Colorectal cancer （CRC） is one of the most common cancers， with its incidence ranking high among cancers. It stands as the second leading cause of cancer-related death worldwide. In the early stages， CRC lacks specific symptoms， and most patients are diagnosed at advanced stages， making it a major research focus in the field of gastrointestinal tumors. Currently， clinical CRC treatments face several common challenges， including high surgical risks， frequent metastasis and recurrence， drug resistance， and significant side effects from chemotherapy and radiation therapy. With the development and application of traditional Chinese medicine （TCM）， it has been found that TCM and its active ingredients can effectively inhibit CRC cell proliferation， invasion， migration， and angiogenesis， and promote apoptosis and autophagy， thereby slowing the progression of CRC. This has become a key focus of CRC treatment research. Salvia Miltiorrhiza has multiple pharmacological effects， including activating blood circulation to dispel blood stasis， unlocking meridians to relieve pain， clearing heat to calm irritability， and cooling blood to reduce abscesses. It contains a variety of chemical components， including diterpenoids， phenolic acids， flavonoids， polysaccharides， nitrogen-containing compounds， steroids， and lactone compounds. This review summarized the molecular mechanisms of Salvia miltiorrhiza and its active ingredients in the treatment of CRC. It is found that these ingredients exert anti-CRC effects through various molecular mechanisms， including cell cycle arrest， promotion of apoptosis， inhibition of cell invasion and migration， induction of autophagy， suppression of tumor angiogenesis， and remodeling of the tumor microenvironment. The review aims to provide new insights for the drug development and clinical application of Salvia miltiorrhiza in CRC treatment.

Background/Aims: Acetyl coenzyme A (acetyl-CoA) is one of the most essential metabolites in cell metabolism but its function and concentration in hepatocellular carcinoma (HCC) remain elusive and controversial. Methods: A comprehensive analysis of acetyl-CoA levels and acetyl-CoA synthetase 2 (ACSS2) expression across a range of samples, including patient specimens from both hepatitis B virus (HBV) positive and HBV negative HCC individuals, HBV-transgenic mouse HCC models, and multiple cell lines. Furthermore, to evaluate the functional significance of ACSS2 in HBV-related HCC, we implemented both genetic and pharmacological inhibition strategies targeting ACSS2. Molecular mechanism and mitophagy assessment were revealed by cleavage under target and tagmentation sequencing, RNA sequencing, bioinformatic analyses, transmission electron microscopy and JC-1 staining. Results: Our study revealed a distinct metabolic signature of HBV-related HCC, marked by elevated acetyl-CoA, which was driven by ACSS2. ACSS2 was upregulated by the carbohydrate response element-binding protein in HBV-related HCC. Furthermore, ACSS2 improved tumor cell proliferation, an effect that was dependent on its enzymatic activity. Mechanistically, ACSS2-induced acetyl-CoA accumulation activated voltage-dependent anion channels 1 transcription through increased H3K27ac occupancy, which subsequently promoted mitophagy and HBV-related HCC tumorigenesis. Notably, targeting ACSS2 by depletion or inhibition with a catalytic inhibitor significantly suppressed tumor growth. Conclusions These findings not only illustrate the interplay between metabolic reprogramming, epigenetic modification, and tumorigenesis in the context of HBV infection, but also highlight ACSS2 as a novel metabolic vulnerability in HBV-related HCC. Therefore, targeting ACSS2 could be a novel strategy against HBV-related HCC.

