Objective To investigate the regulatory mechanism of the central nervous system in patients with refractory overactive bladder (rOAB) using diffusion tensor imaging (DTI) and graph theory analysis. Methods A total of 43 rOAB patients (rOAB group) and 46 matched healthy controls (HC group) were recruited during May and Nov.2024. All participants were scanned with DTI, and surveyed with the overactive bladder symptom score (OABSS), and overactive bladder questionnaire (OAB-q). Their age, gender, height, weight, and educational years were collected.DTI plus graph theory analysis was employed to explore the alterations in global and local topological properties of the brain structural network in rOAB patients. Brain regions showing significant group differences in structural metrics [specifically, the right paracentral lobule (PCL.R) ]were further used as seed points for functional connectivity (FC) analysis. Correlations between the nodal clustering coefficient (NCp) of the identified region, FC strength, OABSS, and OAB-q score were investigated. Results The OABSS [8 (6,10) vs.0 (0,1) ]and OAB-q [71 (53,80) vs.20 (19,24) ]were higher in the rOAB group than the HC group (P<0.001). Graph theory analysis revealed no statistically significant differences in global network metrics between the two groups (P>0.05). However, the NCp was significantly higher in the PCL.R of rOAB group compared to HC group (P<0.05, FDR-corrected).FC analysis using the PCL.R as a seed region demonstrated significantly reduced FC value in the left cerebellar crus Ⅱ (Cerebelum_Crus2_L) of the rOAB group (P<0.05, FDR-corrected). Partial correlation analysis showed that the NCp of PCL.R was positively correlated with both OABSS (r=0.255, P=0.018) and OAB-q score (r=0.257, P=0.017). Conversely, the FC of Cerebelum_Crus2_L was significantly negatively correlated with OABSS (r=-0.545, P<0.001) and OAB-q score (r=-0.535, P<0.001). Conclusion Patients with rOAB exhibit distinct brain structural network alterations compared to healthy individuals, primarily manifestation in the NCp value of PCL.R increased, and the FC intensity of Cerebelum_Crus2_L is significantly weakened. These alterations in the topological properties of the structural network may be implicated in the pathogenesis of rOAB.

Objective:To investigate the role of heat shock transcription factor 1(HSF1)in hepatitis B virus X protein(HBx)-driven migration and invasion of hepatocellular carcinoma(HCC)cells,and to preliminarily explore the mechanism of HSF1 mediating HBx-driven HCC progression.Methods:4D label-free quantitative proteomics and Western blot were used to analyze the effect of HBx on HSF1 expression.HBx was overexpressed in the HCC cell lines Huh7 and MHCC97H,and its impact on the mRNA and protein levels and stability of HSF1 was assessed by RT-PCR and Western blot.The Cancer Genome Atlas database was used to analyze the expres-sion of HSF1 in hepatitis B virus(HBV)-associated HCC tissues and its relationship with tumor stage/grade and patient prognosis,and Western blot was used to measure the expression of HSF1 in HBV-associated HCC tissues.HBx was overexpressed in HCC cells,fol-lowed by HSF1 knockdown or cell treatment with the HSF1 inhibitor KRIBB11,and Transwell migration and invasion assay,scratch as-say,and F-actin staining experiment were performed to analyze the role of HSF1 in HBx-driven HCC cell migration and invasion.GEO and HCMDB datasets were used to identify the downstream target of HSF1,and the role of downstream target c-Myb in HSF1-me-diated HBx-driven HCC progression.Results:HBx upregulated HSF1 protein levels without significantly affecting its mRNA expres-sion,through enhancing HSF1 protein stability.HSF1 was highly ex-pressed in HBV-associated HCC tissues,and its elevated expres-sion correlated with tumor stage/grade and poor prognosis.HBx overexpression significantly promoted the migration,invasion,wound-healing capacity,and pseudopodia formation capacity of Huh7 and MHCC97H cells,while HSF1 knockdown or KRIBB11 treatment significantly attenuated the HBx-driven migration and in-vasion of HCC.HSF1 promoted the expression of the metastasis-associated protein c-Myb,and c-Myb overexpression in HSF1-knock-down HCC cells restored the promotive effect of HBx on HCC cell migration and invasion.Conclusion:HBx enhances HSF1 protein stability to promote its expression.Upregulation of c-Myb by HSF1 plays a pivotal role in HBx-driven HCC cell migration and inva-sion.Targeting HSF1 may help to delay the progression of HBV-associated HCC.

