ObjectiveStarting from the etiology， pathogenesis， and treatment strategies of endometriosis and adenomyosis， to integrate and sort out the academic characteristics of contemporary renowned experts and schools in the field of traditional Chinese medicine gynecology. MethodsAccording to the systematic review of text and opinion （SrTO） process developed by the Joanna Briggs Institute （JBI） in Australia， this paper determined literature screening criteria by searching China National Knowledge Infrastructure （CNKI）， VIP， Wanfang， and China Biomedical Literature Database. Information was extracted after literature screening， and quality evaluation was conducted using the JBI Narrative， Text， and Opinion Systematic Review Strict Evaluation Checklist. The JBI Narrative， Opinion， Text Evaluation， and Review Tool Summary Table was used for information synthesis， and data analysis and display were conducted in the form of text and charts. ResultsThe 146 articles related to 39 renowned experts and 19 articles related to 10 schools of thought were included. Research has found that contemporary experts and schools in traditional Chinese medicine gynecology consider blood stasis as the core pathogenesis in understanding the etiology and pathogenesis of two diseases and related infertility. Their viewpoints varied from multiple aspects such as clinical symptom characteristics， meridian circulation location， pathological product evolution， disease duration， emotional psychology， lifestyle habits， preference for food and drink， innate endowment， and acquired injury. In terms of treatment， it was advocated to divide the stage， treat according to different types， adapt to the times， integrate nature and humans， and combine multiple methods to treat comprehensively when necessary. It was also recommended to skillfully use insects， make good use of classic formulas and small prescriptions， pay attention to protecting the spleen and stomach and regulating emotions， and make good use of self-formulated empirical formulas for internal or external use. Besides， individualized long-term management of patients was also advocated. ConclusionThis study applies the SrTO process to systematically summarize the academic ideas of contemporary renowned experts and schools in traditional Chinese medicine gynecology regarding the causes， mechanisms， diagnosis， and treatments of endometriosis， providing a scientific and standardized reference for future theoretical exploration.

ObjectiveTo describe the medical services quality and safety of rehabilitation medicine departments in general hospitals and rehabilitation hospitals in 2022 from the aspects of structure, link and outcome quality. MethodsThrough the National Clinical Improvement System of the National Health Commission, all secondary and above general hospitals and rehabilitation hospitals were investigated in 2022, the relevant data from 7 250 hospitals, including traditional Chinese medicine hospitals and integrated traditional Chinese and Western medicine hospitals in 2022. A total of 3 153 sampling hospitals that equipped with rehabilitation medicine wards were included for analysis. ResultsAmong the 7 250 general hospitals surveyed this year, only 3 277 equipped with rehabilitation wards. In general hospitals, the average number of physicians per bed in 56.46% hospitals, the average number of rehabilitation therapists per bed in 77.67% hospitals, and the average number of nurses per bed in 51.18% hospitals did not meet the national requirements. The rates of early rehabilitation intervention were 13.98%, 20.82% and 21.36% respectively in the department of orthopedics, department of neurology and department of intensive care in general hospitals. The average activity of daily living improvement rate of discharged patients from rehabilitation departments of general hospitals was 77.69%, and that of discharged patients from rehabilitation specialized hospitals was 66.78%. ConclusionThere are insufficient allocation of wards and facility scales in the department of rehabilitation medicine, a shortage of human resources for rehabilitation services, inadequate integration of rehabilitation services with clinical services, and there is still scope for enhancing the effect and efficiency of rehabilitation services. It is recommended to expand the scale of rehabilitation services and improve discipline construction; increase the quantity and quality of rehabilitation human resources; incorporate rehabilitation services into the health service system; establish and modify clinical rehabilitation guidelines and technical specifications; and construct a rehabilitation medical information platform.

