OBJECTIVE:Postoperative recurrence is a common complication of percutaneous endoscopic lumbar discectomy for lumbar disc herniation,which can significantly increase the risk of reoperation.A well-performing risk prediction model can help identify high-risk groups early and prevent postoperative recurrence.This study systematically evaluated the risk prediction model for postoperative recurrence after percutaneous endoscopic lumbar discectomy to provide a reference for surgical decision-making.METHODS:The PubMed,Embase,Web of Science,CNKI,WanFang Data,VIP,and CBM were electronically searched to collect studies on the recurrence risk prediction models after percutaneous endoscopic lumbar discectomy from inception to July 1,2024.Two reviewers independently screened the literature and extracted data.The models' risk of bias,applicability,and report quality were assessed using prediction model risk of bias assessment tool(PROBAST)and Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis(TRIPOD)tools,respectively.Meta-analysis of postoperative recurrence rate of percutaneous endoscopic lumbar discectomy and related predictors was performed using Revman 5.4 software.RESULTS:(1)A total of 15 studies were included,all of which were retrospective studies,including 24 models for predicting the risk of recurrence after percutaneous endoscopic lumbar discectomy.(2)The PROBAST evaluation results indicated that all 15 studies exhibited a high risk of bias.Regarding applicability,two studies demonstrated a low risk,while 13 presented a high risk.(3)Regarding the TRIPOD reporting quality,the overall quality across the 15 studies was low.The primary reasons for this low compliance included the failure to report blinding,a lack of explanation for the sample size calculation method,lack of detailed description of missing data processing methods,and lack of information such as introduction to the model used.(4)Furthermore,the area under the receiver operating characteristic curve for the model ranged from 0.684 to 0.972,with the number of potential predictor variables varying from 15 to 28.(5)The results of meta-analysis showed that the postoperative recurrence rate of lumbar disc herniation patients treated with percutaneous endoscopic lumbar discectomy was 12％(95％CI=9.0％-15.0％),Modic changes(OR=6.72,95％CI=3.90-11.59),body mass index(OR=1.28,95％CI=1.10-1.49),work intensity(OR=3.22,95％CI=1.85-5.59),age(OR=2.28,95％CI=1.50-3.48),and smoking history(OR=2.65,95％CI=1.75-4.00)were independent influencing factors for postoperative recurrence of percutaneous endoscopic lumbar discectomy(all P＜0.05).CONCLUSION:The overall predictive performance of the recurrence risk prediction models after percutaneous endoscopic lumbar discectomy is satisfactory;however,the model exhibits a high overall risk of bias and applicability,coupled with low reporting quality.Additionally,there is a lack of prospective research and external validation.Future,risk prediction models should consider factors such as Modic changes,body mass index,work intensity,age,and smoking history as potential predictors.

Objective To explore scientific and accurate prediction methods for the incidence of hand, foot, and mouth disease in the post-pandemic era, and to address modeling challenges caused by abnormal fluctuations in case numbers from 2020 to 2023. Methods The seasonal index was used to pre-process the data. The traditional seasonal autoregressive integrated moving average (SARIMA) model, singular spectrum analysis (SSA)-ARIMA model, ARIMA-Long short-term memory (LSTM) model, and SSA-ARIMA-LSTM model were used to fit the incidence from 2013 to 2023, and the incidence of hand, foot and mouth disease in 2024 was predicted. The real data collected in 2024 were used as the test set to compare the prediction performance of the models. Results The fitting performance of the constructed models was as follows: the ARIMA model had MAE=107.50 and RMSE=144.53, the SSA-ARIMA model showed MAE=2.84 and RMSE=4.33, the ARIMA-LSTM model achieved MAE=99.46 and RMSE=131.59, and the SSA-ARIMA-LSTM model had MAE=96.35 and RMSE=132.13. In terms of prediction performance, the ARIMA model resulted in MAE=151.64 and RMSE=146.70, the SSA-ARIMA model demonstrated MAE=41.22 and RMSE=57.01, the ARIMA-LSTM model yielded MAE=220.75 and RMSE=257.89, and the SSA-ARIMA-LSTM model recorded MAE=58.83 and RMSE=72.06. Conclusion The SSA-ARIMA model has the best fitting degree and the highest prediction accuracy, and is suitable for predicting the incidence trend of hand, foot and mouth disease.

