The incidence and mortality rates of hepatocellular carcinoma(HCC)remain high in China,and the application of surgical resection is often limited due to the fact that most patients are in the advanced stage at the time of confirmed diagnosis.This article reviews commonly used advanced locoregional therapies for HCC and the advances in mainstream techniques such as local ablation(radiofrequency ablation,microwave ablation,irreversible electroporation,and cryoablation),intravascular intervention(transcatheter arterial chemoembolization,hepatic arterial infusion chemotherapy,and Y90 hepatic arterial infusion chemotherapy),and radiotherapy(CyberKnife,proton therapy,and heavy-ion therapy),and a multidimensional decision-making framework is constructed for HCC locoregional therapy by comparing treatment principles,indications,limitations,and clinical data of these techniques.This article aims to provide evidence-based support for persistent dilemmas in clinical decision-making,promote the role of locoregional therapies in clinical practice,and propose the directions for future research and clinical application.This article also establishes a comprehensive clinical roadmap for HCC locoregional therapy,which helps to address current challenges regarding technique selection and delineate future directions for innovation,in order to reshape the treatment of HCC through technological integration and paradigm innovation.

Objective:To explore the effects of different combination of Er∶YAG laser irradiation parameters on the dentinal tu-bule sealing.Methods:160 dentin discs with 2 mm thickness were etched with 0.5 mmol/L EDTA to establish the dentine hyper-sensitivity models.The discs were randomly divided into 16 groups(n=10).The R02 and R14 handpieces were used to deliver Er∶YAG laser to the dentin discs according to the different output power(W),irradiation distance(cm)and irradiation time(s/cm2).Then,the samples of each group were divided into immediate irradiation subgroup and acid etching and wear subgroup(n=5).The dentinal tubules were observed with SEM,and the exposed area,the sealed rate and the occlusion depth of dentinal tubules were e-valuated with ImageE-Pro Plus 6.0 software.Results:The dentinal tubules in the control group opened uniformly with clear perime-ter,they were enlarged and opened after acid etching and tooth brushing.The dentinal tubules shrinked or sealed well with the melt layer after treatment by Er∶YAG laser irradiation with either parameter combination.Especially,uniform and seamless melt layer as well as similar dentin surface morphology before and post the acid etching and tooth brushing were obtained when the dentin discs were exposed to the following Er∶YAG laser irradiation parameter combinations,i.e.(R02,0.5 W,3 cm,20 s/cm2),(R14,0.5 W,3 cm,20 s/cm2)and(R14,0.6 W,3 cm,20 s/cm2).Significantly decreased exposed area and increased seal rate in the dentinal tubules treated in the above 3 laser irradiation parameter combina-tion groups were observed than those in the other groups(P＜0.05).Morphological analysis confirmed that whether the acid etching and tooth brushing were exerted.The occlusion depth of dentin tubule was more than 2.0 μm in the dentinal tubules treated in the above 3 groups.Conclusion:Er∶YAG laser irradiation parameter combinations of R02,0.5 W,3 cm,20 s/cm2,R14,0.5 W,3 cm,20 s/cm2 and R14,0.6 W,3 cm,20 s/cm2 are suitable for the best dentin tubule sealing.

Objective:To investigate the effect of irbesartan on hypoxia reoxygenation(HR)induced myocardial cell pyropto-sis by regulating the cGAS-STING signaling pathway.Methods:H9c2 myocardial cells were cultured in vitro and grouped into control group,HR group,low-dose irbesartan group,high-dose irbesartan group,high-dose irbesartan+RocA(cGAS-STING signaling path-way activator)group,and RU.521(cGAS-STING signaling pathway inhibitor)group.Cell viability was detected by CCK-8;ELISA was applied to detect levels of lactate dehydrogenase(LDH),IL-6,IL-18 and IL-1β;propidium iodide(PI)staining method was applied to detect the formation of cell membrane pores;RT-qPCR method was applied to detect the expressions of cGAS and STING mRNA in cells;Western blot method was applied to detect the expressions of NLRP3,Caspase-1,GSDMD,cGAS and STING pro-teins.Results:Compared with the control group,the A450 values(24 h,48 h)of H9c2 cells in the HR group were obviously reduced,the levels of LDH,IL-6,IL-18,IL-1β,PI staining positive rate,the expressions of cGAS,STING mRNA,the expressions of NLRP3,Caspase-1,GSDMD,cGAS,STING proteins were obviously increased(P<0.05);compared with the HR group,the A450 values(24 h,48 h)of H9c2 cells in the low and high dose irbesartan groups and the RU.521 group were obviously increased,the levels of LDH,IL-6,IL-18,IL-1β,PI staining positive rate,the expressions of cGAS,STING mRNA,the expressions of NLRP3,Caspase-1,GSDMD,cGAS,STING proteins were obviously reduced(P<0.05);RocA was able to partially reverse the protective effect of irbe-sartan on HR-induced myocardial cells(P<0.05);the detection indicators of H9c2 cells in the RU.521 group were at the same level as those in the high-dose irbesartan group(P>0.05).Conclusion:Irbesartan can inhibit HR-induced myocardial cell pyrop-tosis by inhibi-ting the cGAS-STING signaling pathway.

