In recent years， hyperuricemia （HUA） has shown a rapidly increasing incidence and tends to occur in increasingly young people， with a wide range of cardiac， renal， joint， and cancerous hazards and all-cause mortality associations. Western medicine treatment has limitations such as large liver and kidney damage， medication restriction， and easy recurrence. The intestine is the major extra-renal excretion pathway for uric acid （UA）， and the intestinal microecology can be regulated to promote UA degradation. It offers great potential to develop UA-lowering strategies that target the intestinal microecology， which are promising to provide safer and more effective therapeutic approaches. Traditional Chinese medicine （TCM） can treat HUA via multiple targets and multiple pathways from a holistic view， with low toxicity and side effects. Studies have shown that intestinal microecology is a crucial target for TCM in the treatment of HUA. However， its specific mechanism of action has not been fully elucidated. Focusing on the key role of intestinal microecology in HUA， this review explores the relationship between intestinal microecology and HUA in terms of intestinal flora， intestinal metabolites， intestinal UA transporters， and intestinal barriers. Furthermore， we summarize the research progress in TCM treatment of HUA by targeting the intestinal microecology， with the aim of providing references for the development of TCM intervention strategies for HUA and the direction of future research.

Objective: To investigate the trend in disease burden of injuries among children and adolescents in China from 1990 to 2021, so as to provide a basis for formulating prevention and control strategies and reducing this disease burden. Methods: Data on mortality, disability-adjusted life years (DALY) rate, incidence, and prevalence of injuries among children and adolescents aged <20 years in China from 1990 to 2021 were collected from the Global Burden of Disease (GBD) 2021 database. All rates were standardized using the GBD 2021 world standard population. The trend in incidence of disease burden of injuries among children and adolescents across differents genders and ages from 1990 to 2021 was evaluated using average annual percent change (AAPC). Results: From 1990 to 2021, the standardized mortality (AAPC=-5.435%), standardized DALY rate (AAPC=-5.311%), standardized incidence (AAPC=-0.466%), and standardized prevalence (AAPC=-0.810%) of injuries among children and adolescents in China showed downward trends (all P<0.05). Among these, the standardized mortality of animal contact (AAPC=-9.138%) and the standardized DALY rate of medical side effects (AAPC=-8.389%) decreased at a relatively fast pace, while the standardized incidence of falls (AAPC=0.083%) and the standardized prevalence of exposure to natural forces (AAPC=2.656%) showed upward trends (all P<0.05). The standardized mortality, standardized DALY rate, standardized incidence and standardized prevalence of injuries were higher in males than in females. The trend in males showed a downward trend (all P<0.05), consistent with the total population. The crude incidence of injuries in the group aged 15-<20 years showed an upward trend (AAPC=0.391%, P<0.05), while the trend in the group aged 10-<15 years was not statistically significant (P>0.05). The crude incidence of injuries in the groups aged 5-<10 years and <5 years showed downward trends (AAPC=-0.488% and -2.275%, both P<0.05). In 2021, the <5 years age group had the highest crude mortality and crude DALY rate of injuries, at 13.94/100 000 and 1 257.26/100 000, respectively. The 15-<20 years age group exhibited the highest crude incidence and crude prevalence, at 4 874.05/100 000and 4 050.35/100 000, respectively. Drowning and falls were major components of the disease burden across all age groups. Conclusions From 1990 to 2021, the disease burden of injuries among children and adolescents in China showed an overall downward trend. The disease burden was consistently higher in males than in females. Children aged <5 years face a high risk of fatality and disability, while adolescents aged 15-<20 years experience a high incidence and frequency of injuries. Drowning and falls were key priorities for prevention and control.