ObjectiveBased on the conjoint analysis of transcriptome and metabolome， the key genes in the phenylpropanoid biosynthesis pathway of Lonicera macranthoides were explored， which provided a basis for further exploring the synthesis and regulation mechanism of phenylpropanoid compounds in "Xianglei" L. macranthoides. MethodsThe stem， leaves， and three flowering flowers of "Xianglei" L. macranthoides were selected as experimental materials to construct transcriptome and metabolome. The transcriptome and metabolomics were conjointly analyzed by the Kyoto Encyclopedia of Genes and Genomes （KEGG） database and weighted correlation network analysis （WGCNA）， and the key genes in the phenylpropanoid biosynthesis pathway of L. macranthoides were explored. ResultsIn this study， 77 differential phenylpropanoids and 315 differential genes were found. Through the joint analysis of transcription and metabolism， nine key differential metabolites and four key genes related to them were finally discovered. Among them， cinnamic acid， 5-O-caffeoylshikimic acid，sinapyl alcohol， and chlorogenic acid were higher in flowers， and the content of the iconic effective component， namely chlorogenic acid，decreased sharply during the withering period. Caffeic acid，ferulic acid， 5-hydroxyconiferaldehyde，p-coumaryl alcohol， and syringin were higher in leaves. These four key genes belong to the cinnamic alcohol dehydrogenase （CAD） family， 4-coumaric acid： Coenzyme A （4CL） family， hydroxycinnamyl transferase （HCT） family， and L-phenylalanine ammonlyase （PAL） family genes. ConclusionAmong the four key genes excavated from L. macranthoides， TRINITY_DN42767_c0_g6 is related to the synthesis of p-coumaryl alcohol and sinapyl alcohol. TRINITY_DN43525_c4_g1 uses caffeic acid，ferulic acid，and cinnamic acid as substrates to catalyze the next reaction. TRINITY_DN47958_c3_g4 correlates with the synthesis of 3-p-coumaroyl quinic acid and caffeoyl-CoA， and TRINITY_DN52595_c1_g2 correlates with cinnamic acid synthesis. These findings provide a basis for further exploring the synthesis and regulation mechanism of phenylpropanoids in "Xianglei" L. macranthoides.

Objective To investigate the probability and dosimetric risk factors of lung injury after sequential immune checkpoint inhibitors (ICIs) and thoracic radiotherapy. Methods A retrospective analysis was conducted on 139 patients who received sequential ICIs and thoracic radiotherapy in Xuzhou Cancer Hospital and Affiliated Hospital of Xuzhou Medical University between February 2020 and February 2024. The relationships of clinical factors and lung and heart volume dose parameters with grade ≥ 2 acute lung injury (ALI) in patients with thoracic tumors were studied using univariable (χ² test, t test, nonparametric test) and multivariable (binary logistic regression analysis) methods. The thresholds of dosimetric risk factors were determined using the receiver operating characteristic curves. Clinical factors included age, gender, smoking history, type of ICIs, cycle of ICI application, and the interval between ICI application and thoracic radiotherapy. Dose parameters included total radiotherapy dose, single dose, planning target volume, maximum dose of planning target volume, average dose of planning target volume, total lung volume, heart volume, and the V₅, V₁₀, V₁₅, V₂₀, V₂₅, V₃₀, V₃₅, and V₄₀ of lung and heart. Results The incidence of grade ≥ 2 ALI in the included cases was 36% (50/139). The χ² test did not find any statistically significant clinical factors. In the univariable and binary Logistic regression analysis, lung V₁₅ and V₂₀, heart V₁₅ and V₂₀, and lung volume were independent risk factors for the occurrence of grade ≥ 2 ALI in sequential ICIs and thoracic radiotherapy. The thresholds were 18.51% for lung V₁₅, 14.43% for lung V₂₀, 32.41% for heart V₁₅, and 17.74% for heart V₂₀. Conclusion For patients who are going to receive thoracic radiotherapy after ICIs, the thresholds of lung V₁₅ and V₂₀ and heart V₁₅ and V₂₀ in the radiotherapy plan are recommended to be less than 18.51%, 14.43%, 32.41%, and 17.74%, respectively, which can effectively reduce the occurrence of grade ≥ 2 ALI.

