Objective:Radiotherapy is the primary treatment for nasopharyngeal carcinoma,but it frequently leads to radiotherapy-induced temporal lobe injury(RTLI).Magnetic resonance imaging(MRI)is the main diagnostic method for RTLI after radiotherapy for nasopharyngeal carcinoma,but it is prone to missed diagnoses.This study aims to investigate the causes of missed diagnoses of RTLI in nasopharyngeal carcinoma patients undergoing MRI after radiotherapy. Methods:Clinical and MRI data from nasopharyngeal carcinoma patients diagnosed and treated with radiotherapy at Xiangya Hospital of Central South University,from January 2010 to April 2021,were collected.Two radiologists reviewed all head and neck MRIs(including nasopharyngeal and brain MRIs)before and after radiotherapy of identify cases of late delayed response-type RTLI for the first time.If the original diagnosis of the initial RTLI in nasopharyngeal carcinoma patients did not report temporal lobe lesions,it was defined as a missed diagnosis.The first diagnosis of RTLI cases was divided into a missed diagnosis group and a non-missed diagnosis group.Clinical and imaging data were compared between the 2 groups,and multivariate logistic regression analysis was used to identify independent risk factors for MRI missed diagnoses of initial RTLI. Results:A total of 187 nasopharyngeal carcinoma with post-radiotherapy RTLI were included.The original diagnostic reports missed 120 cases and accurately diagnosed 67 cases,with an initial RTLI diagnosis accuracy rate of 35.8%and a missed diagnosis rate of 64.2%.There were statistically significant differences between the missed diagnosis group and the non-missed diagnosis group in terms of lesion size,location,presence of contralateral temporal lobe lesions,white matter high signal,cystic degeneration,hemorrhage,fluid attenuated inversion recovery(FLAIR),and examination site(all P<0.05).Multivariate logistic regression analysis showed that lesions≤25 mm,non-enhancing lesions,lesions without cystic degeneration or hemorrhage,lesions located only in the medial temporal lobe,and MRI examination only of the nasopharynx were independent risk factors for missed MRI diagnosis of initial RTLI(all P<0.05). Conclusion:The missed diagnosis of initial RTLI on MRI is mainly related to lesion size and location,imaging characteristics,and MRI examination site.

AIM:To explore the impact of histidine triad nucleotide-binding protein 2(HINT2)on atheroscle-rosis(AS),and to elucidate its underlying mechanisms.METHODS:Peripheral blood mononuclear cells(PBMCs)were isolated from patients with chest pain and induced to differentiate into macrophages for assessing HINT2 expression.In vitro,RAW264.7 mouse macrophages were cultured to evaluate inflammatory cytokine levels and cell death in superna-tants.An apolipoprotein E gene knockout(apoE-/-)mouse model of AS was developed to analyze plaque formation,lipid metabolism and macrophage foaminess in the aortic root.Pyroptosis-related protein expression in cultured RAW264.7 cells and the aorta of apoE-/-mice was determined by RT-qPCR and Western blot.RESULTS:Significantly reduced HINT2 expression was observed in PBMCs from patients with acute coronary syndrome,which was negatively correlated with pro-inflammatory and positively correlated with anti-inflammatory serum factors,suggesting HINT2's potential role in mitigating AS-related inflammation.In vitro experiments demonstrated that HINT2 overexpression inhibited lipid accumu-lation and foam cell formation in macrophages induced by oxidized low-density lipoprotein(ox-LDL).It also reduced se-cretion of inflammatory cytokines,including interleukin-6(IL-6),IL-1β,IL-18 and tumor necrosis factor-α,and de-creased cell death and pyroptosis-related protein expression.In vivo experiments in apoE-/-mice confirmed that HINT2 overexpression lessened plaque burden in the aortic root,reduced macrophage foaminess,and inhibited the expression of pyroptosis-related proteins such as nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3),caspase-1,gasdermin D(GSDMD),IL-1β and IL-18.CONCLUSION:HINT2 potentially inhibits ox-LDL-induced macrophage pyroptosis,attenuates inflammatory responses in AS,and may slow the progression of this disease.

