OBJECTIVE: To explore the rules of acupoint selection and compatibility of acupuncture and moxibustion in treatment of chronic cough using data mining. METHODS: The ancient and modern medical record cloud platform, and the databases, i.e. CNKI, Wanfang, VIP, EMbase, Web of Science and PubMed, were searched to screen the ancient and modern literature on acupuncture and moxibustion treatment of chronic cough. The prescription database was established for acupuncture and moxibustion treatment of chronic cough, and the analysis conducted on the frequency and use percentage in the aspects of intervention measures, acupoint selection, acupoint distribution, meridian tropism, special points and acupoint combination, as well as the association rules and clustering rules of acupoint selection. The subgroup analysis was performed in accordance with the etiology of chronic cough and intervention measures. RESULTS: A total of 106 articles were included and 158 prescriptions were extracted. The intervention measures were acupuncture, moxibustion, herbal medication and the combination of several measures. The high-frequency acupoints included Feishu (BL13), Zusanli (ST36), Dazhui (GV14), Pishu (BL20), Danzhong (CV17), Shenshu (BL23), Lieque (LU7), Dingchuan (EX-B1), Tiantu (CV22), and Fenglong (ST40). These acupoints are mainly distributed on the back, lumbar region, chest and abdomen. The involved meridians were bladder meridian of foot-taiyang, conception vessel, and lung meridian of hand-taiyin. The special points covered back-shu points, crossing points and five-shu point. Regarding the compatibility of acupoints, the combination of upper and lower points, and the combination of front and back points were predominant in treatment. The analysis of association rules found that the support of Feishu (BL13)→Zusanli (ST36) was the highest; the cluster analysis obtained 8 clusters of acupoints. The acupoint compatibility and overall rules were similar when cough variant asthma (CVA) or the mixed reasons were involved, and the local treatment approach was adopted if the etiology of disease was related to upper airway cough syndrome (UACS) and gastroesophageal reflux cough (GERC). The acupoint selection was similar among different intervention measures. When two kinds of measures were combined in treatment, Feishu (BL13), Pishu (BL20) and Zusanli (ST36) were the most common. CONCLUSION In treatment with acupuncture and moxibustion for chronic cough, the acupoints are selected on the affected local area, depending on syndrome differentiation, and focusing on back-shu points. The main acupoints are Feishu (BL13), Zusanli (ST36), Dazhui (GV14), Pishu (BL20), Danzhong (CV17) and Shenshu (BL23). The combined therapy is dominant with acupuncture, moxibustion and herbal medicine involved.
Acupuncture Points ; Moxibustion/history* ; Humans ; Cough/history* ; Acupuncture Therapy/history* ; Chronic Disease/therapy* ; Data Mining ; History, Ancient ; Meridians ; Chronic Cough