Objective To investigate the clinical features of thyroid dysfunction in lung cancer patients treated with programmed cell death receptor-1(PD-1)or programmed cell death receptor-ligand 1(PD-L1)and their value for predicting therapeutic efficacy.Methods Lung cancer patients treated with PD-1/PD-L1 inhibitors at West China Hospital,Sichuan University between March 2018 and September 2022 were retrospectively enrolled.Data concerning the medical records,therapeutic efficacy,and thyroid function indicators of the patients were retrieved from the hospital electronic medical record information system.The data were then analyzed to identify risk factors and predictive factors for immune-related adverse events(irAEs)of the thyroid.The predictive value of thyroid irAEs for treatment efficacy and prognosis was assessed.Objective response rate(ORR)was defined as the indicator for therapeutic efficacy and progression-free survival(PFS)was defined as the prognostic indicator.Results A total of 368 lung cancer patients were enrolled.Among them,31.5％(116/368)developed thyroid irAEs.According to the results of logistic regression analysis,baseline thyroid stimulating hormone(TSH)concentration and baseline positive results for thyroglobulin antibody(TGAb)and thyroid peroxidase antibody(TPOAb)were risk factors for thyroid dysfunction caused by PD-1/PD-L1 inhibitors.Among the three measures,baseline TPOAb concentration demonstrated good predictive value for thyroid irAEs,with an area under the receiver-operating characteristic(ROC)curve(AUC)of 0.745.Patients with thyroid irAEs had a longer median PFS(16.0 months vs.9.7 months,P＜0.001)and a higher ORR(55.2％vs.34.9％,P＜0.001)compared to those without thyroid irAEs.Patients with thyroid irAEs had a better ORR than those without thyroid irAEs did.It was more likely for patients with thyroid irAEs to achieve an objective response compared to those without thyroid irAEs(odds ratio[OR]=2.29;95％CI,1.46-3.60).Conclusion In lung cancer patients treated with the PD-1/PD-L1 inhibitors,the TPOAb antibody demonstrates good predictive value for thyroid irAEs.Patients who develop thyroid irAEs have better treatment outcomes and prognosis.

Objective To observe the effect of a Jianpi Huayu Jiedu formula on the NLRP3-mediated pyroptosis pathway in gastric precancerous lesion(GPL)associated with Helicobacter pylori(Hp)infection.Methods A GPL mouse model was prepared using Hp suspension gavage combined with Atp4a gene-deficient mice.The Jianpi Huayu Jiedu formula was administered as an intervention.Gastric mucosal tissue pathological damage was observed using hematoxylin and eosin(HE)staining.The presence of intestinal metaplasia(IM)was assessed using Alcian Blue-Periodic Acid Schiff(AB-PAS)staining.Ultrastructural changes in cell organelles were observed using transmission electron microscopy.Enzyme-linked immunosorbent assay(ELISA)was used to measure levels of gastrin-17(G-17),pepsinogen I(PGI),and proinflammatory cytokines IL-1β and IL-18.The expression of molecules related to the pyroptosis pathway was detected using Western blot and real-time quantitative PCR(RT-qPCR).Results Compared to the control group,Hp-related GPL mice exhibited gastric mucosal atrophy accompanied by IM and dysplasia.Damage to mitochondria and endoplasmic reticulum in parietal cells was observed.Levels of G-17,PGI,and proinflammatory cytokines IL-1β and IL-18 were elevated.The expression of molecules related to the pyroptosis pathway was increased.The Jianpi Huayu Jiedu formula significantly reduced gastric mucosal tissue pathological damage in GPL mice,decreased G-17 and PGI levels,mitigated inflammatory responses,and downregulated the expression of molecules related to the pyroptosis pathway.Conclusion The Jianpi Huayu Jiedu formula may exert its effects by inhibiting the NLRP3-mediated pyroptosis signaling pathway,thereby alleviating or even reversing the pathological damage of gastric mucosa in Hp-related GPL.