Objective:To investigate the effects of dagliprazin combined with olmesartan ester on the expression of Plin and miR-26a in renal tissues of diabetic nephropathy rats.Methods:Sixty male SD rats were selected and fed adaptively for 1 week, then fed high-fat and high-sugar diet for 2 months, and then injected streptozotocin (STZ) 30 mg/kg for modeling. They were given 10 mg/kg daaglizin intragastric administration as daglizin group, 10 mg/kg olmesartan ester intragastric administration as olmesartan ester group, 5 mg/kg daaglizin and 5 mg/kg olmesartan ester intragastric administration as daglizin and olmesartan ester combination group, respectively. Twenty rats were given 10 mg/kg normal saline intragastric administration as normal control group. After 3 months, the serum samples of rats were taken to detect the levels of fasting blood glucose, blood creatinine, urea nitrogen, 24h urinary microalbumin and other renal function indicators and the levels of C-reactive protein (CRP), tumor necrosis factor (TNF-α), cell surface specific marker antigen (ED-1) and other inflammatory responses. Then the rats were killed and their kidney tissues were taken. The protein and gene expression of vascular endothelial growth factor (VEGF), perilipin (Plin), Nephlrin, miR-26a were detected by Western blot and real-time fluorescence quantitative PCR.Results:The levels of fasting blood glucose, urea nitrogen, creatinine and 24h urinary microalbumin in dagliprazin group, olmesartan ester group and combined group were higher than those in normal control group ( P<0.05), while the levels of fasting blood glucose, urea nitrogen, creatinine and 24h urinary microalbumin in combined group were lower than those in dagliprazin group and olmesartan ester group ( P<0.05). The difference between groups was statistically significant ( P<0.05). The levels of serum CRP, TNF-αand ED-1 in dagliprazin group, olmesartan ester group and combined group were higher than those in normal control group ( P<0.05), while the levels of CRP, TNF-αand ED-1 in combined group were lower than those in dagliprazin group and olmesartan ester group ( P<0.05), and the differences between groups were statistically significant ( P<0.05). The expression of serum VEGF, Plin and Nephlrin protein in dagliprazin group, olmesartan ester group and combined group were lower than those in normal control group ( P<0.05), while the protein and gene of Plin and Nephlrin in combined group were lower than those in dagliprazin group and olmesartan ester group. The mRNA and protein expressions of miR-26a and VEGF were higher than those of Daglipzin group and olmesartan ester group ( P<0.05), and the differences between groups were statistically significant ( P<0.05) . Conclusion:Dagliprazin combined with olmesartan ester can reduce kidney injury and delay the progression of diabetic nephropathy by regulating the expression of Plin and miR-26a protein and gene in renal tissue of diabetic nephropathy rats.

With the rapid advancements in minimally invasive spine surgery and the increasingly sophisti-cated concept of visualization,transforaminal endoscopic lumbar discectomy(TELD)has become a primary treatment for lumbar disc herniation.Among the critical preoperative steps in TELD,foraminalplasty plays a pivotal role,as its quality directly impacts surgical outcomes and postoperative recurrence rates.This article systemati-cally reviews the evolution of foraminalplasty techniques,evaluates the selection and application of plasty sites,examines factors influencing stability after lumbar foraminalplasty,and highlights recent advancements in computer-assisted navigation.The goal is to serve as a comprehensive reference for clinicians.