Objective To investigate the serum levels of semaphorin 3E(Sema3E)in patients with intracranial aneurysms,revealing the correlation between Sema3E and 1-month poor prognosis after interventional embolization.Methods This study was a prospective single-center cohort study,recruiting 102 consecutive patients with intracranial aneurysms who underwent interventional surgery from June 2020 to January 2022 in our hospital.Among them,11 patients were excluded.Clinical and radiological profiles were collected.Peripheral blood was collected after admission,and serum Sema3E levels were determined by enzyme-linked immunosorbent assay.All the aneurysms were treated with endovascular coil embolization or stent-assisted coil embolization.The primary outcome was evaluated with the Glasgow Outcome Scale(GOS)1 month after interventional therapy.The favorable outcome was defined as a GOS score of 4-5,and a poor outcome was defined as a GOS score of 1-3(severe disability,vegetative state,or death).Univariate and multivariate logistic regression analyses were used to identify potential prognostic factors after interventional therapy.Results The average age of 91 patients with intracranial aneurysm was 59.9±11.0 years old,including 70 cases(76.9%)with favorable prognosis and 21 cases(23.1%)with poor prognosis.The mean preoperative Glasgow Coma Scale(GCS)score of the poor prognosis group(9.4±4.5)was significantly lower than that of the favorable prognosis group(13.3±2.5;P<0.001).In the poor prognosis group,the Hunt-Hess grade(3.6±0.6 vs.2.0±1.3,P<0.001)and the serum Sema3E levels[(6.21±1.58)μg/L vs.(4.38±1.77)μg/L,P<0.001]were significantly higher than those in the favorable prognosis group.Logistic regression analysis showed the Hunt-Hess grade(OR =7.150,P =0.003),stent-assisted coil embolization(OR =15.777,P =0.010),and the serum Sema3E level(OR =1.756,P =0.027)were independent prognostic factors for intracranial aneurysms after interventional therapy.Conclusions The serum Sema3E level is closely correlated with the severity of intracranial aneurysms.The serum Sema3E level is a prognostic factor for interventional treatment,which can be used as a biomarker for predicting poor outcomes.

This paper elucidates the connotation and extension of the concept of "impending illness" from the perspective of logic. The connotation of impending illness refers to the intermediate state between health （not yet sick） and disease （already sick）， characterized by the initial instability of yin and yang or a low-level balance of yin and yang as its internal mechanism， and mild dysfunctions in physiological， psychological， and social functions as its manifestations. The extension of impending illness includes latent disease status and pre-disease status. By adopting a creative hermeneutic approach to explore the deep-seated connotations of impending illness， this paper systematically analyzes the concept of impending illness from five levels： the existential level， the intentional level， the implicational level， the situational level， and the necessitational level， arguing that impending illness represents the unity of ambiguity and precision， the deviation of the human body system from homeostasis within a certain range， and an important component of the improvement of the traditional Chinese medicine health management system. Thoroughly explicating and clarifying the concept of "impending illness" can provide theoretical references for the study of transitional states between health and disease and the improvement of the traditional Chinese medicine health management system.

AIM:To observe the effect of Pingwei capsule on the precancerous lesions of gastric cancer(PLGC)cell model induced by N-methyl-N'-nitro-N-nitrosoguanidine(MNNG),and to preliminarily explore its mecha-nism.METHODS:Blank serum and Pingwei capsule-containing serum were prepared for later use.A PLGC cell model was established by MNNG-induced human gastric mucosal epithelial cell line GES-1.To evaluate the model,cell morpho-logical changes were observed under inverted microscope,and the expression of proliferating cell-related antigen Ki67 was detected by immunofluorescence staining.CCK-8 assay was used to screen the optimal intervention concentration and time of serum containing drugs.Reactive oxygen species(ROS)content in cells was detected using a fluorescent probe DCFH-DA.Malondialdehyde(MDA)content was detected by ELISA,and the activity of superoxide dismutase(SOD)and gluta-thione peroxidase(GSH-Px)was detected using biochemical reagents.A novel fluorescent probe JC-10 was used to detect mitochondrial membrane potential.The mRNA expression levels of Ki67 and melanoma differentiation-associated gene-7(MDA-7)were detected by real-time fluorescence quantitative PCR.The protein expression levels of Ki67,interleukin-6(IL-6)and MDA-7 were detected by Western blot.RESULTS:Compared with normal group,the ROS and MDA levels in model group and blank serum group were significantly increased(P<0.01),while the activity of SOD and GSH-Px was significantly decreased(P<0.01).The mitochondrial membrane potential was significantly decreased(P<0.01).The protein expression levels of Ki67 and IL-6 were significantly increased(P<0.01),while the protein expression level of MDA-7 was significantly decreased(P<0.01).There were no significant differences of the above indicators between model group and blank serum group(P>0.05).Compared with blank serum group,the Pingwei capsule-containing serum group showed significantly decreased ROS and MDA levels(P<0.01),significantly increased activity of SOD and GSH-Px(P<0.05),significantly increased mitochondrial membrane potential(P<0.01),significantly decreased protein expres-sion levels of Ki67 and IL-6(P<0.01),and significantly increased protein and mRNA expression levels of MDA-7(P<0.01).CONCLUSION:Pingwei capsule can significantly alleviate MNNG-induced oxidative damage and inflammatory response,and regulate the expression of oncogenes and tumor suppressor genes,thereby playing a role in prevention and treatment of PLGC.