OBJECTIVE:Postoperative recurrence is a common complication of percutaneous endoscopic lumbar discectomy for lumbar disc herniation,which can significantly increase the risk of reoperation.A well-performing risk prediction model can help identify high-risk groups early and prevent postoperative recurrence.This study systematically evaluated the risk prediction model for postoperative recurrence after percutaneous endoscopic lumbar discectomy to provide a reference for surgical decision-making.METHODS:The PubMed,Embase,Web of Science,CNKI,WanFang Data,VIP,and CBM were electronically searched to collect studies on the recurrence risk prediction models after percutaneous endoscopic lumbar discectomy from inception to July 1,2024.Two reviewers independently screened the literature and extracted data.The models' risk of bias,applicability,and report quality were assessed using prediction model risk of bias assessment tool(PROBAST)and Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis(TRIPOD)tools,respectively.Meta-analysis of postoperative recurrence rate of percutaneous endoscopic lumbar discectomy and related predictors was performed using Revman 5.4 software.RESULTS:(1)A total of 15 studies were included,all of which were retrospective studies,including 24 models for predicting the risk of recurrence after percutaneous endoscopic lumbar discectomy.(2)The PROBAST evaluation results indicated that all 15 studies exhibited a high risk of bias.Regarding applicability,two studies demonstrated a low risk,while 13 presented a high risk.(3)Regarding the TRIPOD reporting quality,the overall quality across the 15 studies was low.The primary reasons for this low compliance included the failure to report blinding,a lack of explanation for the sample size calculation method,lack of detailed description of missing data processing methods,and lack of information such as introduction to the model used.(4)Furthermore,the area under the receiver operating characteristic curve for the model ranged from 0.684 to 0.972,with the number of potential predictor variables varying from 15 to 28.(5)The results of meta-analysis showed that the postoperative recurrence rate of lumbar disc herniation patients treated with percutaneous endoscopic lumbar discectomy was 12％(95％CI=9.0％-15.0％),Modic changes(OR=6.72,95％CI=3.90-11.59),body mass index(OR=1.28,95％CI=1.10-1.49),work intensity(OR=3.22,95％CI=1.85-5.59),age(OR=2.28,95％CI=1.50-3.48),and smoking history(OR=2.65,95％CI=1.75-4.00)were independent influencing factors for postoperative recurrence of percutaneous endoscopic lumbar discectomy(all P＜0.05).CONCLUSION:The overall predictive performance of the recurrence risk prediction models after percutaneous endoscopic lumbar discectomy is satisfactory;however,the model exhibits a high overall risk of bias and applicability,coupled with low reporting quality.Additionally,there is a lack of prospective research and external validation.Future,risk prediction models should consider factors such as Modic changes,body mass index,work intensity,age,and smoking history as potential predictors.

Purpose: Lung cancer is frequently observed as a second primary malignancy following gastric cancer, yet the genetic causality between them remains uncertain. This study aims to evaluate the causal relationship between gastric and lung cancers using Mendelian randomization (MR) analysis. Materials and Methods: Single nucleotide polymorphisms associated with gastric and lung cancers were selected from genome-wide association study in East Asian and European populations as instrumental variables. The causal effects between gastric and lung cancers were evaluated using univariable and multivariable MR analysis, with the inverse variance weighted (IVW) method serving as the primary criterion. Heterogeneity and sensitivity analyses were performed to ensure the robustness of the findings. Results: Univariable MR analysis demonstrated that genetic susceptibility to gastric cancer in the European population was significantly associated with an increased risk of lung cancer (IVW: odds ratio [OR], 1.285; 95% confidence interval [CI], 1.072 to 1.541; p=6.83E-03), which was consistently validated in the East Asian population (IVW: OR, 1.356; 95% CI, 1.114 to 1.651; p=2.40E-03). Multivariable MR analysis further indicated that the significant positive causal relationship between gastric cancer and lung cancer persisted in both populations after adjusting for confounding factors (all p < 0.05). Conversely, no significant causal relationship was observed for the risk of developing gastric cancer following the diagnosis of lung cancer in either population (p > 0.05). Conclusion This study confirms that genetic susceptibility to gastric cancer increases the risk of lung cancer. This finding provides a theoretical basis for exploring the underlying biological mechanisms and suggests that enhancing lung cancer screening in patients with gastric cancer may be necessary to improve patient prognosis.

