Objective To explore the related risk factors of osteosarcopenia (OS) in elderly patients with type 2 diabetes mellitus (T2DM) and to evaluate their predictive value. Methods We selected 409 elderly patients with T2DM from our hospital between June 2021 and December 2024 as the study subjects, and divided them into an OS occurrence group and a non-occurrence group based on whether they were diagnosed with OS. Results Among the 409 elderly patients with T2DM included, 93 were diagnosed with OS, yielding a prevalence rate of 22.73%. Spearman correlation analysis revealed a significant association between lumbar spine BMD and T-scores with age, history of previous fractures, fasting plasma glucose (FPG), procollagen type I N-terminal propeptide (PINP), osteocalcin (OC), and 25-hydroxyvitamin D (25(OH)D). Gender (OR=0.193), Body Mass Index (BMI) (OR=0.254), history of previous fractures (OR=8.883), FPG (OR=0.543), Total Cholesterol (TC) (OR=3.684), High-Density Lipoprotein Cholesterol (HDL-C) (OR=86.024), PINP (OR=0.818), and OC (OR=0.526) are identified as influential factors for the occurrence of OS in elderly patients with T2DM. The combined prediction of these variables yields a sensitivity of 96.5%, a specificity of 97.8%, and an area under the curve (AUC) of 0.992 for the occurrence of OS in elderly patients with T2DM, indicating an excellent predictive performance. Conclusion The following factors—gender, BMI, history of previous fractures, FPG, TC, HDL-C, PINP, and OC—are influential in the occurrence of OS among elderly patients with T2DM. Formulating intervention measures based on these influencing factors can provide assistance in preventing and treating the occurrence of OS.

Objective:To investigate the effect of ear acupoint bean pressing on gastrointestinal motility and related hormones after laparoscopic surgery in patients with hysteromyoma,and to explore the therapeutic mechanism of ear acupoint bean pressing.Methods:Patients undergoing laparoscopic myomectomy in the Department of Gynecology of The People's Hospital Affiliated to Fujian Univer-sity of Traditional Chinese Medicine from May 2022 to December 2023 were randomly divided into an experimental group and a control group,with 57 patients in each group.The experimental group was treated with postoperative routine nursing and ear acupoint bean pressing(targeting the spleen,stomach,and sympathetic),and the control group was treated with postoperative routine nursing and sham ear acupoint bean pressing(containing no Vaccaria seed,targeting the spleen,stomach,and sympathetic).After the intervention,the time to first postoperative passing of flatus and defecation,clinical efficacy,and changes in gastrointestinal hormone levels were compared between the two groups.Results:The time to first postoperative passing of flatus[20.31(17.52,22.38)h vs.21.51(18.53,28.15)h]and defecation[35.32(31.47,39.17)h vs.38.12(33.44,42.78)h]in the experimental group was lower than that in the control group(P<0.05),and the clinical efficacy was better than that in the control group(P<0.05).There were no significant differ-ences in motilin(MTL),gastrin(GAS),somatostatin(SS),and substance P(SP)levels between the two groups before operation(P>0.05).The MTL and GAS levels were increased and the SS and SP levels were decreased after operation.The MTL[(451.52±54.33)pg/mL vs.(476.24±56.35)pg/mL]and GAS[150.50(133.93,164.52)pg/mL vs.173.44(154.45,184.63)pg/mL]levels at 24 h after operation in the experimental group were lower than those in the control group(P<0.05),and the SS[38.34(33.24,40.23)pg/mL vs.33.36(29.13,38.76)pg/mL]level at 24 h after operation was higher than that in the control group(P<0.05),with no significant change in the SP level(P>0.05).The results of repeated measures analysis of variance and generalized estimation equation showed that there were significant differences in the time effect and interaction effect of MTL(P<0.05),a significant difference in the time effect of SP(P<0.05),and significant differences in the time effect,intergroup effect,and interaction effect of GAS and SS(P<0.05).Conclusion:Ear acupoint bean pressing has significant effect on abdominal distension after laparoscopic surgery in patients with hysteromyoma,ef-fectively regulates the level of gastrointestinal motility related hormones,and promotes the recovery of gastrointestinal function.

