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 develop a full-process data platform of renal rehabilitation, diagnosis and quality control information. MethodsA hierarchical architectural design was proposed, adhering to clinical pathway models and standardized data protocols. The platform comprehensively covered assessment, intervention, follow-up and quality control for maintenance hemodialysis (MHD) patients. By integrating multidisciplinary resources and standardizing rehabilitation workflows, it delivered standardized and intelligent rehabilitation services. ResultsThe platform achieved standardized and intelligent management of rehabilitation services, effectively improved the physiological function, psychological state and quality of life convenience for MHD patients, while significantly reduced the economic and care burden on patients' families and society. ConclusionThe rehabilitation service model based on a full-process data platform may provide scientific and systematic support for MHD patients.

OBJECTIVE To explore the antidepressant mechanism of Wenyang jieyu granules （WYJYG） via the NOD-like receptor thermal protein domain associated protein 3 （NLRP3）/apoptosis-associated speck-like protein containing a CARD （ASC）/Caspase-1 pathway. METHODS A rat model of depression was established by chronic unpredictable mild stress combined with single-housing for 42 consecutive days.The experiment set up blank group， model group， MCC950 （NLRP3 inflammasome inhibitor） group （10 mg/kg）， fluoxetine group （positive control，2.08 mg/kg），low-dose WYJYG（3.78 g/kg） and high-dose WYJYG group （7.56 g/kg），with 10 rats in each group. From the 22nd day of the experiment， rats in the fluoxetine group， low-dose and high-dose WYJYG groups were intragastrically administered with the corresponding drugs and intraperitoneally injected with an equal volume of normal saline. Rats in the MCC950 group were intraperitoneally injected with MCC950 at the corresponding concentration and intragastrically administered with an equal volume of distilled water. Rats in the blank group and model group were given an equal volume of distilled water by gavage and an equal volume of normal saline by intraperitoneal injection. All interventions were performed once a day for 21 consecutive days. Behavioral tests were conducted once a week. After the last administration， the contents of ASC， ionized calcium binding adaptor molecule 1 （Iba1）， interleukin-1β （IL-1β）， and IL-18 in hippocampal tissues were detected. The protein expressions of NLRP3， cluster of differentiation 68 （CD68）， Caspase-1， B-cell lymphoma-2 （Bcl-2）， and Bcl-2-associated X protein were determined， and neuronal apoptosis was observed. RESULTS After the last administration， compared with the model group， the open-field activity time was significantly prolonged （ P ＜0.05）， and the latency to feed in a novel environment was significantly shortened （ P ＜0.05） in rats of the high-dose WYJYG group. In hippocampal tissue， the contents of ASC， Iba1， IL-1β， and IL-18， as well as the protein expression levels of NLRP3， Caspase-1， and CD68， and the positive rate of neuronal apoptosis were all significantly decreased/downregulated （ P ＜0.05）. Bcl-2 protein expression was significantly upregulated （ P ＜0.05）， and the density of neuronal apoptosis-positive cells was significantly reduced （ P ＜0.05）. CONCLUSIONS WYJYG play on antidepressant role by inhibiting the NLRP3/ASC/Caspase-1 pathway， reducing microglia-mediated neuroinflammation， and inhibiting hippocampal neurons apoptosis.