ObjectiveTo investigate the expression features of HBsAg and HBcAg in liver tissue and their correlation with HBV serum markers in children with chronic hepatitis B （CHB）. MethodsA total of 257 patients who were consecutively admitted to The Fifth Medical Center of Chinese PLA General Hospital from January 2013 to December 2023 and underwent liver biopsy to achieve a confirmed diagnosis of CHB were enrolled in this study. The NIS-Elements system was used to capture the immunohistochemical images of HBsAg and HBcAg in liver tissues， and Image J software was used for quantitative analysis. The one-sample chi-square test was used for within-group comparison of continuous data， and the Pearson/Spearman/Kendall’s Tau-b correlation analysis was used to investigate the correlation between viral antigen expression and serological markers. ResultsAmong the 257 CHB patients， there were 162 children （76 children aged<5 years and 86 children aged 5 — 18 years） and 95 adults. There were significant differences in the expression pattern， area， and intensity of HBsAg and the area and intensity of HBcAg in liver tissue between different age groups and between the children with different HBeAg statuses （all P<0.05）. In the children aged<5 years， HBsAg staining area was significantly negatively correlated with anti-HBs and HBeAg （both P<0.05）and was significantly positively correlated with ALT and AST （both P<0.05）， and HBsAg staining intensity was significantly positively correlated with qHBsAg （P<0.05） and was significantly negatively correlated with anti-HBs （P<0.05）. In the children group， HBsAg staining area was negatively correlated with anti-HBs and HBeAg （both P<0.05）， and HBsAg staining intensity was positively correlated with qHBsAg （P<0.05） and was negatively correlated with anti-HBs （P<0.05）. In the adult group， HBsAg staining area was positively correlated with ALT， AST， and liver inflammatory activity （all P<0.05）， and HBsAg staining intensity was positively correlated with qHBsAg， HBeAg， and HBV DNA （all P<0.05） and was negatively correlated with liver inflammatory activity and fibrosis degree （both P<0.05）. In the children aged<5 years， HBcAg staining area was positively correlated with qHBsAg and HBV DNA （both P<0.05）， and HBcAg staining intensity was significantly positively correlated with HBV DNA （P<0.001）. In the children aged 5 — 18 years， the area and intensity of HBcAg staining were positively correlated with qHBsAg， HBeAg， and HBV DNA （all P<0.05）. In the children group， HBcAg staining area was positively correlated with qHBsAg， HBeAg， and HBV DNA （all P<0.05）， and HBcAg staining intensity was positively correlated with qHBsAg and HBV DNA （both P<0.05）. In the adult group， the area and intensity of HBcAg staining were positively correlated with qHBsAg， HBeAg， and HBV DNA （all P<0.001）， and HBcAg staining area was positively correlated with the serum level of ALT （P=0.043）. ConclusionThe expression levels of HBsAg and HBcAg in liver tissue of children with CHB are significantly correlated with serological markers， and in clinical practice， HBsAg and HBcAg combined with serological markers can help to assess the condition of the liver， determine the immune stage， and provide evidence-based guidance for treatment timing.

Objective To detect the expression of N-acetyltransferase 10(NAT10)and polyadenylate bind-ing protein cytoplasmic 1(PABPC1)in non muscle invasive bladder cancer(NMIBC),and analyze the correla-tion between them and epithelial mesenchymal transition(EMT)and prognosis.Methods A total of 122 pa-tients with NMIBC treated in the hospital from May 2019 to May 2021 were selected.Immunohistochemistry was used to detect the expression of NAT10 and PABPC1 proteins in NMIBC tissues.Real time fluorescence quantitative polymerase chain reaction(qPCR)was used to detect the expression of NAT10,PABPC1 mRNA,and EMT markers in NMIBC tissues.Pearson correlation analysis was conducted on the correlation between EMT indicators[Snail,N-cadherin(N-cad),vimentin(Vim)mRNA].Cox regression analysis was conducted on the relationship between NAT10,PABPC1 and prognosis of NMIBC.Results Compared with adjacent tis-sues,the expression of NAT10 mRNA,PABPC1 mRNA,Snail mRNA,N-cad mRNA,and Vim mRNA in NMIBC cancer tissues was higher,and the difference was statistically significant(P＜0.001).The expression of NAT10 mRNA,PABPC1 mRNA in NMIBC cancer tissues was positively correlated with Snail mRNA,N-cad mRNA,and Vim mRNA(r=0.678,0.702,0.711,0.754,0.788,0.663,P＜0.001).The positive rates of NAT10 and PABPC1 in NMIBC cancer tissues were 59.02％(72/122)and 60.66％(74/122),respectively,while those in adjacent tissues were 6.56％(8/122)and 4.92％(6/122),respectively(x2=76.176,85.995,P＜0.001).The positive rates of NAT10 and PABPC1 in NMIBC cancer tissues were higher than those in ad-jacent tissues,and the difference was statistically significant(x2=76.176,85.995,P＜0.001).The positivity rates of NAT10 and PABPC1 in cancer tissues of stage T1,high-grade NMIBC patients were higher than those in cancer tissues of Ta/Ti,low-grade patients,and the differences were statistically significant(P＜0.05).The 3-year overall progression free survival rates of NMIBC patients in the NAT10 positive and negative groups were 48.61％(35/72)and 80.00％(40/50),respectively,with a statistically significant difference(Log rank x2=13.780,P=0.000).The 3-year overall progression free survival rates of PABPC1 positive and negative patients were 47.30％(35/74)and 83.33％(40/48),respectively,with a statistically significant difference(Log rank x2=11.830,P=0.001).T1 stage,high-grade,NAT10 positive,and PABPC1 positive were risk fac-tors affecting the prognosis of NMIBC.Conclusion The expression of NAT10 and PABPC1 in NMIBC cancer tissue is significantly upregulated and positively correlated with EMT markers,which is correlated with poor prognosis of NMIBC.