Chronic cerebral hypoperfusion (CCH) plays an important role in the occurrence and development of vascular dementia (VD). Recent studies have indicated that multiple stages of immune-inflammatory response are involved in the process of cerebral ischemia, drawing increasing attention to immune therapies for cerebral ischemia. This study aims to identify potential immune therapeutic targets for CCH using bioinformatics methods from an immunological perspective. We identified a total of 823 differentially expressed genes associated with CCH, and further screened for 9 core immune-related genes, namely RASGRP1, FGF12, SEMA7A, PAK6, EDN3, BPHL, FCGRT, HSPA1B and MLNR. Gene enrichment analysis showed that core genes were mainly involved in biological functions such as cell growth, neural projection extension, and mesenchymal stem cell migration. Biological signaling pathway analysis indicated that core genes were mainly involved in the regulation of T cell receptor, Ras and MAPK signaling pathways. Through LASSO regression, we identified RASGRP1 and BPHL as key immune-related core genes. Additionally, by integrating differential miRNAs and the miRwalk database, we identified miR-216b-5p as a key immune-related miRNA that regulates RASGRP1. In summary, the predicted miR-216b-5p/ RASGRP1 signaling pathway plays a significant role in immune regulation during CCH, which may provide new targets for immune therapy in CCH.
Humans ; Computational Biology/methods* ; Brain Ischemia/therapy* ; Immunotherapy ; MicroRNAs/genetics* ; Signal Transduction ; Dementia, Vascular/genetics* ; Chronic Disease

Objective:To investigate the influencing factors for sarcopenia in hospitalized patients,to construct a risk prediction model for sarcopenia in elderly hospitalized patients,and to provide a quantitative tool for early screening and intervention of sarcopenia based on the integration of multi-dimensional indicators.Methods:A retrospective analysis was performed for the data of 2105 elderly patients who were hospitalized in The First Affiliated Hospital of Chongqing Medical University from March 2016 to June 2023.The least absolute shrinkage and selection operator analysis was used for the screening of variables,and the logistic regression analysis was used to investigate the influencing factors for sarcopenia.A predictive model was constructed,and internal and external validation was performed.The Shapley additive explanations model was used to analyze feature contributions,and a nomogram model was constructed to visualize and interpret the results.Results:The 1259 patients from March 2016 to December 2020 were randomly divided into a training set with 882 patients and an internal test set with 377 patients at a ratio of 7∶3,and the 846 patients from January 2021 to June 2023 were established as the external validation set.A total of 489 cases of sarcopenia(55.44%)were detected in the training set.The logistic regression analysis based on the training set showed that asthenia,dependence on Activity of Daily Living,malnutrition,and in-creasing age were risk factors for sarcopenia(odds ratio[OR]>1,P<0.05),and male sex,normal body mass index,and overweight were protective factors against sarcopenia(OR<1,P<0.05).The model had an AUC of 0.876(95%CI=0.854-0.899)in the training set,0.883(95%CI=0.849-0.918)in the internal test set,and 0.750(95%CI=0.717-0.783)in the external validation set,suggesting that the model had good performance.The decision curve analysis showed that the nomogram model had a good clinical value.Conclu-sion:The predictive model for sarcopenia has good performance and holds promise for clinical application.

Objective To retrieve,analyze and synthesize evidence on post-transplant diabetes mellitus(PTDM)in lung transplant patients,providing reference for clinical healthcare professionals in preventing and managing PTDM in lung transplant patients.Methods Based on the"6S"evidence model,systematic searches were conducted across guideline websites,professional associations,and Chinese/English databases regarding post-transplant diabetes mellitus(PTDM)in lung transplant patients.The search period spanned from data-base inception to January 2025.Two researchers independently completed literature screening,quality assess-ment,and evidence extraction.Results A total of 14 articles were included,comprising 1 clinical decision,2 guidelines,5 expert consensuses,2 specifications,1 evidence summary,and 3 systematic reviews.Twenty-four pieces of best evidence were synthesized from seven aspects:risk factors,diagnosis,screening,prevention,treatment,glycemic control targets,and health education.Conclusion The best evidence for preventing and managing post-transplant diabetes mellitus in lung transplant patients provides an evidence-based foundation for clinical practice among healthcare professionals.Evidence should be selected and applied according to spe-cific clinical situations and patient needs.