Background: and Purpose This study aimed to investigate the association between residual inflammatory risk (RIR) and vulnerable plaques using high-resolution magnetic resonance imaging (HRMRI) in symptomatic intracranial atherosclerotic stenosis (ICAS). Methods: This retrospective study included 70%–99% symptomatic ICAS patients hospitalized from January 2016 to December 2022. Patients were classified into four groups based on high-sensitivity C-reactive protein (hs-CRP) and low-density lipoprotein cholesterol (LDL-C): residual cholesterol inflammatory risk (RCIR, hs-CRP ≥3 mg/L and LDL-C ≥2.6 mmol/L), RIR (hs-CRP ≥3 mg/L and LDL-C <2.6 mmol/L), residual cholesterol risk (RCR, hs-CRP <3 mg/L and LDL-C ≥2.6 mmol/L), and no residual risk (NRR, hs-CRP <3 mg/L and LDL-C <2.6 mmol/L). Vulnerable plaque features on HRMRI included positive remodeling, diffuse distribution, intraplaque hemorrhage, and strong enhancement. Results: Among 336 included patients, 21, 60, 58, and 197 were assigned to the RCIR, RIR, RCR, and NRR groups, respectively. Patients with RCIR (adjusted odds ratio [aOR], 3.606; 95% confidence interval [CI], 1.346–9.662; P=0.011) and RIR (aOR, 3.361; 95% CI, 1.774–6.368, P<0.001) had higher risks of strong enhancement than those with NRR. Additionally, patients with RCIR (aOR, 2.965; 95% CI, 1.060–8.297; P=0.038) were more likely to have intraplaque hemorrhage compared with those with NRR. In the sensitivity analysis, RCR (aOR, 2.595; 95% CI, 1.201–5.608; P=0.015) exhibited an additional correlation with an increased risk of intraplaque hemorrhage. Conclusion In patients with symptomatic ICAS, RIR is associated with a higher risk of intraplaque hemorrhage and strong enhancement, indicating an increased vulnerability to atherosclerotic plaques.

Background: and Purpose This study aimed to investigate the association between residual inflammatory risk (RIR) and vulnerable plaques using high-resolution magnetic resonance imaging (HRMRI) in symptomatic intracranial atherosclerotic stenosis (ICAS). Methods: This retrospective study included 70%–99% symptomatic ICAS patients hospitalized from January 2016 to December 2022. Patients were classified into four groups based on high-sensitivity C-reactive protein (hs-CRP) and low-density lipoprotein cholesterol (LDL-C): residual cholesterol inflammatory risk (RCIR, hs-CRP ≥3 mg/L and LDL-C ≥2.6 mmol/L), RIR (hs-CRP ≥3 mg/L and LDL-C <2.6 mmol/L), residual cholesterol risk (RCR, hs-CRP <3 mg/L and LDL-C ≥2.6 mmol/L), and no residual risk (NRR, hs-CRP <3 mg/L and LDL-C <2.6 mmol/L). Vulnerable plaque features on HRMRI included positive remodeling, diffuse distribution, intraplaque hemorrhage, and strong enhancement. Results: Among 336 included patients, 21, 60, 58, and 197 were assigned to the RCIR, RIR, RCR, and NRR groups, respectively. Patients with RCIR (adjusted odds ratio [aOR], 3.606; 95% confidence interval [CI], 1.346–9.662; P=0.011) and RIR (aOR, 3.361; 95% CI, 1.774–6.368, P<0.001) had higher risks of strong enhancement than those with NRR. Additionally, patients with RCIR (aOR, 2.965; 95% CI, 1.060–8.297; P=0.038) were more likely to have intraplaque hemorrhage compared with those with NRR. In the sensitivity analysis, RCR (aOR, 2.595; 95% CI, 1.201–5.608; P=0.015) exhibited an additional correlation with an increased risk of intraplaque hemorrhage. Conclusion In patients with symptomatic ICAS, RIR is associated with a higher risk of intraplaque hemorrhage and strong enhancement, indicating an increased vulnerability to atherosclerotic plaques.

Objective To explore the neurophysiological signatures of auditory event-related potentials(AERP)during propofol-induced graded sedation depths,and their correlations with sedation levels and behavioral responsiveness,and further to evaluate the feasibility of AERP components as potential biomarkers for quantifying consciousness states.Methods An auditory Oddball paradigm was used to evoke AERP responses in healthy volunteers under propofol-induced graded sedation.Linear mixed model was applied to explore the relationships between the mean amplitudes of AERP components[mismatch negativity(MMN);P300]and both sedation-induced conscious states[Modified Observer's Assessment of Alertness/sedation Scale(MOAA/S)scores]and behavioral performance(response accuracy).Results Twenty-two healthy volunteers were included.Data analysis revealed significant negative correlations between the mean amplitudes of MMN components[MMN-Dev:β=-0.62(-2.70--0.07),P=0.04;MMN-Nov:β=-0.15(-0.27--0.03),P=0.02]and MOAA/S scores during propofol sedation.Novel stimulus-evoked MMN amplitudes also correlated with response accuracy[MMN-Nov:β=-5.08(-7.78--2.37),P<0.01].There was a weak positive correlation between novel stimulus-evoked P300 amplitudes and MOAA/S scores[β=0.16(0.04-0.39),P=0.04],however,the correlation was no significant difference after adjusting for confounding factors including age,education level,and cognitive level.Conclusion The mean amplitude of MMN component elicited during auditory tasks was correlated with conscious states and behavioral accuracy under propofol-induced graded sedation.MMN holds promise as a potential neurophysiological indicator for quantifying conscious states or behavioral responsiveness during sedation.