This review systematically summarizes the unique metabolic mechanisms of breast cancer,their interac-tions with the tumor microenvironment(TME),and the latest advances in targeted therapies.The interplay between metabolic reprogramming and the TME underpins malignant progression and therapeutic resistance.Breast cancer cells reshape energy supply through the Warburg effect,aberrant fatty acid synthesis,and amino acid metabolism,while immune cells,fibroblasts,and the acidic milieu within the TME promote immune evasion and drug resistance via metabolic coupling.Although traditional strategies targeting key metabolic enzymes remain valuable,they are often insufficient to overcome metabolic adaptability.In recent years,combined metabolic and immunotherapeutic approaches have emerged as promising strategies:by reducing lactate accumulation,restoring T-cell function,and reprogramming tumor-associated macrophages and cancer-associated fibroblasts,these therapies can remodel the immunosuppressive microenvironment and enhance immunotherapy efficacy.The application of metabolomics and single-cell sequencing further elucidates breast cancer heterogeneity,providing a basis for individualized precision treatment.Future challenges include deciphering resistance mechanisms,developing highly selective metabolic in-hibitors,and designing integrated multi-omics-based therapeutic regimens.

OBJECTIVE: To explore the incidence, clinical features, genetic variant characteristics and prognosis of Glutaric acidemia type I (GA1) among neonates from Henan Province. METHODS: A total of 814 625 neonates undergoing screening for inherited metabolic diseases by tandem mass spectrometry (MS/MS) at the Third Affiliated Hospital of Zhengzhou University from January 2016 to December 2022 were selected as the study subjects. A retrospective method was adopted to collect the clinical data of the patients. Whole exome sequencing was carried out to detect GCDH gene variants in individuals with positive results by GA1 newborn screening, and Sanger sequencing was used to verify the candidate variants. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the pathogenicity of candidate variants was rated. This study was approved by the Medical Ethics Committee of the Hospital (Ethics Number: 2019 Medical Ethics Review No. 67). RESULTS: Eight cases of GA1 were diagnosed among the 814 625 neonates. Blood glutaryl carnitine (C5DC) and urine glutaric acid (GA) levels of the 8 children were higher than the normal reference values. In total 12 variants were detected, all of which were missense variants. c.1064G>A (p.Arg355His) was the most common one, accounting for 21.4% (3/14). Three GCDH gene variants, including 1297G>C (p.Ala433Pro), c.467G>A (p.Gly156Asp) and c.1125T>G (p.Cys375Trp), were previously unreported. REVEL software analysis predicted that all of the three variants were harmful. 3D protein structure modeling indicated that the three variants may cause amino acid residue alterations, and c.1297G>C (p.Ala433Pro) and c.1125T>G (p.Cys375Trp) may result in increase in hydrogen bonds and affect the function of GCDH protein. By December 2023, one of the eight children had deceased, and another child had severe clinical symptoms with poor prognosis. Six children had a good prognosis, of which two had mild motor development delay and four had normal development without clinical symptoms. CONCLUSION The incidence of GA1 in newborns screened by MS/MS in Henan Province is 1/101 828, and the carrier rate of pathogenic GCDH variants is 1/160. The c.1064G>A (p.Arg355His) may be the hotspot variant of the GCDH gene among children with GA1 in Henan. Discovery of the three novel variants has enriched the mutational spectrum of the GCDH gene and provide a basis for the early diagnosis, treatment, prognosis and genetic counseling of this disease.
Humans ; Amino Acid Metabolism, Inborn Errors/epidemiology* ; Glutaryl-CoA Dehydrogenase/chemistry* ; Infant, Newborn ; Female ; Neonatal Screening/methods* ; Male ; Brain Diseases, Metabolic/epidemiology* ; China/epidemiology* ; Retrospective Studies ; Mutation ; Genetic Variation ; Glutarates