Papillary thyroid carcinoma (PTC) is prone to lateral lymph node metastasis (LLNM). It is crucial to assess the status of lateral lymph nodes accurately before surgery, determine the appropriate surgical scope and minimize trauma to patients while thoroughly cleaning. Preoperative evaluation is constantly advancing towards intelligence and precision, and the use of contrast enhanced ultrasound, detection of fine needle aspiration eluent, three-dimensional visualization technology, and contrast enhanced CT-based deep learning model in clinical practice can improve the accuracy of diagnosing LLNM. The new directions for the development of preoperative evaluation include contrast enhanced US, new fine needle aspiration eluent markers, rapid detection of eluent, the combination of radiomics and artificial intelligence. The exploration of risk factors for LLNM has been a hot research topic in recent years, and clinical prediction models can be constructed based on different risk factors and applied in clinical practice. This article presents the top ten risk factors commonly used in clinical research and lists multiple new predictive indicators, which are combined with nomograms for personalized prediction. At the same time, the controversial points in the clinical management of occult LLNM are discussed, as well as the latest progress in the treatment of lateral lymph nodes in PTC.

Objective:To investigate the feasibility and effectiveness of three-dimensional visualization technology in the precise diagnosis and treatment of locally advanced differentiated thyroid cancer(DTC).Methods:A retrospective analysis was conducted on the clinical data of 196 patients with locally advanced DTC treated at the 960th Hospital of the PLA from December 2021 to August 2023. The cohort included 71 male and 125 female patients, with a mean age of 43.7 years (rangd from 18 to 77 years). All patients underwent neck-enhanced CT scans and were divided into two groups: the study group( n=102), which underwent preoperative three-dimensional visualization of CT data, and the control group( n=94), which did not. Baseline data for both groups were matched using SPSS27.0 with 1∶1 propensity score matching (PSM) and the caliper value was 0.02. A total of 49 patients were included in each group, including 35 first-time surgeries and 14 reoperation. Among the 70 first-time surgeries, 29 patients underwent robotic surgery and 41 underwent open surgery. Among the 28 reoperations, 4 underwent robotic surgery and 24 underwent open surgery. In the study group, three-dimensional visual models were used to comprehensively evaluate the tumor and metastatic lesion size, spatial location, and adjacent relationship with surrounding organs, surgical treatments were guided by these models, whereas the control group relied on two-dimensional imaging for guidance. The clinical data were statistically analyzed using SPSS27.0. Results:All operations were successfully completed. There were no statistical differences in baseline data between the two groups( P>0.05). Among first-time surgeries, the study group showed shorter operation times [175(145, 200) min vs 205(182, 249) min, P<0.001], a lower incidence of postoperative chyle leak (0 vs 8.57%, P=0.027), a higher rate of robotic surgery (48.57% vs 34.28%, P=0.225), a greater number of harvested lymph nodes [46(40, 62) vs 37(28, 56), P=0.032], a greater number of cervical lymph node metastasis[15(7, 22) vs 5(1, 14), P=0.004] and a larger diameter of metastasis lymph nodes[12(10, 16) mm vs 4(1, 10) mm, P<0.001]. There were no significant differences in intraoperative blood loss, postoperative drainage days and incidence of hypoparathyroidism( P>0.05). During the reoperation, the study group had shorter operation times[103.5(95.0, 122.5) min vs 146.50(133.25, 172.25) min, P<0.001], less intraoperative blood loss[12.50(8.75, 22.50) mL vs 30.00(17.50, 35.00) mL, P=0.021], fewer postoperative drainage days[5.00(4.00, 6.00) d vs 6.00(5.00, 7.25) d, P=0.016] and a lower incidence of hypoparathyroidism(7.14% vs 42.86%, P=0.038).The robotic surgery rate was higher in the study group (21.42% vs 7.14%, P=0.596). There were no significant differences in lymph node dissection numbers, metastatic lymph node counts, or chyle leak incidences between the two groups ( P>0.05). No acute bleeding or incision infection occurred in any patient postoperatively. Conclusion:Three-dimensional visualization technology is an effective preoperative assessment method for evaluating the resectability of tumors and metastases lesions in locally advanced DTC. It enhances the accuracy and safety of surgery for locally advanced DTC.

