Lung cancer is the leading cause of cancer-related deaths worldwide， and tumor metastasis is a key factor contributing to the mortality of most lung cancer patients. Aberrant activation of epithelial-mesenchymal transition （EMT） is a major driver of lung cancer progression and metastasis. EMT is characterized by the loss of apical-basal polarity and intercellular adhesion in highly differentiated， polarized， and organized epithelial cells， which acquire motility， migratory potential， and invasive properties. During this process， cells undergo cytoskeletal remodeling and transform into a mesenchymal phenotype， accompanied by associated changes in cellular markers. The EMT process is highly complex and is tightly regulated by intricate networks involving multiple transcription factors， post-translational controls， epigenetic modifications， and non-coding RNAs. Therefore， therapies targeting the mechanisms of malignant transformation and their associated pathways in lung cancer are of significant clinical importance. In recent years， EMT has attracted increasing attention as a potential target for cancer therapy. Chinese medicine， with its characteristics of multi-target action， low side effects， and good therapeutic efficacy， has demonstrated an important role in anticancer treatment. A series of studies have investigated the role of Chinese medicine in inhibiting EMT in lung cancer. Active ingredients of Chinese medicine， including flavonoids， glycosides， phenols， terpenoids， saccharides， and alkaloids， as well as Chinese medicine compound formulas， have shown significant regulatory effects on EMT. Their mechanisms mainly involve multiple pathways， targets， and links， including signaling pathways， exosomes， microRNAs （miRNAs）， and the tumor-associated immune microenvironment. This article summarizes the mechanisms by which EMT promotes malignant tumor progression and reviews the current research on how Chinese medicine active ingredients， monomers， and compound formulas inhibit EMT and suppress lung cancer cell migration and invasion. This study is expected to provide comprehensive theoretical information for basic and translational research on lung cancer.