ObjectiveTo evaluate the comparative clinical outcomes of zero-profile interbody fusion （Zero-P） and traditional anterior cervical discectomy and fusion with titanium plate （ACDF-plate） for three-level cervical spondylosis， providing a reference to optimize surgical strategies for three-level cervical spondylosis. MethodsIn this retrospective comparative study， 113 patients were included and assigned to either the Zero-P group （n=51） or the ACDF-plate group （n=62） according to their surgical approaches. Clinical outcomes were evaluated and compared between the two groups using operative time， intraoperative blood loss， length of hospital stay， visual analog scale （VAS） scores， cervical range of motion （ROM）， neck disability index （NDI）， Cervical Disability Index （CDI）， Japanese orthopaedic association （JOA） scores， and postoperative complication rates. ResultsCompared with the ACDF-plate group， the Zero-P group had a shorter operative time and less intraoperative blood loss （P<0.05）； the neck pain VAS score was lower on the 1st day and 1st week after surgery （P<0.05）； the cervical flexion range of motion was higher at 1 month after surgery （P<0.05）； the JOA score was higher at 3 months after surgery， while the NDI and CDI scores were lower （P<0.05）； the total incidence of complications （11.76%） was significantly lower than that in the plate fixation group （35.48%）， and the incidence of neck foreign body sensation/stiffness was lower （P<0.05）. ConclusionZero-P not only demonstrates safety and efficacy comparable to the ACDF-plate， but also highlights the significant value of the minimally invasive concept in facilitating early recovery. Both procedures have their respective emphasis on biomechanical maintenance and minimally invasive benefits， providing a clear evidence-based reference for individualized and precise surgical decision-making in three-level cervical spondylosis.

Objective:To summarize the clinical characteristics of elderly patients with stage Ⅰ diffuse large B-cell lymphoma (DLBCL) and analyze the factors associated with prognosis.Methods:A case series study was conducted by retrospectively collecting clinical data from patients aged over 60 years with newly diagnosed stage Ⅰ DLBCL across 20 medical centers in Jiangsu Province, China, between June 2010 and April 2023. The involved site, classification and treatment plan were summarized. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Statistical analyses were performed using the Kaplan-Meier method, and Cox regression model.Results:The study included 255 patients with a median age of 69 years, of whom 130 (51.0%) were male, 66 (25.9%) were aged ≥75 years and 26 (10.1%) had a high Charlson Comorbidity Index (CCI) score of ≥2. Extranodal involvement was observed in 163 (63.9%) patients, with the stomach (37.4%, 61/163), intestine (19.0%, 31/163), testes (11.0%, 18/163), and breast (7.4%, 12/163) being the most frequently affected sites. The non-germinal center B-cell (non-GCB) subtype was prevalent in 63.7% of patients (142/223), with no significant difference between the nodal and extranodal groups ( P=0.681). Furthermore, 73.9% (184/249) and 11.7% (29/249) of patients received the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and R-miniCHOP regimen, respectively. The overall 3-year PFS rate was 81.5%, and the 3-year OS rate was 85.6%. Patients aged ≥75 years ( HR=2.910, 95% CI 1.565-5.408, P=0.001) and/or with a CCI score ≥2 ( HR=2.324, 95% CI 1.141-4.732, P=0.020) had a significantly poorer PFS. Incorporating age ≥75 years and CCI score ≥2 into the stage-modified international prognostic index (sm-IPI) can better stratify the prognosis of elderly patients with stage Ⅰ DLBCL. The 3-year PFS rate was 48.7% in the high-risk group versus 85.7% in the low-risk group ( P<0.001). Conclusions:Our findings show that the elderly patients with stage Ⅰ DLBCL were predominantly characterized by extranodal involvement (particularly in the stomach and intestinal tract) and non-GCB subtype. Age ≥75 years and CCI ≥2 were identified as independent prognostic factors. The newly established sm-IPI-75-CCI incorporating these factors demonstrated superior prognostic discrimination compared to conventional risk assessment systems.