Objective:To analyze the prognostic factors of patients with liver cirrhosis and portal vein thrombosis (PVT), and to construct a prognostic prediction model based on machine learning methods.Methods:The clinical data of 388 patients with liver cirrhosis and PVT admitted to the Fifth Medical Center of PLA General Hospital from January 2022 to April 2024 were retrospectively collected and analyzed, including 243 males and 145 females, aged (56.9±10.9) years. A total of 388 patients were randomly divided into the training set ( n=310) and the testing set ( n=78) in a 4∶1 ratio. The Boruta algorithm was used to screen the key features in the training set, and then four machine learning algorithms, including random forest, support vector machine, generalized linear model and Bayesian, were used to establish a survival prediction model. Model performance was evaluated by the receiver operating characteristic (ROC) curves of the test set and the training set. The patients were followed up for 1 year for survival. Sort the importance of features based on the SHAP value. Results:There were 250 patients (80.6%) who survived and 60 (19.4%) who died. The model for end-stage liver disease score, total bilirubin, serum creatinine, prothrombin time, international normalized ratio, D-dimer, white blood cell count, severe ascites ratio, and Child-Pugh grade C ratio of liver function in the death group were higher than those in the survival group, and the red blood cell count and hematocrit were lower than those in the survival group, and the differences were statistically significant (all P<0.05). The areas under the ROC curve for predicting survival by random forest, support vector machine, generalized linear model and Bayesian model were 0.92, 0.78, 0.81 and 0.71 in the training set, and the area under the ROC curve in the testing set were 0.81, 0.72, 0.67 and 0.68, respectively. Random forest had the best prediction performance, with an accuracy of 81.7%, a sensitivity of 84.6%, and a specificity of 76.9% in the testing set. In the analysis of the importance of characteristic parameters of the random forest model, total bilirubin, red blood cells, hematocrit, serum creatinine, ascites classification, etc. had a relatively high contribution to the model. Conclusion:In the survival prediction model of patients with liver cirrhosis and PVT based on machine learning algorithm, the random forest model had high prediction performance, and total bilirubin may be the most important factor affecting the survival prognosis of patients.

Objective To investigate the effect of lung lobe surface projection localization combined with lung segment drainage sputum technique on airway clearance in patients with aspiration pneumonia,providing a reference for clinical nursing practice.Methods A convenience sampling method was used to select 62 patients with perioperative aspiration pneumonia secondary to brain diseases admitted to a tertiary A hospital in Beijing from May 2022 to October 2024 as the research subjects.A total of 31 patients admitted from August 2023 to October 2024 were assigned to a control group,and 31 patients admitted from May 2022 to July 2023 were assigned to an experimental group.The experimental group received lung lobe surface projection positioning combined with lung segment drainage sputum technique on top of conventional back percussion sputum clearance technique,while the control group received conventional back percussion sputum clearance technique.After the intervention,the differences in oxygenation state,inflammatory test indicators,treatment efficiency,vital signs and frequency of suction coughing between 2 groups were compared.Results After the intervention,the experimental group showed better oxygenation index,frequency of suction coughing,white blood cell count,percentage of neutrophils,procalcitonin levels,interleukin-6 levels,and treatment efficiency compared to those in the control group(P＜0.05).There was no statistically significant difference in heart rate,respiratory rate,and C-reactive protein levels between 2 groups(P＞0.05).Conclusion Lung lobe surface projection positioning combined can effectively promote the patients with aspiration pneumonia of loosening of sputum in the lungs,improve airway clearance efficiency,enhance the patient's pulmonary ventilation and gas exchange capacity,improve oxygenation levels,and reduce systemic inflammatory levels.

Recently， Asian Pacific Association for the Study of the Liver published the recommendations for the diagnosis and management of non-cirrhotic portal fibrosis （NCPF）/idiopathic portal hypertension （IPH）. The guidelines mainly elaborate on the definition， diagnosis， histological features， natural history， and management of NCPF/IPH， in order to strengthen the understanding of NCPF/IPH-related issues and establish a global consensus. This article makes an excerpt of the key statements in the guidelines.