Objective:To investigate the effects of dagliprazin combined with olmesartan ester on the expression of Plin and miR-26a in renal tissues of diabetic nephropathy rats.Methods:Sixty male SD rats were selected and fed adaptively for 1 week, then fed high-fat and high-sugar diet for 2 months, and then injected streptozotocin (STZ) 30 mg/kg for modeling. They were given 10 mg/kg daaglizin intragastric administration as daglizin group, 10 mg/kg olmesartan ester intragastric administration as olmesartan ester group, 5 mg/kg daaglizin and 5 mg/kg olmesartan ester intragastric administration as daglizin and olmesartan ester combination group, respectively. Twenty rats were given 10 mg/kg normal saline intragastric administration as normal control group. After 3 months, the serum samples of rats were taken to detect the levels of fasting blood glucose, blood creatinine, urea nitrogen, 24h urinary microalbumin and other renal function indicators and the levels of C-reactive protein (CRP), tumor necrosis factor (TNF-α), cell surface specific marker antigen (ED-1) and other inflammatory responses. Then the rats were killed and their kidney tissues were taken. The protein and gene expression of vascular endothelial growth factor (VEGF), perilipin (Plin), Nephlrin, miR-26a were detected by Western blot and real-time fluorescence quantitative PCR.Results:The levels of fasting blood glucose, urea nitrogen, creatinine and 24h urinary microalbumin in dagliprazin group, olmesartan ester group and combined group were higher than those in normal control group ( P<0.05), while the levels of fasting blood glucose, urea nitrogen, creatinine and 24h urinary microalbumin in combined group were lower than those in dagliprazin group and olmesartan ester group ( P<0.05). The difference between groups was statistically significant ( P<0.05). The levels of serum CRP, TNF-αand ED-1 in dagliprazin group, olmesartan ester group and combined group were higher than those in normal control group ( P<0.05), while the levels of CRP, TNF-αand ED-1 in combined group were lower than those in dagliprazin group and olmesartan ester group ( P<0.05), and the differences between groups were statistically significant ( P<0.05). The expression of serum VEGF, Plin and Nephlrin protein in dagliprazin group, olmesartan ester group and combined group were lower than those in normal control group ( P<0.05), while the protein and gene of Plin and Nephlrin in combined group were lower than those in dagliprazin group and olmesartan ester group. The mRNA and protein expressions of miR-26a and VEGF were higher than those of Daglipzin group and olmesartan ester group ( P<0.05), and the differences between groups were statistically significant ( P<0.05) . Conclusion:Dagliprazin combined with olmesartan ester can reduce kidney injury and delay the progression of diabetic nephropathy by regulating the expression of Plin and miR-26a protein and gene in renal tissue of diabetic nephropathy rats.

The incidence and mortality rates of hepatocellular carcinoma(HCC)remain high in China,and the application of surgical resection is often limited due to the fact that most patients are in the advanced stage at the time of confirmed diagnosis.This article reviews commonly used advanced locoregional therapies for HCC and the advances in mainstream techniques such as local ablation(radiofrequency ablation,microwave ablation,irreversible electroporation,and cryoablation),intravascular intervention(transcatheter arterial chemoembolization,hepatic arterial infusion chemotherapy,and Y90 hepatic arterial infusion chemotherapy),and radiotherapy(CyberKnife,proton therapy,and heavy-ion therapy),and a multidimensional decision-making framework is constructed for HCC locoregional therapy by comparing treatment principles,indications,limitations,and clinical data of these techniques.This article aims to provide evidence-based support for persistent dilemmas in clinical decision-making,promote the role of locoregional therapies in clinical practice,and propose the directions for future research and clinical application.This article also establishes a comprehensive clinical roadmap for HCC locoregional therapy,which helps to address current challenges regarding technique selection and delineate future directions for innovation,in order to reshape the treatment of HCC through technological integration and paradigm innovation.