Objective To investigate alterations in plasma complement levels and white matter imaging characteristics,along with their relationship in patients with first-episode schizophrenia(SCZ).Methods Thirty-eight patients with first-episode schizophrenia and 42 healthy controls were enrolled.Whole-brain diffusion tensor imaging(DTI)was performed using a Philips 3.0 T MRI scanner.Tract-based spatial statistics(TBSS)combined with the Johns Hopkins University(JHU)white matter labels atlas was used to extract and compare white matter characteristics between the two groups.Plasma levels of complement components(C1q,C3,C4,factor B,factor H,and factor P)were measured using the MILLIPLEX? human complement assay kit via multiplex analysis.Spearman correlation analysis was conducted to examine the association between plasma complement levels and white matter features.Results The radial diffusivity(RD)of the left fornix/stria terminalis was significantly higher in the patient group compared to the control group[(0.62±0.04)×10-3mm2/s vs.(0.60±0.03)×10-3mm2/s,PFDR=0.048)].Factor H[677.71(551.58,846.21)ng/mL vs.582.76(513.93,729.71)ng/mL,P=0.041]and factor P[71.36(57.30,95.99)ng/mL vs.60.08(46.67,80.03)ng/mL,P=0.011]were both significantly elevated compared to the control group.Moreover,RD values in the left fornix/stria terminalis were negatively correlated with plasma C3 levels in the patient group(r=-0.362,P=0.025).Conclusion Patients with first-episode schizophrenia exhibit white matter microstructural abnormalities in left fornix/stria terminalis,which are significantly associated with plasma complement levels.

Objective This study aims to explore the application value of spectral CT and perfusion CT parameters in the pathological classification and prognostic assessment of lung cancer.Methods A total of 94 lung cancer patients confirmed by pathology at Shanghai Chest Hospital from January 2023 to November 2024 were included in the study,including 49 cases of lung adenocarcinoma(LUAD),30 cases of lung squamous cell carci-noma(LUSC),and 15 cases of small cell lung cancer(SCLC).All patients underwent spectral CT combined with perfusion scanning using a 256-slice Revolution Apex from GE.Two radiologists independently measured the spectral and perfusion parameters of the three groups of images,including spectral curve slope(K),iodine concentration in the lesion area(ICL),effective atomic number(Zeff),surface permeability(PS),and perfusion index(PI),and established a lung cancer pathological subtype discrimination prediction model based on spectral CT radiomics features.All subjects were randomly divided into a training group and a validation group at a ratio of 3∶1.The discrimination efficacy of the spectral discrimination model between different pathological subtypes and the discrimination efficacy of arterial and venous phase images were compared in multiple dimensions.The performance of the model was evaluated using the receiver operating characteristic(ROC)curve.Results Statistical analysis showed that the spectral curve slope,ICL,NIC,and Zeff of LUAD patients were significantly higher than those of LUSC and SCLC patients(P<0.05),while there were no significant differences in these parameters between LUSC and SCLC patients(P>0.05).Among the perfusion CT parameters,surface permeability(PS)showed significant differences among the three groups(P<0.05),while blood volume(BV),blood flow(BF),perfusion index(PI),time to peak(TTP),and mean transit time(MTT)did not show statistical differences.The multi-factor logistic regression model based on spectral parameters showed strong discriminatory performance:the area under the curve(AUC)of the LUAD and LUSC discrimination model was 0.806/0.77(training group/test group)in the arterial phase and 0.867/0.9(training group/test group)in the venous phase;the AUC of the LUAD and SCLC discrimination model was 0.885/0.883(training group/test group)in the arterial phase and 0.851/0.776(training group/test group)in the venous phase.Conclusion This study indicates that the multi-dimensional functional metabolic analysis indicators of spectral and perfusion CT imaging have significant value in the differential diagnosis of lung cancer pathological subtypes.The diagnostic model constructed by combining multiple spectral parameters can significantly improve the discrimination efficacy of lung adenocarcinoma,squamous cell carcinoma,and small cell lung cancer,providing precise imaging evidence for the formulation of individualized treatment plans.