ObjectiveTo observe the effects of Tongmai Kaiqiao pills on AMP-activated protein kinase （AMPK）/peroxisome proliferator-activated receptor gamma coactivator-1α （PGC-1α） signaling pathway and mitochondrial biogenesis in hippocampal tissue of rats with vascular cognitive impairment （VCI） and to investigate the potential mechanism of Tongmai Kaiqiao pills in improving cognitive impairment in rats with VCI. MethodsTwelve of 72 male SD rats were selected as the sham operation group， and the remaining rats were modelled using the modified 2VO method. The rats that were successfully modelled were divided into the model group， the high-dose group of Tongmai Kaiqiao pills （27.6 g·kg^-1）， the low-dose group of Tongmai Kaiqiao pills （13.8 g·kg^-1）， the combination group （27.6 g·kg^-1 Tongmai Kaiqiao pills + 25 mg·kg^-1 dorsomorphin）， and the donepezil hydrochloride group （0.45 g·kg^-1） according to the random number table method. After four weeks of continuous intraperitoneal injection of the corresponding drugs， the Morris water maze test was used to test the learning and memory ability of rats. Hematoxylin-eosin （HE） staining and Nissl staining were used to detect pathological changes in the hippocampus of the rats. The content of mitochondrial adenosine triphosphate （ATP） in the brain hippocampus was detected by colorimetry， and reactive oxygen species （ROS） level was detected in rat mitochondria by MitoSOX Red assay. Mitochondrial DNA copy number was detected by real-time fluorescent quantitative PCR （Real-time PCR）. Pathological changes in mitochondria were observed by transmission electron microscopy （TEM）， and AMPK， PGC-1α， phosphorylated AMP-activated protein kinase （p-AMPK）， nuclear respiratory factor 1 （Nrf1）， and mitochondrial transcription factor A （TFAM） protein expression in the hippocampus of the rats were detected by Western blot. ResultsCompared with those in the sham operation group， rats in the model group had a reduced number of platform crossings （P<0.01）， significantly prolonged evasion latency （P<0.01）， disorganized neuronal arrangement in the hippocampal region， widened gaps， and blurred nucleus membrane and nucleolus boundaries. The emergence of necrotic cells was visible. The color of the nissl bodies was light， and the number was reduced with severe loss. Mitochondria were atrophied， and cristae were lost. Severe damage was observed. The content of ROS was increased， and the level of ATP was decreased. mtDNA copy number decreased significantly （P<0.01）， and the protein expression of p-AMPK， PGC-1α， Nrf1， and TFAM decreased （P<0.05， P<0.01）. Compared with those in the model group， rats in the high-dose group of Tongmai Kaiqiao pills and donepezil hydrochloride group showed a shorter time to find the platform （P<0.01）， increased number of platform crossings （P<0.01）， restored mitochondrial morphology and structure of the hippocampal neurons， alleviated neuronal death， increased number of nissl bodies， weaken degree of injury， lower content of ROS， and significantly increased levels of ATP and number of copies of mtDNA （P<0.05， P<0.01）. In addition， there was increased protein expression of p-AMPK， PGC-1α， Nrf1， and TFAM （P<0.05， P<0.01）. Compared with the model group， the evasion latency was shortened in the low-dose group of Tongmai Kaiqiao pills （P<0.01）， and the number of platform crossings was increased， but the difference was not statistically significant. The mitochondria were swollen and deformed， and the cristae became shorter and partially disappeared. The degree of damage did not improve significantly， and the number of nissl bodies was increased but not statistically significant. The ROS content decreased （P<0.01）， but there was no significant difference in ATP level and mtDNA copy number. The protein expression of PGC-1α was increased （P<0.05）， but there was no significant difference in the protein expression of p-AMPK， Nrf1， and TFAM， and the results were not statistically significant. Compared with the donepezil hydrochloride group， there was no significant change in the results of each assay in the high-dose group of Tongmai Kaiqiao pills， and the difference was not statistically significant. Compared with the high-dose group of Tongmai Kaiqiao pills， rats in the combination group had a significantly lower number of platform crossings （P<0.01）， a significantly longer evasion latency （P<0.01）， a reduced number of neuronal cells， disorganized tissue structure， swollen and blurred cell outlines， a significant reduction in the number of nissl bodies. Moreover， there was an increase in the content of ROS， a decrease in the level of ATP and the number of mtDNA copies （P<0.01）， and a decrease in the expression of p-AMPK， PGC-1α， Nrf1， and TFAM （P<0.05）. ConclusionTongmai Kaiqiao pills is able to improve cognitive function in rats by activating the AMPK/PGC-1α signaling pathway， promoting mitochondrial biogenesis， and attenuating pathological damage to neurons in the hippocampal region， thereby demonstrating its therapeutic potential.

OBJECTIVE: To investigate whether adding 1 transverse screw (TS) to the triangular parallel cannulated screw (TPCS) fixation has a mechanical stability advantage for Pauwels type Ⅲ femoral neck fractures by conducting finite element analysis on four internal fixation methods. METHODS: Based on CT data of a healthy adult male volunteer's femur, three Pauwels type Ⅲ femoral neck fracture models (Pauwels angle 70°, Pauwels angle 80°, and Pauwels angle 70° combined with bone defect) were constructed using Mimics 21.0 software and SolidWorks 2017 software. Four different internal fixation models were built at the same time, including TPCS, TPCS+TS, three cross screws (TCS), and TPCS+medial buttress plate (MBP). The mechanical stability of different models under the same load was compared by finite element analysis. RESULTS: The femoral model established in this study exhibited a maximum stress of 28.62 MPa, with relatively higher stress concentrated in the femoral neck. These findings were comparable to previous studies, indicating that the constructed femoral finite element model was correct. The maximum stress of internal fixation in finite element analysis showed that TCS was the lowest and TPCS+MBP was the highest in Pauwels angle 70° and 80° models, while TPCS+TS was the lowest and TCS was the highest in Pauwels angle 70° combined with bone defect model. The maximum displacement of internal fixation in each fracture model was located at the top of the femoral head, with TCS having the highest maximum displacement of the femur. The maximum stress of fracture surface in finite element analysis showed that TCS was the lowest and TPCS was the highest in the Pauwels angle 70° model, while TPCS+MBP was the lowest and TPCS/TCS were the highest in the Pauwels angle 80° model and the Pauwels angle 70° combined with bone defect model, respectively. The maximum displacement of fracture surfece analysis showed that TPCS+MBP was the lowest and TCS was the highest in Pauwels angle 70° and 80° models, while TPCS+TS was the lowest and TCS was the highest in Pauwels angle 70° combined with bone defect model. CONCLUSION For Pauwels type Ⅲ femoral neck fractures, the biomechanical stability of TPCS+TS was superior to that of TPCS alone and TCS, but it has not yet reached the level of TPCS+MBP.
Finite Element Analysis ; Humans ; Femoral Neck Fractures/diagnostic imaging* ; Bone Screws ; Fracture Fixation, Internal/instrumentation* ; Male ; Bone Plates ; Stress, Mechanical ; Biomechanical Phenomena ; Tomography, X-Ray Computed ; Adult ; Femur Neck/surgery*