Multidrug resistant organism refers to bacteria that are insensitive to three or more antibiotics commonly used in clinic, including Pseudomonas aeruginosa, Acinetobacter Baumannii and Klebsiella pneumoniae, etc. MDRO infection is a major factor affecting the survival rate after lung transplantation (LTx), accounting for 30% of the causes of death in the first year after transplantation. Antibiotic treatment has low specificity and is prone to drug resistance. The development of new drugs has a long cycle and high cost, with significant limitations. Phage has high specificity for bacteria, which can proliferate in large quantities in the infected lesion and co-evolve with bacteria during the action process. Phage also have a good killing effect on MDRO, which is expected to make up for the deficiencies of existing antibiotic therapy. This article reviews the development background and mechanism of action of phage therapy, and summarizes its application status and early clinical trial results in the field of LTx, in order to providing new thinking paths for clinical work.

HDAC7, a member of class IIa HDACs, plays a pivotal regulatory role in tumor, immune, fibrosis, and angiogenesis, rendering it a potential therapeutic target. Nevertheless, due to the high similarity in the enzyme active sites of class IIa HDACs, inhibitors encounter challenges in discerning differences among them. Furthermore, the substitution of key residue in the active pocket of class IIa HDACs renders them pseudo-enzymes, leading to a limited impact of enzymatic inhibitors on their function. In this study, proteolysis targeting chimera (PROTAC) technology was employed to develop HDAC7 drugs. We developed an exceedingly selective HDAC7 PROTAC degrader B14 which showcased superior inhibitory effects on cell proliferation compared to TMP269 in various diffuse large B cell lymphoma (DLBCL) and acute myeloid leukemia (AML) cells. Subsequent investigations unveiled that B14 disrupts BCL6 forming a transcriptional inhibition complex by degrading HDAC7, thereby exerting proliferative inhibition in DLBCL. Our study broadened the understanding of the non-enzymatic functions of HDAC7 and underscored the importance of HDAC7 in the treatment of hematologic malignancies, particularly in DLBCL and AML.

OBJECTIVES: To investigate the neuroprotective effects of electroacupuncture (EA) preconditioning against cerebral ischemia-reperfusion injury (CIRI) mediated by gut microbiota modulation, Nrf2/HO-1 pathway activation, and ferroptosis suppression. METHODS: Adult male SD rats were divided into sham operation group, CIRI model group, and EA preconditioning group. In the latter two groups, rat models of CIRI were established by middle cerebral artery occlusion (MCAO), and in EA preconditioning group, EA was applied at Baihui (DU20) and Zusanli (ST36) for 3 days before modeling. Neurological deficits, cerebral infarction, and hippocampal pathology of the rats were evaluated using behavioral tests, TTC staining, and Nissl and HE staining, and the oxidative stress markers (MDA, ROS, and SOD), apoptosis/ferroptosis-related proteins (Bax, Bcl-2, GPX4, and SLC7A11), and changes in gut microbiota were analyzed. RESULTS: EA preconditioning significantly reduced neurological deficits, decreased infarct volume, promoted hippocampal neuronal survival, and improved structural integrity of the hippocampal neurons in MCAO rats. EA preconditioning also significantly lowered MDA and ROS and increased SOD levels, upregulated Bcl-2, GPX4, and SLC7A11 expressions, and downregulated Bax expression in the hippocampal tissue of the rats, causing also activation of Nrf2/HO-1 signaling and improvement of gut microbiota composition. CONCLUSIONS EA preconditioning alleviates CIRI in rats by suppressing ferroptosis and apoptosis, enhancing antioxidant defenses via activating Nrf2/HO-1 signaling, and regulating the gut-brain axis.
Animals ; Electroacupuncture ; NF-E2-Related Factor 2/metabolism* ; Rats, Sprague-Dawley ; Signal Transduction ; Reperfusion Injury/therapy* ; Ferroptosis ; Male ; Rats ; Brain Ischemia ; Gastrointestinal Microbiome ; Heme Oxygenase (Decyclizing)/metabolism* ; Brain/metabolism* ; Oxidative Stress ; Heme Oxygenase-1/metabolism* ; Apoptosis