Aim To investigate the antidepressant mechanism of hyperforin via the utilization of single-cell sequencing technology.Methods C57BL/6 mice were randomly divided into the control group,depres-sion model group,and hyperforin intervention group.The chronic unpredictable mild stress(CUMS)model was induced and drug interventions were administered for 28 d.Behavioral experiments were conducted to as-sess depressive symptoms,and hippocampal tissue was collected for single-cell RNA sequencing.Key cell populations and differentially expressed genes across groups were identified,followed by PPI network,GO,and KEGG enrichment analysis.Results Behavioral experiments indicated that CUMS successfully induced depressive symptoms in mice,while hyperforin im-proved depressive behavior.In the depression model group,the proportion of brain perivascular macrophages(PVM)increased,and this proportion decreased after hyperforin intervention,approaching the level seen in the control group.The top 20 common differentially ex-pressed genes in the PVM subpopulation were Saa3,Hbb-bs and Ccl24.PPI network analysis identified core targets,including Ccl2,Dhx9,C3,Msr1,Cxcl2 and Cx3cr1.KEGG enrichment analysis revealed pathways related to chemokines,phagosome formation,and inosi-tol phosphate metabolism.Conclusion The antide-pressant mechanism of hyperforin may be related to the regulation of Ccl24 and its related chemokine signaling pathway by PVM.

Objective To observe the impact of low-dose oxycodone-nalbuphine on pain mediator release in patient-controlled intravenous analgesia(PCIA)following laparoscopic radical resection of rectal cancer.Methods 120 patients who underwent laparoscopic radical surgery for colorectal cancer in our hospital from October 2022 to September 2023 were selected and randomly divided into the control group and the experimental group(60 cases in each).PCIA was administered within 48 h postoperatively,formulated as 10 mg hydromorphone and 40 mg nalbuphine diluted in saline to 100 ml.No background dose was administered in the control group,and a background dose of 1 ml/h was administered in the test group.Compare the number of effective PCIA compressions,the rate of remedial analgesia,the rate of remedial antiemesis,the dosage of analgesic pump,Visual Analogue Scale(VAS),Ramsay sedation score,the release of serum pain mediators and the occurrence of postoperative adverse reactions in patients within ≤24 hours and 24-48 hours.Results VAS Scores:The VAS scores during activity in the experimental group at 24 h and 48 h after surgery(2.21±0.25,1.78±0.44)were lower than those in the control group(2.58±0.23,2.12±0.27)(both P＜0.05).The VAS scores at rest in the experimental group at 12 h,24 h,and 48 h after surgery(2.52±0.28,2.14±0.26,1.75±0.32)were lower than those in the control group(3.17±0.39,2.68±0.33,2.04±0.21)(P＜0.05).Pump Usage:The amounts of analgesic pump used in the experimental group at 24 h and 48 h after surgery[(27.64±0.28)ml,(49.11±0.25)ml]were higher than those in the control group[(12.06±0.33)ml,(20.15±0.36)ml)](both P＜0.001).PCIA Pressing Times:The effective pressing times of PCIA in the experimental group within ≤24 h and 24-48 h(5.89±0.31,4.73±0.28)were lower than those in the control group(7.28±0.38,6.21±0.37)(both P＜0.001).Rescue Analgesia and Antiemesis Rates:The rescue analgesia rate(11.67％vs 28.33％,P=0.023)and rescue antiemesis rate(5.00％vs 18.33％,P=0.023)in the experimental group were both lower than those in the control group.Ramsay Sedation Scores:The Ramsay sedation scores in the experimental group at 12 h,24 h,and 48 h after surgery(2.18±0.31,1.74±0.42,1.46±0.14)were lower than those in the control group(2.43±0.48,2.12±0.32,2.03±0.38)(P＜0.001).In the experimental group,substance P[(35.26±5.27)pg/ml,(26.37±4.17)pg/ml],neuropeptide Y[(147.28±27.43)pg/ml,(127.26±18.49)pg/ml],and prostaglandin E2[(56.48±3.69)at 24 hours and 48 hours after the operation 9)The levels of pg/ml,(42.47±5.35)pg/ml and norepinephrine[(3.12±0.48)ng/ml,(1.57±0.19)ng/ml]were all lower than those of the control group[(41.27±6.48)pg/ml,(34.37±4.86)pg/ml,(35.26±5.27 pg/ml,(26.37±4.17)pg/ml,(62.47±4.26)pg/ml,(53.95±4.73)pg/ml,(3.64±0.64)ng/ml,(2.16±0.26)ng/ml,(P＜0.001)].Conclusion Low-dose oxycodone-nalbuphine in patient-controlled intravenous analgesia following laparoscopic radical resection of rectal cancer can improve analgesic effects and reduce serum pain mediator release.