Fractures requiring surgical intervention during pregnancy is rarely seen in clinic,and these patients need special treatment and nursing,necessitating the consideration of both maternal fracture repair and fetal safety.For patients in late pregnancy,they have higher risk of complications,such as premature birth,placental abruption,venous thromboembolism(VTE),and anesthesia-relat-ed manifestations during the perioperative period.This article reported a case of a patient at 28 weeks of gestation with medial and lateral malleolar fractures accompanied by ankle joint subluxation and summarized the successful experience of collaboration by a multidisciplinary team(MDT).In terms of nursing,personalized body position management was implemented to relieve inferior vena cava com-pression;a phased analgesic strategy combining nerve block with drugs safe for the fetus was adopted;continuous electronic fetal heart rate and uterine contraction monitoring were carried out to ensure fetal stability during surgery;VTE prevention was strengthened by combining intermittent pneumatic com-pression devices with low-molecular-weight heparin;nutritional support and psychological counseling were provided.No complications such as infection,thrombosis,or fetal distress occurred after surgery.The Patient's ankle Kofoed score reached 88 points three months after surgery,indicating good func-tional recovery.Finally,the patient delivered a healthy male infant at full term,with a good Apgar score,and both the mother and the infant were safe.The case indicates that refined perioperative nursing combined with multidisciplinary collaboration can effectively reduce risks and improve the clinical outcomes of pregnant patients with fractures.

Natural products (NPs) are an important source of new drugs for the treatment of stroke. Identifying cellular targets for bioactive molecules is a major challenge and critical issue in the development of new drugs for stroke. Small-molecule probes play a unique role in target discovery. However, drawbacks to these probes include non-specificity, unstable activity, and difficulty in synthesis. Small-molecule probes based on NPs at least partially compensate for these shortcomings. NPs feature rich chemical and structural diversity, biocompatibility, and unique biological activities. These features could be exploited to provide new ideas and tools for target discovery. Small-molecule probes based on NPs provide a precise and direct search for interacting protein targets of NPs-active small molecules. This review explores the properties of small-molecule probes based on NPs and their applications in mechanistic studies of stroke and other diseases. We hope that this review will bring new perspectives to the mechanistic study of NPs-active small molecules and accelerate the translation of these ingredients into drug candidates for the treatment of stroke.

OBJECTIVE To evaluate the clinical value of dose-escalated postoperative radiotherapy(PORT)in improving local control and survival outcomes for head and neck adenoid cystic carcinoma(ACC)patients.METHODS This retrospective study analyzed 336 ACC patients treated with surgery plus PORT at Beijing Tongren Hospital from January 2015 to January 2021.Cohort stratification compared high-dose(>60 Gy,n=146)and conventional-dose(≤60 Gy,n=190)regimens.Survival analysis employed Kaplan-Meier estimates with log-rank testing,complemented by multivariate Cox regression for risk adjustment.RESULTS The cohort demonstrated 39.29%(132/336)cumulative local failure rate.The overall survival rates at 1,3,and 5 years after surgery were 98.81%,94.05%,and 90.48%,respectively.Dose-response relationships revealed:1.Significantly reduced local recurrence with high-dose PORT(28.08%vs.47.89%,P<0.001),corresponding to 41.37%lower recurrence risk(a HR=0.59,95%CI=0.38-0.91;P=0.041);2.Superior progression-free survival in the high-dose group(3-year:86.99%vs.76.32%;5-year:82.19%vs.66.32%,all P<0.05);3.Comparable overall survival between groups(median OS:200 vs.160 months,P=0.292).CONCLUSION Dose escalation beyond 60 Gy significantly enhances locoregional control and progression-free survival in head and neck ACC without conferring overall survival advantage,likely reflecting the disease's characteristic indolent metastatic progression.These results establish>60 Gy as an optimal dose threshold for PORT in high-risk ACC management.

Objective To investigate the clinical characteristics,treatment strategies,and prognostic factors of adenoid cystic carcinoma(ACC)of the external auditory canal(EAC),and to provide evidence for optimizing surgical extent and adjuvant therapy.Methods A retrospective cohort study was conducted on 58 patients with pathologically confirmed ACC of the EAC treated in Department of Otorhinolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,between January 2001 and December 2021.All patients underwent surgical treatment,with some receiving adjuvant radiotherapy.The primary outcome was local recurrence,while secondary outcomes included overall survival(OS)and local recurrence-free survival(LRFS).Survival analysis was performed by the Kaplan-Meier method,and Cox regression models were used to identify risk factors for recurrence.Results The median follow-up time for the entire cohort was 6.27(3.25,11.30)years.The 1-year,3-year,and 5-year OS rates were 96.55％,91.37％,and 89.66％.43.10％of cases were classified as T4 stage at diagnosis,indicating advanced local progression.Local recurrence occurred in 23 patients(39.66％),and distant metastasis was observed in 28 patients(48.28％),with pulmonary metastasis accounting for 92.86％of cases.Multivariate analysis revealed that the solid histological pattern(HR=2.729,95％CI:1.025-7.226,P=0.044)and perineural invasion(PNI)(HR=9.891,95％CI:3.525-27.752,P＜0.01)were independent risk factors for local recurrence.Conclusion ACC of the EAC is characterized by a high propensity for local recurrence and distant metastasis.The solid histological pattern and perineural invasion are critical prognostic determinants.Multimodal therapy(surgery combined with adjuvant radiotherapy)may improve clinical outcomes,and early diagnosis and intervention are pivotal for enhancing survival rates.