Objective:To investigate the feasibility and safety of implementing a domestic vehicle-mounted remote mobile robotic surgical system in thyroid surgery applications, integrated with 5G communication technology.Methods:Using the main system located on the vehicle-mounted mobile robot operating platform of the 960th Hospital of PLA Joint Logistics Support Force and the slave system of Weifang Traditional Chinese Hospital, the remote radical thyroidectomy 5G communication technology, and analyze the clinical and information transmission data of two female patients who underwent remote mobile robot thyroid cancer surgery on October 21, 2024 at Weifang Traditional Chinese Medicine Hospital.Results:The remote radical thyroidectomy was conducted by the robosurgeons utilizing a vehicle-mounted mobile robotic surgical system, and the procedure was successfully completed without necessitating intermediate open surgery. The operation durations for patient 1 and patient 2 were 135 minutes and 108 minutes, respectively, with 7 and 13 lymph nodes dissected, respectively. The average delay in surgical data transmission was recorded at 61.9 milliseconds, with no instances of signal interruption or frame loss. The procedure proceeded smoothly, without any jamming, and the audio and video transmissions were consistently clear. Follow up for 21 days after surgery showed no complications such as hoarseness, skin damage, or lymphatic fistula.Conclusion:The implementation of a vehicle-mounted remote mobile robotic surgery system for thyroid surgery has demonstrated safety and feasibility. Furthermore, the utilization of the 5G network offers rapid data transmission and minimal latency, closely approximating the therapeutic efficacy of traditional robotic thyroidectomy.

Objective:To analyze the molecular mechanism of Huangqin Decoction in the treatment of acute lung injury (ALI) with network pharmacology; To conduct experimental validation.Methods:Active compounds and corresponding targets of Huangqin Decoction were retrieved from the TCMIP database. ALI-related targets were obtained from GeneCards, DisGeNet, TTD, and OMIM, and the intersection targets were obtained. The intersection targets were imported into the string database to build the PPI network, and the core targets were obtained through topology analysis by Cytoscape 3.10.1 software. GO and KEGG pathway enrichment analyses were conducted using clusterProfiler software. 16 SD rats were divided into two groups ( n = 8 per group) with random number table method: control and Huangqin Decoction. Rats in the Huangqin Decoction group received Huangqin Decoction by gavage at a dosage of 40 mg/kg, while the control group was administered an equal volume of distilled water. After seven consecutive treatments, drug-containing serum was collected. A549 cells were divided into four groups: control, model, Huangqin Decoction, and received relevant drugs as intervention for 24 h. Levels of SOD, MDA, GSH-Px, IL-1β, TNF-α, and IL-6 in the culture supernatant were measured by ELISA. Apoptosis was analyzed by flow cytometry. The expressions of PI3K, p-PI3K, Akt, p-Akt, mTOR, p-mTOR, LC3Ⅱ/Ⅰ, and Beclin-1 proteins were determined by Western blot. Results:A total of 137 active compounds and 178 common targets were identified in Huangqin Decoction, with TP53, AKT1, STAT3, TNF, IL6, and ESR1 as core nodes. GO enrichment indicated involvement in oxidative stress and responses to lipopolysaccharides, bacterial molecules, and hypoxia. KEGG analysis revealed enrichment in lipid and atherosclerosis, PI3K-Akt signaling pathway, hepatitis, MAPK signaling pathway, prostate cancer, small-cell lung cancer, and mTOR signaling pathway. In cell experiments, compared with the model group, Huangqin Decoction and inhibitor groups showed increased A549xibo ( P<0.05); levels of IL-1β, TNF-α, IL-6, and MDA in the supernatant were reduced ( P<0.05 or P<0.01), while SOD and GSH-Px levels were elevated ( P<0.05 or P<0.01); the apoptosis rate decreased ( P<0.05 or P<0.01); the expressions of LC3-Ⅱ/Ⅰ and Beclin-1 proteins decreased ( P<0.05 or P<0.01), whereas the expressions of p-mTOR/mTOR, p-Akt/Akt, and p-PI3K/PI3K increased ( P<0.05 or P<0.01). Conclusion:Huangqin Decoction exerts protective effects against ALI mainly by reducing cellular autophagy, and its mechanism may be related to the activation of the mTOR/Akt/PI3K signaling pathway.