Objective:To investigate the association of urinary cadmium levels with peripheral leukocyte classification counts among middle-aged and older adults aged 40 to 89 years in selected areas of China.Methods:The research was based on the survey of the impact of soil quality of agricultural land on human health in typical areas conducted in 2019-2020. A total of 5 600 middle-aged and older adults aged 40 to 89 years were included by using a multi-stage stratified random sampling method. Baseline characteristics of the subjects were collected and physical examinations were performed. Random midstream urine was collected to measure urinary cadmium and urinary creatinine and fasting venous blood was collected to measure the leukocyte count, neutrophil count, lymphocyte count, monocyte count and eosinophil count. The linear mixed effect model was used to analyse the association of urinary cadmium levels with leukocyte classification counts, and the dose-response relationship between them was analyzed by using the restricted cubic spline (RCS) function.Results:The age of the subjects was (63.17±12.02) years; 2 851 (50.91%) were males; and the M ( Q 1, Q 3) of urinary creatinine-corrected urinary cadmium levels was 2.69 (1.52, 4.69) μg/g·creatinine. After adjusting for confounding factors, the results of linear mixed effects model analysis showed that for each 1-unit increase in urinary creatinine-corrected urinary cadmium level, the percentage change [% (95% CI)] of leukocyte count and lymphocyte count was -1.70% (-2.61%, -0.79%) and -1.57% (-2.86%, -0.26%), respectively. RCS function showed a negative linear relationship between urinary creatinine-corrected urinary cadmium levels and leukocyte counts and lymphocyte counts, respectively (all Pnon-linear>0.05). Conclusion:Urinary cadmium levels are negatively associated with leukocyte count and lymphocyte count among middle-aged and older adults aged 40 to 89 years in selected areas of China.

Robotic surgery is known as the"third technological revolution"in the field of surgery,and is an important milestone in the development of modern surgery.However,our country's innovative surgical robot industry is still in its early stages,and it is only being utilized in certain surgical fields.To explore the effectiveness of the application of do-mestic surgical robot in oral and maxillofacial surgery,the author successfully completed a case of benign parotid tumor resection with the assistance of a domestic autonomous robot.The operation was successful,facial nerve function was preserved,and postoperative wound healing was good.

Macrophages have strong plasticity and heterogeneity,and can undergo functional transformation in response to different signal stimuli,such as classical activation of M1 type(M1 type polarization)and selective activation of M2 type(M2 type polarization).The pathways of macrophage M1/M2 polarization are quite extensive,involving nuclear factor-κB(NF-κB)/mitogen-activated protein kinase(MAPK)signaling pathway,interleukin-4(IL-4)/signal transduction and activator of transcription 6(STAT6)signaling pathway,Notch signaling pathway,Wnt/β-catenin signaling pathway,etc.At the same time,M1/M2 polarization of macrophages is also regulated by exosomes,metabolites,non-coding RNA,electrical stimulation,probiotics,etc.,and its imbalance is closely related to the occurrence and development of different types of liver disease.In this paper,the mechanism of its polarization was reviewed,and it was found that M1 polarization of macrophages played a promoting role in the process of liver tissue injury,inflammation and fibrosis,while M2 polarization of macrophages played the opposite role.Among them,hepatocellular carcinoma,as the advanced stage of chronic liver disease,was characterized by increased M2 polarization and impaired M1 polarization of macrophages.Therefore,this paper pays attention to the role of M1/M2 polarization of macrophages in different types of liver diseases,in order to better establish the targeted therapy of macrophage subsets.

Objective To explore the impact of bisphenol A(BPA)exposure on liver lipid metabolism in C57BL/6J mice and uncover the mechanisms at work.Methods Male C57BL/6J mice,aged eight weeks,were stratified into six cohorts:a control group on a standard diet(ND),a group on a standard diet with low-dose BPA(BPA-50 ND),a group on a standard diet with high-dose BPA(BPA-500 ND),a control groupon a high-fat diet(HFD),a group on a high-fat diet with low-dose BPA(BPA-50 HFD),and a group on a high-fat diet with high-dose BPA(BPA-500 HFD).Dosages for the low-and high-dose BPA groups were 50 and 500 μg/(kg·d),respectively,administered via gavage over a duration of 12 weeks.Hepatic tissue underwent histological examination through he-matoxylin and eosin(HE)staining.Furthermore,the expression levels of miR-122-5p and miR-143-3p in hepatic tissue,in addition to interleukin(IL)-6 and IL-10 in peripheral serum,were quantitatively measured employing quantitative reverse transcription-polymerase chain reaction(qRT-PCR)and enzyme-linked immunosorbent assay(ELISA),respectively.Results Histopathological analysis via HE staining indicated intact hepatic lobule archi-tecture in the ND group,whereas other groups displayed variable degrees of lipid droplet accumulation and damage to hepatic lobules.Notably,supplementation with BPA,particularly in conjunction with a high-fat diet,led to a progressive increase in IL-6 levels and a decrease in IL-10 levels in peripheral blood.In the context of a standard diet,an augmentation in BPA concentration corresponded with a decline in the expression of miR-122-5p and miR-143-3p.Conversely,within the high-fat diet cohort,enhanced BPA concentrations were associated with increased expressions of these microRNAs.Pearson correlation analysis disclosed a significant positive correlation between the expression of miR-122-5p and miR-143-3p and the level of IL-10 in the standard diet group(P＜0.01).In the high fat diet group,the expression level of miR-122-5p was positively correlated with the concentration of IL-6(P＜0.05),and the expression level of miR-143-3p was negatively correlated with the concentration of IL-10(P＜0.05).Conclusion BPA can induce the occurrence and progression of nonalcoholic fatty liver disease(NAFLD)by regulating the expression of miR-122-5p and miR-143-3p and regulating the levels of inflammatory factors IL-6 and IL-10.