Hungary, as the first European country to legislate TCM, its legislation experience has significant implications for the international development of TCM. This article reviewed the historical process of TCM legislation in Hungary, summarized its legislative achievements, and analyzed the problems encountered during the implementation process. It was found that the current challenges faced by TCM legislation in Hungary mainly include constraints from the dominance of modern medicine, restrictions from strict qualification requirements, insufficient public awareness, difficulties in TCM registration, and challenges in policy coordination and cooperation. Based on these findings, the article proposed countermeasures such as improving the legal framework, strengthening educational cooperation, enhancing public awareness, promoting the mutual recognition of standards between China and Europe, and deepening China-Hungary collaboration. These measures aim to further improve the legislation and implementation of TCM in Hungary, thereby promoting the healthy development of TCM in Hungary and the global service trade of TCM.

PD is a neurodegenerative disease characterized by degenerative death of dopaminergic neurons in the substantia nigra,exhibiting a range of motor and non-motor symptoms with serious effects on quality of life.circRNA is a covalently closed-loop non-coding RNA that plays a major role in PD progression.This article reviews the involvement of circRNA in oxidative stress,regulation of transcription,neuroinflammation,autophagy,and α-synuclein.

Objective:To compare the efficacy of pedicle screw placement between computer navigation guidance and freehand assistance in the surgical treatment of isthmic spondylolysis at the lumbar vertebrae.Methods:A retrospective study was conducted to analyze the 47 patients with bilateral isthmic spondylolysis at the L 5 vertebra who had been treated at Department of Spinal Surgery, The General Hospital of Xinjiang Military Command from January 2020 to April 2023. All were male patients with an age of (24.0±4.3) years. They were divided into a study group (13 cases subjected to pedicle screw placement assisted by computer navigation guidance) and a control group (34 cases subjected to pedicle screw placement assisted freehandedly). The 2 groups were compared in terms of surgical incision length, intraoperative bleeding, screw placement time, postoperative hospital stay, total hospitalization cost, postoperative complications, rate of screw reposition, angle between pedicle screw and upper endplate, angle between bilateral pedicle screws, and placement accuracy; the visual analogue scale (VAS) for pain, Japanese Orthopaedic Association (JOA) score for lumbar spine function, and Oswestry disability index (ODI) were also compared between preoperation, 1-week postoperation, and the last follow-up. Patient satisfaction was assessed according to the modified MacNab criteria, and internal fixation failure and isthmic healing were also evaluated at the last follow-up. Results:There were no statistically significant differences in the preoperative general data between the 2 groups, showing comparability ( P>0.05). The differences were not statistically significant in surgical incision length, intraoperative bleeding, screw placement time, postoperative hospital stay, or postoperative complications ( P>0.05). However, in the study group, the total hospitalization cost was significantly higher than that in the control group, the rate of screw reposition [7.7% (2/26)] significantly lower than that in the study group [26.5% (18/68)], the angle between pedicle screw and upper endplate and the angle between bilateral pedicle screws were both significantly smaller than those in the control group, and the placement accuracy [92.3% (24/26)] was significantly greater than that [70.6% (48/68)] in the control group (all P<0.05). All patients were followed up for 7.0 (5.0, 14.0) months. Patients in both groups showed significant improvements in VAS, JOA score, and ODI at postoperative 1 week and the last follow-up compared with the preoperative values, and the improvements at the last follow-up were significantly larger than those at postoperative 1 week ( P<0.05). According to the modified MacNab criteria at the last follow-up, patient satisfaction was rated as excellent in 10 cases, as good in 2 cases and as moderate in 1 case in the study group while as excellent in 27 cases, as good in 3 cases, as moderate in 3 cases and as poor in 1 case in the control group. In the study group, there were 1 case of internal fixation failure, 1 case of spine cutting-out by titanium cable, and 12 cases of bony healing of the isthmus; in the control group, there were 2 cases of internal fixation failure, 2 cases of spine cutting-out by titanium cable, and 29 cases of bony healing of the isthmus. Conclusions:In the surgical treatment of bilateral isthmic spondylolysis at the L 5 vertebra, computer navigation-guided pedicle screw placement is safe and reliable, showing an advantage of higher accuracy over freehand placement. It deserves clinical promotion due to its satisfactory therapeutic effects.