Objective:To analyze the efficacy and safety of different surgical approaches for the treatment of anterior skull base malignancies involving the orbit.Methods:Retrospective analysis was conducted on patients with anterior skull base malignancies involving orbit who attended Xuanwu Hospital of Capital Medical University from April 2013 to July 2021. They were divided into endoscopic endonasal approach(EEA), lateral orbital approach(ELOA), and sublabial transmaxillary approach(ESTMA) groups according to the primary surgical approach. One-way analysis of variance and χ 2 test were used to compare the clinical characteristics, degree of tumour resection, rate of postoperative cranial nerve palsy and improvement of visual acuity; Log-rank test was applied to assess the difference in overall survival (OS). Results:One hundred and ninety-eight patients were enrolled, including 107 males and 91 females, aged (48.5±15.3) years. There were 153, 33, and 12 patients in the EEA, ESTMA, and ELOA groups, respectively. There were no significant differences among the three groups in age, gender, and history of radiotherapy, chemotherapy or surgery ( P>0.05 for all). All patients in ELOA group had preoperative visual impairment (12/12), with a significantly higher percentage than EEA group (56/153) and ESTMA group (14/33) ( χ2=19.72, P<0.001). There was no significant difference between three groups in the degree of tumor resection (gross total resection: 84.97% vs. 81.82% vs. 58.33%, χ2=5.58, P>0.05), postoperative cranial nerve palsy rate (13.07% vs. 30.30% vs. 16.67%, χ2=5.95, P>0.05), visual improvement rate (58.93% vs. 57.14% vs. 58.33%, χ2=0.04, P>0.05) and 5-year OS (60.69% vs. 42.66% vs. 50.00%, χ2=3.22, P>0.05). Conclusion:All three surgical approaches were safe, effective and feasible treatment modalities.

This study aims to investigate the mechanisms underlying the effects of the combined ac-tion of high-fat diet-induced obesity and the aflatoxin B1(AFB1)on hepatic oxidative stress and inflammatory responses.Thirty-six rats of similar weight and 4 weeks old were randomly divided into 4 groups,with 9 rats in each group:the blank control group(basal diet),the AFB1 group(0.4 mg/kg AFB1+basal diet),the HFD group(high-fat diet),and the HFD+AFB1 group(high-fat diet+0.4 mg/kg AFB1).Histological changes and lipid deposition were observed via hematox-ylin-eosin(HE)staining and Oil Red O staining.Levels of oxidative stress and inflammation-relat-ed factors were measured using commercial assay kits.The relative protein expression levels of factors involved in the Nrf2-Keap1 signaling pathway were assessed by Western blot analysis.The HE staining results showed that in the AFB1 group,the liver cells exhibited widespread watery de-generation,with shrunk and ruptured nuclei,inflammatory cells infiltration,and increased fibrosis.In the HFD group,liver cell fatty degeneration was observed,with cytoplasmic lipid droplet infil-tration.In the portal area,liver fibrosis was seen,with liver cell necrosis and inflammatory cell in-filtration in the fibrotic area,accompanied by lipofuscous granules.When HFD was applied to the AFB1 group,the abnormal state of liver interstitial and interstitial spaces was further aggravated,and a large number of lipid droplets appeared.The Oil Red O staining results showed that there were large numbers of dark red lipid droplets in the liver tissue of the HFD group,which were fused in strands.In the AFB1 group,lipid droplets could also be observed in the liver tissue of rats,but the number and degree were significantly less than those in the HFD group.The number and degree of red lipid droplets in the liver tissue of rats in the HFD+AFB1 group were higher than those in the AFB1 group and the HFD group.HFD exacerbated AFB1-induced oxidative stress by elevating ROS,MDA levels,and decreasing the expression of antioxidant stress factors such as CAT,SOD,Nrf2,HO-1,NQO1,and GCLC.Furthermore,the combined effect of HFD and AFB1 further significantly increased the levels of pro-inflammatory cytokines IL-2,IL-6,TNF-α,and IL-1β in the body.In summary,HFD treatment significantly exacerbated liver oxidative stress and in-flammatory responses in rats exposed to AFB1 through the Nrf2-keap1 signaling pathway.