results The operation time of the Bassini group was significantly shorter than that of the TAPP group,the intraoperative blood loss was significantly more than that in the TAPP group,and the hospital stay was significantly longer than that in the TAPP group,the differences were statistically significant(P<0.05).The visual analogue scale(VAS)score of the two groups of patients after surgery showed a trend of first increasing and then decreasing.The VAS scores of the TAPP group at 3 and 7 days after surgery were significantly lower than those of the Bassini group,and the differences were statistically significant(P<0.05).The levels of cortisol and norepinephrine in both groups of patients 3 days after the operation were significantly higher than those before the operation,and the Bassini group was significantly higher than the TAPP group,the differences were statistically significant(P<0.05).The total effective rate of the TAPP group was 98.15%,significantly higher than that of the Bassini group(83.02%),and the difference was statistically significant(P<0.05).The Short Form 36(SF-36)score of the two groups of patients one month after the operation was significantly higher than that before the operation,and the TAPP group was significantly higher than the Bassini group,the differences were statistically significant(P<0.05).The incidence of complications in the TAPP group was 3.70%,significantly lower than 18.87%in the Bassini group,and the difference was statistically significant(P<0.05).Conclusion Compared with Bassini herniorrhaphy,TAPP can effectively shorten the hospital stay,reduce intraoperative blood loss,lower postoperative pain and stress response,improve the postoperative quality of life of patients,enhance rehabilitation effect and reduce the incidence of complications.It is worthy of clinical promotion and application.

Objective:To investigate the causal relationship between plasma proteins and spontaneous abor-tion using a two-sample Mendelian randomization method.Methods:Using genome-wide association study(GWAS)data from an Icelandic population as an exposure factor and spontaneous abortion data from the Finn-ish Genetic Research Project(FinnGen)as an outcome,the causal relationship between plasma proteins and the risk of developing spontaneous abortion was analyzed using a Mendelian randomization(MR)study.The inverse variance weighting(IVW)method was used as the primary study method,with MR-Egger,weighted median and weighted mode complementing the results;and sensitivity analyses were performed using Cochrane's Q test,MR-Egger intercept testand leave-one-out method to validate the reliability of the data.Results:Seven plasma proteins were identified as potentially correlated with the risk of spontaneous abortion of which fucosyltransferase 10(FUT10)(OR 0.955,95％CI 0.915-0.996,P=0.034),plexin B2(PLXNB2)(OR 0.947,95％CI 0.902-0.995,P=0.030),and interleukin-11 receptor alpha(IL-11Rα)(OR0.905,95％CI 0.848-0.966,P=0.003)were associ-ated with a reduced risk of SA development,while plasma proteins soluble L-selectin(SL-selectin)(OR 1.076,95％CI 1.021-1.134,P=0.006),Cripto protein(OR 1.039,95％CI 1.008-1.071,P=0.012),dendritic cell-specif-ic intercellular adhesion molecule 3-grabbing non-integrin(DC-SIGN)(OR 1.051,95％CI 1.022-1.082,P=0.001),and protein Z-dependent protease inhibitor(ZPI)(OR 1.035,95％CI 1.001-1.071,P=0.045)levels were positively associated with the risk of developing SA.No heterogeneity or horizontal pleiotropy was detected(Co-chrane's Q test and MR-Egger intercept test,P＞0.05),and leave-one-out analysis showed that there were no individual single-nucleotide polymorphisms that had a large impact on the overall data.Conclusions:This Mende-lian randomization analyses confirmed the causal relationship between multiple plasma proteins and spontaneous abortion,which is potentially clinically valuable for studying the correlation between plasma proteins and spontane-ous abortion.

The female reproductive system is essential for sustaining reproductive endocrine homeostasis,however,its vulnerability to various endogenous and exogenous insults,including pathological conditions,pharmacological agents,genetic predispositions,and environmental factors,often results in compromised fertility.The existing protective approaches(including surgical interventions,hormonal replacement therapies,and assisted reproductive techniques)are constrained by several limitations,such as adverse therapeutic effects,technical complexities,and their incapacity to reverse ovarian senescence.Artemisinin and its derivatives(ARTs),characterized by their unique endoperoxide bridge configuration,have exhibited outstanding therapeutic performance across multiple domains including malaria treatment,anticancer therapy,inflammation modulation,and parasitic infection control.Emerging research has identified their novel protective capabilities against various reproductive system pathologies.This comprehensive review systematically elucidates the molecular mechanisms underlying artemisinin-based interventions in reproductive pathologies and evaluates their clinical translation prospects,thereby proposing innovative strategies for the development of next-generation fertility-protective agents with enhanced safety and efficacy profiles.