A brain-computer interface (BCI) based on motor imagery (MI) provides additional control pathways by decoding the intentions of the brain. MI ability has great intra-individual variability, and the majority of MI-BCI systems are unable to adapt to this variability, leading to poor training effects. Therefore, prediction of MI ability is needed. In this study, we propose an MI ability predictor based on multi-frequency EEG features. To validate the performance of the predictor, a video-guided paradigm and a traditional MI paradigm are designed, and the predictor is applied to both paradigms. The results demonstrate that all subjects achieved > 85% prediction precision in both applications, with a maximum of 96%. This study indicates that the predictor can accurately predict the individuals' MI ability in different states, provide the scientific basis for personalized training, and enhance the effect of MI-BCI training.
Humans ; Imagination/physiology* ; Electroencephalography/methods* ; Brain-Computer Interfaces ; Male ; Female ; Adult ; Young Adult ; Brain/physiology* ; Movement/physiology* ; Motor Activity/physiology* ; Psychomotor Performance/physiology*

Psoriasis is a chronic inflammatory skin disease, and its pathogenesis is largely modulated by abnormal angiogenesis. Previous research has indicated that AlkB homolog 5 (ALKBH5), an important demethylase affecting N⁶-methyladenosine (m⁶A) modification, plays a role in regulating angiogenesis in cardiovascular and eye diseases. Our present study found that ALKBH5 was upregulated and co-localized with cluster of differentiation 31 (CD31) in the skin of IMQ group compared with control group. ALKBH5-deficient mice decreased IMQ-induced psoriatic dermatitis and exhibited histological improvements, including decreased epidermal thickness, hyperkeratosis, numbers of dermal capillary vessels and inflammatory cell infiltration. ALKBH5-KO mice alleviated angiogenesis in psoriatic lesions by downregulating the protein kinase B (AKT)/mammalian target of rapamycin (mTOR) pathway. Additionally, the expression of ALKBH5 was significantly upregulated in IL-17A-induced human umbilical vein endothelial cells (HUVECs), which further promoted the expression of angiogenesis-related cytokines and endothelial cell proliferation. Cell proliferation and angiogenesis were suppressed in ALKBH5 knockdown group, whereas ALKBH5 overexpression promoted these processes. The regulation of angiogenesis in HUVECs by ALKBH5 was facilitated through the AKT-mTOR pathway. Collectively, ALKBH5 plays a pivotal role in psoriatic dermatitis and angiogenesis, which may offer a new potential targets for treating psoriasis.
Animals ; Psoriasis/chemically induced* ; Mice ; Humans ; Neovascularization, Pathologic/genetics* ; Human Umbilical Vein Endothelial Cells/metabolism* ; AlkB Homolog 5, RNA Demethylase/genetics* ; Proto-Oncogene Proteins c-akt/metabolism* ; TOR Serine-Threonine Kinases/metabolism* ; Cell Proliferation ; Mice, Knockout ; Disease Models, Animal ; Signal Transduction ; Male ; Skin/blood supply* ; Mice, Inbred C57BL ; Angiogenesis

ObjectiveTo identify the characteristic exhaled volatile organic compounds （VOCs） associated with postoperative pulmonary complications （PPCs） in patients after abdominal surgery. MethodsThis study prospectively enrolled 76 patients with tracheal intubation who were transferred to intensive care unit （ICU） after abdominal surgery at Peking University People's Hospital between December 10， 2022 and June 30， 2023. The patients' basic information was collected during their perioperative period， and their exhaled VOCs were collected within 24 hours after their admission to the ICU， and then analyzed by gas chromatography and mass spectrometry （GC-MS）. According to whether PPCs occurred 24 hours after surgery， the patients were divided into PPCs group （n=44） and non-PPCs group （n=32）， and the differences of VOCs were compared between the two groups. Lasso regression analysis was used to screen the valuable variables of VOCs， and Logistics regression analysis to determine the characteristic VOCs associated with the occurrence of PPCs. ResultsAmong the 76 patients， 44 had PPCs and 32 had no PPCs. Lasso regression analysis screened 4 PPCs-related compounds from exhaled VOCs of two groups for further analysis and Logistics regression analysis showed that the increase of 1-Hexadecanol content in exhaled breath was significantly correlated with the occurrence of PPCs （OR： 1.000， P=0.002）. ConclusionThis study indicated that the increased content of 1-Hexadecanol in patients' exhaled breath after abdominal surgery may be associated with the occurrence of PPCs.