Objective To explore the application value of quadriceps fat fraction(FF)in the early diagnosis of patellofemoral arthritis(PA).Methods A total of 98 patients were selected for conventional knee MRI examination and IDEAL-IQ sequence imaging.The FFm,FFl and FFt of quadriceps were measured.The patient group[chondromalacia patellae(CMP)(CMP group)and PA group]was compared with normal control(NC)(NC group).The receiver operating characteristic(ROC)curve was applied to assess diag-nostic efficacy.Results FFm,FFl,and FFt in the NC group were significantly lower than those in the patient group(P＜0.001).The FFm and FFl in the PA group were significantly higher than those in the CMP group(P=0.015,P=0.011).Additionally,within both CMP and PA groups,FFl was significantly higher than FFm(P＜0.01).The diagnostic efficacy of FFm was the highest for early PA diagnosis,with an optimal threshold of 8.4％.Conclusion The quadriceps FF can effectively quantify muscle fat infiltration in PA patients,especially in the lateral muscle.An increase in FF value can serve as an early quantitative biomarker for PA,providing sig-nificant reference value for clinical diagnosis and disease progression monitoring.

Objective To explore the neurophysiological signatures of auditory event-related potentials(AERP)during propofol-induced graded sedation depths,and their correlations with sedation levels and behavioral responsiveness,and further to evaluate the feasibility of AERP components as potential biomarkers for quantifying consciousness states.Methods An auditory Oddball paradigm was used to evoke AERP responses in healthy volunteers under propofol-induced graded sedation.Linear mixed model was applied to explore the relationships between the mean amplitudes of AERP components[mismatch negativity(MMN);P300]and both sedation-induced conscious states[Modified Observer's Assessment of Alertness/sedation Scale(MOAA/S)scores]and behavioral performance(response accuracy).Results Twenty-two healthy volunteers were included.Data analysis revealed significant negative correlations between the mean amplitudes of MMN components[MMN-Dev:β=-0.62(-2.70--0.07),P=0.04;MMN-Nov:β=-0.15(-0.27--0.03),P=0.02]and MOAA/S scores during propofol sedation.Novel stimulus-evoked MMN amplitudes also correlated with response accuracy[MMN-Nov:β=-5.08(-7.78--2.37),P<0.01].There was a weak positive correlation between novel stimulus-evoked P300 amplitudes and MOAA/S scores[β=0.16(0.04-0.39),P=0.04],however,the correlation was no significant difference after adjusting for confounding factors including age,education level,and cognitive level.Conclusion The mean amplitude of MMN component elicited during auditory tasks was correlated with conscious states and behavioral accuracy under propofol-induced graded sedation.MMN holds promise as a potential neurophysiological indicator for quantifying conscious states or behavioral responsiveness during sedation.

Objective To analyze the global burden of disease and cross-national imbalances of tracheal,bronchial and lung cancer from 1990-2021 and to further predict changes up to 2040.Methods Age-standardised incidence rate(ASIR),prevalence rate(ASPR),mortality rate(ASMR),disability-adjusted life years rate(ASDR)and 95%confidence interval(95%UI)were extracted from GHDx.The official data platform of the institute for health metrics and evaluation(IHME)and the source of data were the Global Burden of Disease Study 2021(GBD 2021)for global burden of disease of trachea,bronchus and lung cancer.The estimated annual percentage change(EAPC)was calculated to describe the prevalence at global,regional and national levels,to understand the differences in diseases at different gender,age and socio-demographic index(SDI)levels,and to explore the overall situation through cluster analysis,cross-country health inequality analysis and to predict the future prevalence up to 2040 through Nordpred model.Results Globally,the ASIR for tracheal,bronchial and lung cancer fluctuated slightly from 1990 to 2009,and began to decline rapidly after 2009,with an ASIR of 26.42/100 000 in 2021.ASPR showed an increasing and then decreasing trend,reaching a peak in 2011,with a peak of 37.28/100 000 in 2021,while the ASMR and the ASDR showed a general decreasing trend.Tracheal,bronchial and lung cancer diseases showed the highest disease burden in men,those aged 65-74 and in countries and regions with high SDI.ASDR burden showed significant inequalities globally,with a significant positive correlation between ASDR and SDI,mainly concentrated in countries and regions with high SDI,and the unequal burden of ASDR for tracheal,bronchial and lung cancer decreases over time.Predictive analyses found that the number of new cases,current cases,deaths and disability-adjusted life years(DALY)for tracheal,bronchial and lung cancer were expected to increase through 2040,whereas ASIR,ASPR,ASMR and ASDR were projected to decrease each year.Conclusion The overall burden of tracheal,bronchial and lung cancer has declined globally from 1990 to 2021,but with demographic and regional differences.The actual number of cases will continue to climb in the future,despite the continuing decline in age-specified rates,and disease prevention and control will need to focus on growth trends and equity in resource allocation.