Objective To investigate the protective mechanisms of huanglian jiedu decoction(HLJDD)against hypertensive cardiac hypertrophy(HCH)in rats.Methods The HCH model was constructed in SD rats through abdominal aortic constriction(AAC).Rats were randomly divided into the sham operation(Sham)group,model(Mod)group,Mod+HLJDD high,medium and low-dose(Mod+H,Mod+M,Mod+L)groups,and Mod+Captopril(Cap)group using a simple random sampling method.Blood pressure,echocardiography,hematoxylin-eosin staining,and Masson staining were performed to assess the impact of HLJDD on HCH.Based on the results of part one,rats were further randomly divided into Sham group,Mod group,Mod+Notch1 inhibitor(DAPT)group,Mod+Notch1 agonist(Jagged-1)group,Mod+HLJDD high-dose(HLJDD)group,Mod+HLJDD high-dose+Notch1 inhibitor(DAPT+H)group,and Mod+HLJDD high-dose+Notch1 agonist(Jagged-1+H)group using a simple random sampling method.Hematoxylin-eosin staining and Masson staining were observed.Real-time fluorescence quantitative polymerase chain reaction(RT-qPCR)and Western blot were used to detect the expression levels of related inflammatory factors,to further explore the mechanisms of HLJDD.Results Compared with the Mod group,rats in the Mod+H group exhibited reduced blood pressure(P＜0.05),improved cardiac func-tion(P＜0.05),relieved myocardial injury and decreased myocardial fibrosis(P＜0.05).Compared with the Mod group,the DAPT group displayed aggravated myocardial injury and fibrosis,decreased expression levels of Notch1 and Hes1(P＜0.05),and increased ex-pression levels of inflammatory factors and NF-κB p65(P＜0.05).The Jagged-1 group and HLJDD group showed opposite results.Compared with HLJDD group,the DAPT+H group displayed aggravated myocardial injury and fibrosis,decreased expression levels of Notch1 and Hes1(P＜0.05,P＜0.01),and increased expression levels of inflammatory factors and NF-κB p65(P＜0.05).The Jag-ged-1+H group showed opposite results,indicating that HLJDD can partially activate the Notch1signaling pathway while inhibiting the NF-κB signaling pathway and the release of inflammatory factors.Conclusion HLJDD can alleviate AAC-induced HCC in rats,and its mechanism may be achieved through the modulation of the Notch1/NF-κB signaling pathway.Additionally,a certain negative feed-back regulatory relationship exists between the Notch1 signaling pathway and the NF-κB signaling pathway.

Background and Aims:Intrahepatic cholangiocarcinoma(ICC)is a highly malignant liver tumor,with an increasing incidence worldwide,particularly in Asia.Although radical surgical resection is currently the only potentially curative treatment,the high recurrence rate and low postoperative overall survival(OS)rate of ICC remain major clinical challenges.Adjuvant therapy(AT)and neoadjuvant therapy(NAT)are important strategies to reduce postoperative recurrence and prolong OS.Several studies have shown certain efficacy of these treatments.However,the specific efficacy and safety of combined NAT and AT in ICC treatment require further validation.This study was conducted to evaluate the value of combining NAT and AT in improving the therapeutic outcomes of ICC patients through a multicenter retrospective analysis,so as to provide scientific evidence for optimizing treatment strategies.Methods:The clinicopathologic data of 576 patients with ICC who underwent radical resection and were pathologically confirmed from 13 hospitals in China between December 2011 and December 2017 were retrospectively collected.Patients were grouped based on their treatment modality:NAT+AT group,AT group,and non-NAT/AT group.The three patient groups were matched pairwise in a 1∶1 ratio using propensity score matching(PSM)to balance baseline data.The Kaplan-Meier method was used to analyze OS and disease-free survival(DFS),and subgroup analyses were conducted according to the 8th edition of the AJCC TNM staging system.Results:A total of 395 ICC patients were included in the final analysis,with 42 patients(10.6%)in the NAT+AT group,62 patients(15.7%)in the AT group,and 291 patients(73.7%)in the non-NAT/AT group.Before PSM,significant differences were observed between groups in terms of CA19-9,liver function Child-Pugh classification,intraoperative blood loss,surgical margin,differentiation grade,vascular invasion,ECOG score,and lymph node dissection ratio(all P<0.05).After PSM,there were no significant differences in baseline characteristics between the groups(all P>0.05).After matching,the median OS and DFS in the NAT+AT group were significantly better than in the AT and non-NAT/AT groups(both P<0.05),while there were no significant differences in OS and DFS between the AT and non-NAT/AT groups(both P>0.05).Subgroup analysis showed that in TNM stage I patients,DFS in the NAT+AT group was significantly better than in the non-NAT/AT group(P<0.05),but OS was not significantly different(P>0.05).In TNM stage Ⅱ and Ⅲ patients,both OS and DFS in the NAT+AT and AT groups were significantly better than in the non-NAT/AT group(both P<0.05),and DFS in the NAT+AT group was significantly better than in the AT group in TNM stage Ⅲ patients(P<0.05).Conclusion:NAT combined with AT provides better survival benefits for patients with locally advanced ICC,but its benefit for early-stage ICC patients is limited.However,the retrospective design and sample size limitations of this study may affect the stability of the results,and future large-sample,multicenter,prospective studies are needed for further validation.