Objective:To investigate the effect of irbesartan on hypoxia reoxygenation(HR)induced myocardial cell pyropto-sis by regulating the cGAS-STING signaling pathway.Methods:H9c2 myocardial cells were cultured in vitro and grouped into control group,HR group,low-dose irbesartan group,high-dose irbesartan group,high-dose irbesartan+RocA(cGAS-STING signaling path-way activator)group,and RU.521(cGAS-STING signaling pathway inhibitor)group.Cell viability was detected by CCK-8;ELISA was applied to detect levels of lactate dehydrogenase(LDH),IL-6,IL-18 and IL-1β;propidium iodide(PI)staining method was applied to detect the formation of cell membrane pores;RT-qPCR method was applied to detect the expressions of cGAS and STING mRNA in cells;Western blot method was applied to detect the expressions of NLRP3,Caspase-1,GSDMD,cGAS and STING pro-teins.Results:Compared with the control group,the A450 values(24 h,48 h)of H9c2 cells in the HR group were obviously reduced,the levels of LDH,IL-6,IL-18,IL-1β,PI staining positive rate,the expressions of cGAS,STING mRNA,the expressions of NLRP3,Caspase-1,GSDMD,cGAS,STING proteins were obviously increased(P<0.05);compared with the HR group,the A450 values(24 h,48 h)of H9c2 cells in the low and high dose irbesartan groups and the RU.521 group were obviously increased,the levels of LDH,IL-6,IL-18,IL-1β,PI staining positive rate,the expressions of cGAS,STING mRNA,the expressions of NLRP3,Caspase-1,GSDMD,cGAS,STING proteins were obviously reduced(P<0.05);RocA was able to partially reverse the protective effect of irbe-sartan on HR-induced myocardial cells(P<0.05);the detection indicators of H9c2 cells in the RU.521 group were at the same level as those in the high-dose irbesartan group(P>0.05).Conclusion:Irbesartan can inhibit HR-induced myocardial cell pyrop-tosis by inhibi-ting the cGAS-STING signaling pathway.

Objective:To explore the effects of different combination of Er∶YAG laser irradiation parameters on the dentinal tu-bule sealing.Methods:160 dentin discs with 2 mm thickness were etched with 0.5 mmol/L EDTA to establish the dentine hyper-sensitivity models.The discs were randomly divided into 16 groups(n=10).The R02 and R14 handpieces were used to deliver Er∶YAG laser to the dentin discs according to the different output power(W),irradiation distance(cm)and irradiation time(s/cm2).Then,the samples of each group were divided into immediate irradiation subgroup and acid etching and wear subgroup(n=5).The dentinal tubules were observed with SEM,and the exposed area,the sealed rate and the occlusion depth of dentinal tubules were e-valuated with ImageE-Pro Plus 6.0 software.Results:The dentinal tubules in the control group opened uniformly with clear perime-ter,they were enlarged and opened after acid etching and tooth brushing.The dentinal tubules shrinked or sealed well with the melt layer after treatment by Er∶YAG laser irradiation with either parameter combination.Especially,uniform and seamless melt layer as well as similar dentin surface morphology before and post the acid etching and tooth brushing were obtained when the dentin discs were exposed to the following Er∶YAG laser irradiation parameter combinations,i.e.(R02,0.5 W,3 cm,20 s/cm2),(R14,0.5 W,3 cm,20 s/cm2)and(R14,0.6 W,3 cm,20 s/cm2).Significantly decreased exposed area and increased seal rate in the dentinal tubules treated in the above 3 laser irradiation parameter combina-tion groups were observed than those in the other groups(P＜0.05).Morphological analysis confirmed that whether the acid etching and tooth brushing were exerted.The occlusion depth of dentin tubule was more than 2.0 μm in the dentinal tubules treated in the above 3 groups.Conclusion:Er∶YAG laser irradiation parameter combinations of R02,0.5 W,3 cm,20 s/cm2,R14,0.5 W,3 cm,20 s/cm2 and R14,0.6 W,3 cm,20 s/cm2 are suitable for the best dentin tubule sealing.

With the rapid advancements in minimally invasive spine surgery and the increasingly sophisti-cated concept of visualization,transforaminal endoscopic lumbar discectomy(TELD)has become a primary treatment for lumbar disc herniation.Among the critical preoperative steps in TELD,foraminalplasty plays a pivotal role,as its quality directly impacts surgical outcomes and postoperative recurrence rates.This article systemati-cally reviews the evolution of foraminalplasty techniques,evaluates the selection and application of plasty sites,examines factors influencing stability after lumbar foraminalplasty,and highlights recent advancements in computer-assisted navigation.The goal is to serve as a comprehensive reference for clinicians.