Aim To investigate the antidepressant mechanism of hyperforin via the utilization of single-cell sequencing technology.Methods C57BL/6 mice were randomly divided into the control group,depres-sion model group,and hyperforin intervention group.The chronic unpredictable mild stress(CUMS)model was induced and drug interventions were administered for 28 d.Behavioral experiments were conducted to as-sess depressive symptoms,and hippocampal tissue was collected for single-cell RNA sequencing.Key cell populations and differentially expressed genes across groups were identified,followed by PPI network,GO,and KEGG enrichment analysis.Results Behavioral experiments indicated that CUMS successfully induced depressive symptoms in mice,while hyperforin im-proved depressive behavior.In the depression model group,the proportion of brain perivascular macrophages(PVM)increased,and this proportion decreased after hyperforin intervention,approaching the level seen in the control group.The top 20 common differentially ex-pressed genes in the PVM subpopulation were Saa3,Hbb-bs and Ccl24.PPI network analysis identified core targets,including Ccl2,Dhx9,C3,Msr1,Cxcl2 and Cx3cr1.KEGG enrichment analysis revealed pathways related to chemokines,phagosome formation,and inosi-tol phosphate metabolism.Conclusion The antide-pressant mechanism of hyperforin may be related to the regulation of Ccl24 and its related chemokine signaling pathway by PVM.

Objective:To summarize the clinical characteristics of elderly patients with stage Ⅰ diffuse large B-cell lymphoma (DLBCL) and analyze the factors associated with prognosis.Methods:A case series study was conducted by retrospectively collecting clinical data from patients aged over 60 years with newly diagnosed stage Ⅰ DLBCL across 20 medical centers in Jiangsu Province, China, between June 2010 and April 2023. The involved site, classification and treatment plan were summarized. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Statistical analyses were performed using the Kaplan-Meier method, and Cox regression model.Results:The study included 255 patients with a median age of 69 years, of whom 130 (51.0%) were male, 66 (25.9%) were aged ≥75 years and 26 (10.1%) had a high Charlson Comorbidity Index (CCI) score of ≥2. Extranodal involvement was observed in 163 (63.9%) patients, with the stomach (37.4%, 61/163), intestine (19.0%, 31/163), testes (11.0%, 18/163), and breast (7.4%, 12/163) being the most frequently affected sites. The non-germinal center B-cell (non-GCB) subtype was prevalent in 63.7% of patients (142/223), with no significant difference between the nodal and extranodal groups ( P=0.681). Furthermore, 73.9% (184/249) and 11.7% (29/249) of patients received the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and R-miniCHOP regimen, respectively. The overall 3-year PFS rate was 81.5%, and the 3-year OS rate was 85.6%. Patients aged ≥75 years ( HR=2.910, 95% CI 1.565-5.408, P=0.001) and/or with a CCI score ≥2 ( HR=2.324, 95% CI 1.141-4.732, P=0.020) had a significantly poorer PFS. Incorporating age ≥75 years and CCI score ≥2 into the stage-modified international prognostic index (sm-IPI) can better stratify the prognosis of elderly patients with stage Ⅰ DLBCL. The 3-year PFS rate was 48.7% in the high-risk group versus 85.7% in the low-risk group ( P<0.001). Conclusions:Our findings show that the elderly patients with stage Ⅰ DLBCL were predominantly characterized by extranodal involvement (particularly in the stomach and intestinal tract) and non-GCB subtype. Age ≥75 years and CCI ≥2 were identified as independent prognostic factors. The newly established sm-IPI-75-CCI incorporating these factors demonstrated superior prognostic discrimination compared to conventional risk assessment systems.