Objective To evaluate the efficacy of four-dimensional traction in elderly patients with degenera-tive lumbar spinal stenosis(DLSS),focusing on changes in lumbar muscle morphology and mechanical properties.Methods Elderly patients with DLSS admitted to the Second Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2022 to February 2024 were enrolled.Based on the treatment method,they were categorized into the study group(muscle exercise combined with four-dimensional traction,n=40)and the control group(routine muscle exercise,n=40).All participants underwent a 4-week treatment regimen and subsequently received multimodal ultrasound examinations.The morphology and mechanical properties of the lumbar muscle group,lumbar range of motion,walking distance in intermittent claudication,Visual Analogue Scale(VAS),and Oswestry Disability Index(ODI)scores were compared between the two groups.Results After treatment,the study group exhibited significantly greater improvements in multifidus muscle thickness,circumference,cross-sectional area,pressure pain threshold,and lumbar range of motion(P<0.05).In contrast,the shear wave velocity(SWV),Young's modulus,muscle tension,and flexion-extension ratio of the multifidus muscle were significantly lower in the study group(P<0.05).Additionally,the walking distance in intermittent claudication for the study group was markedly longer(P<0.05).During the 12-month follow-up period after treatment,the VAS and ODI scores of the study group remained significantly lower(P<0.05).Conclusion Four-dimensional traction in combination with muscle exercise can effectively alleviate clinical symptoms,enhance muscle function,and improve mechanical properties in elderly patients with DLSS.

Objective To observe the effect of a Jianpi Huayu Jiedu formula on the NLRP3-mediated pyroptosis pathway in gastric precancerous lesion(GPL)associated with Helicobacter pylori(Hp)infection.Methods A GPL mouse model was prepared using Hp suspension gavage combined with Atp4a gene-deficient mice.The Jianpi Huayu Jiedu formula was administered as an intervention.Gastric mucosal tissue pathological damage was observed using hematoxylin and eosin(HE)staining.The presence of intestinal metaplasia(IM)was assessed using Alcian Blue-Periodic Acid Schiff(AB-PAS)staining.Ultrastructural changes in cell organelles were observed using transmission electron microscopy.Enzyme-linked immunosorbent assay(ELISA)was used to measure levels of gastrin-17(G-17),pepsinogen I(PGI),and proinflammatory cytokines IL-1β and IL-18.The expression of molecules related to the pyroptosis pathway was detected using Western blot and real-time quantitative PCR(RT-qPCR).Results Compared to the control group,Hp-related GPL mice exhibited gastric mucosal atrophy accompanied by IM and dysplasia.Damage to mitochondria and endoplasmic reticulum in parietal cells was observed.Levels of G-17,PGI,and proinflammatory cytokines IL-1β and IL-18 were elevated.The expression of molecules related to the pyroptosis pathway was increased.The Jianpi Huayu Jiedu formula significantly reduced gastric mucosal tissue pathological damage in GPL mice,decreased G-17 and PGI levels,mitigated inflammatory responses,and downregulated the expression of molecules related to the pyroptosis pathway.Conclusion The Jianpi Huayu Jiedu formula may exert its effects by inhibiting the NLRP3-mediated pyroptosis signaling pathway,thereby alleviating or even reversing the pathological damage of gastric mucosa in Hp-related GPL.

Objective:To conduct a scoping review on the application of telemedicine in patients with breast cancer-related lymphedema (BCRL), to generalize and summarize the intervention methods, application forms, outcome indicators and effects of telemedicine, so as to provide a reference for healthcare professionals to implement interventions.Methods:Computerized searches of PubMed, Web of Science, Embase, Cochrane Library, CINAHL, China National Knowledge Infrastructure, Wanfang Data, China Biology Medicine disc, and VIP were performed with a search period from their establishment to June 1, 2024. The included articles were screened, summarized and analyzed.Results:A total of 14 papers were included. Telemedicine intervention methods included tele-education, tele-exercise, tele-monitoring, tele-consultation, tele-psychological interventions, tele-visits, and tele-evaluation. Application forms involved web-based cloud platforms, social network service systems, telemedicine APPs, and remote portable monitoring devices. Outcome indicators included physical indicators, psychological indicators, quality of life, incidence of lymphedema, degree of lymphedema symptoms, and feasibility indicators.Conclusions:Telemedicine relies on web-based platforms and social network service software to conduct tele-education, tele-consultation, and tele-exercise for BCRL patients, and its feasibility and effectiveness have been proven. In the future, it is necessary to accelerate the establishment of breast cancer telemedicine centers, optimize the telemedicine service team, and increase the investment in the development of portable lymphedema telemonitoring equipment, so as to build a comprehensive and perfect breast cancer telemedicine system and improve the effectiveness of the prevention and treatment of BCRL.