BACKGROUND:Traditional Chinese medicine compound prescription has a long history in the treatment of primary osteoporosis,and the curative effect is definite,but the medication rule and mechanism are not clear. OBJECTIVE:Using the methodology of data mining and network pharmacology,to explore and verify the law of drug use and molecular mechanism of modern traditional Chinese medicine in the treatment of primary osteoporosis. METHODS:The relevant documents included in CNKI,WanFang,VIP and PubMed were used as data sources,and the relevant data were statistically counted and extracted by Microsoft EXCEL2019,IBMSPSS25.0 and other software.The high-frequency drugs obtained from the data statistics were analyzed by association rules analysis and cluster analysis,and the core drug combination of traditional Chinese medicine compound prescription in the treatment of primary osteoporosis was obtained by combining the two results.The therapeutic mechanism of this combination was explained by network pharmacology and verified by molecular docking. RESULTS AND CONCLUSION:Finally,151 articles were included and 207 prescriptions were selected,involving 285 flavors of Chinese herbs.(1)Ten groups of important drug combinations were obtained through the above two analyses,among which the core drug combination with the highest confidence and improvement was"Drynaria-Eucommia-Angelica."The key components of the combination in the treatment of primary osteoporosis were quercetin,kaempferol,naringenin and so on.The core targets were SRC proto-oncogene,phosphoinositide-3-Kinase regulatory subunit 1 and RELA proto-oncogene.The main pathways were cancer signaling pathway,JAK-STAT signaling pathway,VEGF signaling pathway,and NF-κB signaling pathway.(2)The key active components were docked with the core targets,and the two showed a good combination.To conclude,Chinese herbal compound therapy in the treatment of primary osteoporosis can use a variety of active components to exert its efficacy through multiple signal pathways and acting on multiple targets,which can provide a theoretical basis for the research and development of new drugs for the follow-up treatment of primary osteoporosis.

Objective To detect the expression level of ki-67 in gastric adenocarcinoma tissues,and to analyze the correlation be-tween ki-67 and clinicopathological parameters of tumor and its clinical significance.Methods A total of 113 patients with gastric ade-nocarcinoma undergoing surgery in the Affiliated Hospital of Xuzhou Medical University from January 2016 to December 2019 were select-ed.The expression level of ki-67 in gastric adenocarcinoma and paracancerous tissues were detected by immunohistochemical method.The positive expression rates of ki-67 in gastric adenocarcinoma tissues and paracancerous tissues were compared and the correlation be-tween the positive expression of ki-67 in gastric adenocarcinoma tissues and the clinicopathological characteristics of gastric adenocarcino-ma was analyzed;Kaplan-Meier survival curve was used to analyze the correlation between ki-67 levels and the prognosis of patients.COX regression model was established for multivariate prognostic analysis.Results The positive expression rate of ki-67 in gastric ade-nocarcinoma tissues was higher than that in the paracancerous tissues(74.34％vs 38.94％),and the difference was statistically signifi-cant(P＜0.05).Tumor diameter≥5cm(P=0.046),vascular invasion(P=0.028)both increase the positive expression rate of ki-67 in gastric adenocarcinoma tissues.Median survival time of patients with high ki-67 expression level(≥50％)was significantly lower than that of patients with low ki-67 expression level(＜50％),and the difference was statistically significant(P=0.0361).Multivari-ate COX regression analysis showed that TNM stage(P=0.029)and high ki-67 leve(≥50％,P=0.026)were independent risk factosr affecting the prognosis of gastric adenocarcinoma patients.Conclusion The positive expression of ki-67 is closely related to the occur-rence and development of gastric adenocarcinoma,which has important reference value to predict the progression and prognosis of gastric adenocarcinoma.