The formation of bacterial biofilm imposes a formidable challenge to public health.Quorum sensing(QS),as a bacterial communication system with the capacity to sense bacterial density and modulate gene expres-sion,can regulate the formation of bacterial biofilm by regulating the secretion of bacterial basic substances and extracellular proteins and affecting the bacterial motility.At present,some QS inhibitors(QSI)from natural sources and synthesized QSI have become potential choice for treatment of bacterial infections for their inhibiting the formation of bacterial biofilm through inhibition of QS signaling pathways.The article focuses on the progress of research on the effects of QS and QSI on the formation of bacterial biofilm.

Objective To investigate the clinical characteristics,treatment strategies,and prognostic factors of adenoid cystic carcinoma(ACC)of the external auditory canal(EAC),and to provide evidence for optimizing surgical extent and adjuvant therapy.Methods A retrospective cohort study was conducted on 58 patients with pathologically confirmed ACC of the EAC treated in Department of Otorhinolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,between January 2001 and December 2021.All patients underwent surgical treatment,with some receiving adjuvant radiotherapy.The primary outcome was local recurrence,while secondary outcomes included overall survival(OS)and local recurrence-free survival(LRFS).Survival analysis was performed by the Kaplan-Meier method,and Cox regression models were used to identify risk factors for recurrence.Results The median follow-up time for the entire cohort was 6.27(3.25,11.30)years.The 1-year,3-year,and 5-year OS rates were 96.55％,91.37％,and 89.66％.43.10％of cases were classified as T4 stage at diagnosis,indicating advanced local progression.Local recurrence occurred in 23 patients(39.66％),and distant metastasis was observed in 28 patients(48.28％),with pulmonary metastasis accounting for 92.86％of cases.Multivariate analysis revealed that the solid histological pattern(HR=2.729,95％CI:1.025-7.226,P=0.044)and perineural invasion(PNI)(HR=9.891,95％CI:3.525-27.752,P＜0.01)were independent risk factors for local recurrence.Conclusion ACC of the EAC is characterized by a high propensity for local recurrence and distant metastasis.The solid histological pattern and perineural invasion are critical prognostic determinants.Multimodal therapy(surgery combined with adjuvant radiotherapy)may improve clinical outcomes,and early diagnosis and intervention are pivotal for enhancing survival rates.

The formation of bacterial biofilm imposes a formidable challenge to public health.Quorum sensing(QS),as a bacterial communication system with the capacity to sense bacterial density and modulate gene expres-sion,can regulate the formation of bacterial biofilm by regulating the secretion of bacterial basic substances and extracellular proteins and affecting the bacterial motility.At present,some QS inhibitors(QSI)from natural sources and synthesized QSI have become potential choice for treatment of bacterial infections for their inhibiting the formation of bacterial biofilm through inhibition of QS signaling pathways.The article focuses on the progress of research on the effects of QS and QSI on the formation of bacterial biofilm.

Objective: To explore and validate the potential targets of Paeoniae Radix Alba (P. Radix, Bai Shao) in protecting against chemical liver injury through network pharmacology, molecular docking technology, and in vitro cell experiments. Methods: Network pharmacology was used to identify the common potential targets of P. Radix and chemical liver injury. Molecular docking was used to fit the components, which were subsequently verified in vitro. A cell model of hepatic fibrosis was established by activating hepatic stellate cell (HSC)-LX2 cells with 10 ng/mL transforming growth factor-β1. The cells were exposed to different concentrations of total glucosides of paeony (TGP), the active substance of P. Radix, and then evaluated using the cell counting kit-8 assay, enzyme-linked immunosorbent assay, and western blot. Results: Analysis through network pharmacology revealed 13 key compounds of P. Radix, and the potential targets for preventing chemical liver injury were IL-6, AKT serine/threonine kinase 1, jun proto-oncogene, heat shock protein 90 alpha family class A member 1 (HSP90AA1), peroxisome proliferator activated receptor gamma (PPARG), PTGS2, and CASP3. Gene Ontology (GO) enrichment analysis indicated the involvement of response to drugs, membrane rafts, and peptide binding. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis revealed that the main pathways involved lipid and atherosclerosis and chemical carcinogenesis-receptor activation. Paeoniflorin and albiflorin exhibited strong affinity for HSP90AA1, PTGS2, PPARG, and CASP3. Different concentrations of TGP can inhibit the expression of COL-Ⅰ, COL-Ⅲ, IL-6, TNF-α, IL-1β, HSP-90α, and PTGS2 while increasing the expression of PPAR-γ and CASP3 in activated HSC-LX2 cells. Conclusion P. Radix primarily can regulate targets such as HSP90AA1, PTGS2, PPARG, CASP3. TGP, the main active compound of P. Radix, protects against chemical liver injury by reducing the inflammatory response, activating apoptotic proteins, and promoting the apoptosis of activated HSCs.