Objective To evaluate the efficacy of four-dimensional traction in elderly patients with degenera-tive lumbar spinal stenosis(DLSS),focusing on changes in lumbar muscle morphology and mechanical properties.Methods Elderly patients with DLSS admitted to the Second Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2022 to February 2024 were enrolled.Based on the treatment method,they were categorized into the study group(muscle exercise combined with four-dimensional traction,n=40)and the control group(routine muscle exercise,n=40).All participants underwent a 4-week treatment regimen and subsequently received multimodal ultrasound examinations.The morphology and mechanical properties of the lumbar muscle group,lumbar range of motion,walking distance in intermittent claudication,Visual Analogue Scale(VAS),and Oswestry Disability Index(ODI)scores were compared between the two groups.Results After treatment,the study group exhibited significantly greater improvements in multifidus muscle thickness,circumference,cross-sectional area,pressure pain threshold,and lumbar range of motion(P<0.05).In contrast,the shear wave velocity(SWV),Young's modulus,muscle tension,and flexion-extension ratio of the multifidus muscle were significantly lower in the study group(P<0.05).Additionally,the walking distance in intermittent claudication for the study group was markedly longer(P<0.05).During the 12-month follow-up period after treatment,the VAS and ODI scores of the study group remained significantly lower(P<0.05).Conclusion Four-dimensional traction in combination with muscle exercise can effectively alleviate clinical symptoms,enhance muscle function,and improve mechanical properties in elderly patients with DLSS.

Objective:To conduct a scoping review on the application of telemedicine in patients with breast cancer-related lymphedema (BCRL), to generalize and summarize the intervention methods, application forms, outcome indicators and effects of telemedicine, so as to provide a reference for healthcare professionals to implement interventions.Methods:Computerized searches of PubMed, Web of Science, Embase, Cochrane Library, CINAHL, China National Knowledge Infrastructure, Wanfang Data, China Biology Medicine disc, and VIP were performed with a search period from their establishment to June 1, 2024. The included articles were screened, summarized and analyzed.Results:A total of 14 papers were included. Telemedicine intervention methods included tele-education, tele-exercise, tele-monitoring, tele-consultation, tele-psychological interventions, tele-visits, and tele-evaluation. Application forms involved web-based cloud platforms, social network service systems, telemedicine APPs, and remote portable monitoring devices. Outcome indicators included physical indicators, psychological indicators, quality of life, incidence of lymphedema, degree of lymphedema symptoms, and feasibility indicators.Conclusions:Telemedicine relies on web-based platforms and social network service software to conduct tele-education, tele-consultation, and tele-exercise for BCRL patients, and its feasibility and effectiveness have been proven. In the future, it is necessary to accelerate the establishment of breast cancer telemedicine centers, optimize the telemedicine service team, and increase the investment in the development of portable lymphedema telemonitoring equipment, so as to build a comprehensive and perfect breast cancer telemedicine system and improve the effectiveness of the prevention and treatment of BCRL.

Objective: To investigate the willingness to accept preventive treatments and its related factors among college freshmen with latent tuberculosis infection (LTBI), so as to provide the evidence for preventive treatment intervention measures for students with LTBI. Methods: Cluster sampling method was used to select 368 LTBI freshmen from 8 colleges and universities in Changzhou in September 2023, who conducted a questionnaire survey on the willingness to receive preventive treatment. General demographic data were collected and relevant data were collected using tuberculosis knowledge scale, General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Adaptation, Partnership, Growth, Affection and Resolve (APGAR), and a self developed Stigma Scale. A binary Logistic regression model was constructed with the willingness to accept preventive treatment as the dependent variable to analyze the willingness to accept preventive treatment and the influencing factors. Results: A total of 253 LTBI college freshmen were willing to take preventive treatment, the acceptance rate was 68.75%. The rate of willingness to accept preventive treatment for LTBI was higher among students whose fathers had an education level of high school, compared to those whose fathers had an education level of junior high school or below ( OR =2.16, P <0.05). LTBI students whose per capita family income was >5 000-10 000 yuan and >10 000 yuan were more willing to accept LTBI preventive treatment than those whose per capita family income was <3 000 yuan ( OR =2.72, 4.46, P <0.05). LTBI students who engaged in physical exercise for more than 2 hours per week were more willing to accept than those who exercised less than 0.5 hours per week ( OR =1.91, P <0.05). LTBI students with high levels of tuberculosis knowledge and stigma were more likely to receive preventive treatment ( OR =1.18, 1.11, P < 0.05). LTBI students with high PHQ-9 ( OR =0.85) and GAD-7 ( OR =0.92) scores were more likely to refuse preventive treatment ( P <0.05). Conclusion The present study revealed a moderate level of willingness of LTBI students to preventive treatment in Changzhou City, and the acceptance is affected by family factors, healthy lifestyles, tuberculosis knowledge and psychological status.