Objective:To evaluate the clinical efficacy of cannulated screws combined with suture anchor in the treatment of comminuted patellar fractures.Methods:A retrospective study was conducted to analyze the data of 72 patients who had been admitted to Department of Orthopaedics, The Second Hospital of Shanxi Medical University for comminuted patellar fractures between January 2020 and June 2023. The patients were divided into 2 groups based on the surgical techniques used. In group A of 34 patients subjected to fixation using cannulated screws combined with suture anchors, there were 22 males and 12 females with an age of 49 (39, 58) years, and 7 cases of AO type 34-C2 and 27 cases of AO type 34-C3. In group B of 38 patients subjected to fixation using cannulated screws combined with titanium cables, there were 19 males and 19 females with an age of 55 (40, 62) years, and 11 cases of AO type 34-C2 and 27 cases of AO type 34-C3. Comparisons were made between the 2 groups regarding general preoperative data, postoperative range of knee motion, fracture healing time, complications, soft tissue irritation, secondary surgery, postoperative pain assessed by visual analogue scale (VAS), postoperative Bostman knee score, and postoperative Levack knee score.Results:The 2 groups were comparable because there were no statistically significant differences in the general preoperative data and follow-up time between them ( P>0.05). There were no statistically significant differences between the 2 groups either in postoperative range of knee motion, fracture healing time, or Bostman knee score or Levack knee score at the last follow-up (all P>0.05). In group A, the VAS pain score and the rate of soft tissue irritation at the last follow-up were respectively 0.0 (0.0, 1.0) and 0% (0/34), significantly lower than those in group B [1.0 (0.0, 1.3) and 15.8% (6/38)] ( P<0.05). The overall incidence of complications and secondary surgery rate in group A were respectively 5.9% (2/34) and 2.9% (1/34), lower than those in group B [21.1% (8/38) and 15.8% (6/38)], but showing no statistically significant difference between the 2 groups ( P>0.05). Conclusions:In the treatment of comminuted patellar fractures, fixation using cannulated screws combined with both titanium cables and suture anchors can lead to comparable clinical efficacy, but fixation using cannulated screws and suture anchors can reduce soft tissue irritation, alleviate pain, and improve the quality of life of patients.

Objective:To explore the clinical characteristics of hemoglobin H (HbH) disease during pregnancy, and evaluate the impact of prepregnant anemia on maternal and fetal outcomes.Methods:Clinical data of 12 pregnant women, who were diagnosed with HbH disease by genetic testing in the Third Affiliated Hospital of Guangzhou Medical University from January 1, 2017, to December 31, 2022, were retrospectively collected. Thalassemia genotypes, general conditions before and during pregnancy, and perinatal outcomes were analyzed using descriptive analysis.Results:The 12 patients were categorized into moderate anemia (Hb<90 g/L, n=5) and mild anemia (Hb≥90 g/L and <110 g/L, n=7) groups according to the level of Hb before conception. In the moderate anemia group, with one deletional HbH disease and four non-deletional type, all had blood transfusion histories, and four developed severe anemia during pregnancy with four cases of fetal growth restriction. The mild anemia group comprised six deletional and one non-deletional genotype, with no severe anemia or transfusion requirement during pregnancy. In terms of maternal and fetal outcomes, two moderate anemia cases opted for pregnancy termination, while three delivered via cesarean section with two preterm infants having mild asphyxia and one full-term. In the mild anemia group, one case terminated due to intrauterine fetal death, and the remaining six continued the pregnancies, including two were delivered normally, one was assisted by forceps, and three through cesarean section. Among the six delivered cases, one was preterm birth, one infant was born with severe asphyxia and four mothers developed postpartum complications such as puerperal infection and postpartum hemorrhage. Conclusions:Clinical manifestations of HbH disease vary greatly. Individualized management should be offered based on the degree of anemia before pregnancy. For women with moderate anemia, close monitoring and appropriate intervention are required during pregnancy to improve both maternal and infant outcomes.