Objective To observe the effects of Hedysarum Polybotrys polysaccharide(HPS)on the glucose metabolism of small intestinal smooth muscle in rats with diabetic gastroparesis(DGP)of spleen qi deficiency syndrome;To explore its mechanism based on AMPK/GLUT4 signaling pathway.Methods Totally 72 male Wistar rats were randomly divided into 12 in the blank group and the remaining 60 rats were assigned to the model group.The DGP spleen qi deficiency syndrome model was replicated by intraperitoneal injection of streptozotocin+irregular feeding with high-fat and high sugar feed combined with swimming exhaustion method.The model rats were randomly divided into model group,metformin group and HPS high-,medium-and low-dosage groups.The metformin group was given 100 mg/kg metformin hydrochloride by gavage,while the HPS high-,medium-and low-dosage groups were given 200,100 and 50 mg/kg HPS by gavage,respectively.The blank group and model group were given purified water by gavage once a day for 8 consecutive weeks.The gastric emptying rate and small intestine propulsion rate in rats were detected,HE staining was used to observe the smooth muscle morphology of gastric antrum and ileal tissue,immunofluorescence staining was used to detect the expression of glucagon like peptide-1(GLP-1)in ileal tissue,ELISA was used to detect the contents of adiponectin(APN),glucagon(Glu)and insulin(INS)in serum,Western blot was used to detect the protein expressions of glucose transporter(GLUT)4,GLUT1,AMP-activated protein kinase(AMPK)and p-AMPK in ileal tissue.Results Compared with the blank group,the model group rats showed significantly increased random blood glucose,significantly decreased body mass,gastric emptying rate and small intestinal propulsion rate(P<0.01);the edema in the submucosal layer,loose arrangement of connective tissue,infiltration of a small number of lymphocytes,granulocytes and macrophages,reduced number of goblet cells in the ileal tissue,shedding of intestinal villous epithelial cells and widening of the gap between the submucosal layer and the lamina propria;the expression of GLP-1 in ileal tissue was significantly decreased(P<0.05),the contents of serum APN and INS were significantly decreased,and the content of Glu significantly increased(P<0.01),the expressions of GLUT4 and p-AMPK/AMPK proteins in ileal tissue were significantly decreased,while the expression of GLUT1 protein significantly increased(P<0.01).Compared with the model group,rats in metformin group and HPS high-dosage group showed a random decrease in blood glucose,an increase in body mass,gastric emptying rate,and small intestine propulsion rate(P<0.05,P<0.01);a more regular arrangement of gastric antral tissue cells,a reduction of shedding cells and edema,the smooth muscle structure of the ileal tissue was relatively intact,with evenly distributed cells and reduced infiltration of inflammatory cells;the expression of GLP-1 in ileal tissue increased,the contents of serum APN and INS increased,and the content of Glu decreased,the expressions of GLUT4 and p-AMPK/AMPK proteins in ileal tissue increased,while the expression of GLUT1 protein decreased(P<0.05,P<0.01).Conclusion HPS may up-regulate GLUT4 and down-regulate GLUT1 expression through activates AMPK,promotes glucose uptake and utilization by small intestinal smooth muscle,and improves glucose metabolism of DGP rats with spleen qi deficiency syndrome.