Based on network pharmacology,molecular docking,and experimental validation,this study explored the mechanisms of Geranium wilfordii Maxim(GWM)in the treatment of liver injury.Mice were randomly divided into a control group(CON group),a model group(CCl4 group),a high-dose drug group(GWM-H group),and a low-dose group(GWM-L group).The liv-er injury model in mice was induced by CCl4,and liver tissue pathological morphology was ob-served,along with the measurement of the relative gene expression levels of liver inflammatory factors.Active ingredients of traditional Chinese medicine and target information of Chinese medi-cine and diseases were obtained through databases such as TCMSP,PubChem,Swiss Target Pre-diction,Super-PRED,Gene Cards,and DisGeNET.Intersecting the targets of liver injury,necropto-sis,and drugs yielded potential drug targets.String database was used for protein-protein interac-tion(PPI)analysis of the potential targets.Furthermore,Cytoscape was utilized to construct a net-work diagram of"drug-disease-active ingredient-intersection target,"Wei Sheng Xin was used for GO and KEGG pathway analysis.Molecular docking was performed using MOE software,and the results of molecular docking were experimentally validated to detect the expression of key targets in the RIPK1/RIPK3/MLKL signaling pathway.Animal experiments showed that compared to the CON group,the CCl4 group of mice exhibited a significant increase in liver organ index(P＜0.05),markedly elevated serum AST activity(P＜0.05),and a highly significant increase in ALT activity(P＜0.01).Pathological examination revealed chaotic liver lobules,severe hepatocyte steatosis,ex-tensive hepatocyte necrosis,and inflammatory cell infiltration in the livers of mice in the CCl4 group.In comparison to the CCl4 group,the GWM-H group showed a significant decrease in liver organ index(P＜0.05),while the GWM-L group displayed a downward trend.The GWM-H group exhibited a significant reduction in serum AST activity(P＜0.05),the GWM-L group showed a decreasing trend in serum AST activity,the GWM-H group demonstrated a highly significant de-crease in serum ALT activity(P＜0.01),and the GWM-L group displayed a significant decrease in serum ALT activity(P＜0.05).Histopathological examination revealed that the drug treatment groups could improve CCl4-induced liver injury,with the GWM-H group showing better efficacy than the GWM-L group.RT-qPCR results of liver tissues showed that compared to the CON group,the CCl4 group exhibited a highly significant increase in the relative expression of IL-1βand PGE2 mRNA(P＜0.01),while the mRNA relative expression of COX2 showed an increasing trend.In contrast,compared to the CCl4 group,the GWM-H group showed a remarkably significant decrease in the relative expression of IL-1βmRNA(P＜0.01),a significant decrease in PGE2 mR-NA expression(P＜0.05),and a decreasing trend in COX2 mRNA expression.Through network pharmacology,56 potential targets related to GWM in ameliorating necroptosis-induced liver injury were identified.Key targets,based on degree value,include TNF,Bcl2,HSP90AA1,and Caspase8,while the key components are quercetin,luteolin,kaempferol,and ellagic acid.Functional enrich-ment analysis yielded 2 173 entries for GO and 146 biological pathways for KEGG.Molecular doc-king results indicated a strong binding capacity between the main components of GWM and key targets.RT-qPCR experimental results showed that compared to the CON group,the CCl4 group exhibited a extremely significantly increase in the mRNA relative expression of TNF-α,TNFR1,MLKL(P＜0.01),significantly increase in the mRNA relative expression of FAS,RIPK1,RIPK3 mRNA(P＜0.05),and a significant decrease in Caspase 8 mRNA expression(P＜0.05).The addi-tion of GWM successfully reversed this trend;compared to the CCl4 group,the GWM-H group showed a highly significant decrease in the mRNA relative expression of TNF-α,TNFR1,FAS and MLKL mRNA(P＜0.01),significant decrease in RIPK1,RIPK3 mRNA expression(P＜0.05),and an increasing trend in CASPASE8 mRNA expression.GWM exerts hepatoprotective effects through multiple components and pathways,among which inhibition of the RIPK1/RIPK3/MLKL pathway reduces hepatocyte necroptosis,potentially serving as one of the essential mechanisms for its protective effects.

Based on network pharmacology,through molecular docking and experimental validation,the study explored the mechanism of the Hypericum japonicum-Rehmannia glutinosa-Salvia ple-beian compound(HRS)in the treatment of liver injury.Mice were randomly divided into a control group(CON group),a model group(CCL4 group),a high-dose drug group(HRS-H group),and a low-dose group(HRS-L group).A mouse liver injury model was established using CCL4 induction,liver tissue pathological morphology was observed,and the relative expression levels of liver in-flammatory cytokine genes was measured.Active ingredients of traditional Chinese medicine and targets related to Chinese medicine and diseases were obtained from databases such as Herb,TCM-SP,PubChem,Swiss Target Prediction,Gene Cards and DisGeNET.The intersection of targets was used to obtain potential drug targets.The potential targets were analyzed for protein-protein inter-action(PPI)using the string database and a network diagram of"drug-active component-intersec-tion target"was constructed using Cytoscape.DAVID database was used for GO and KEGG path-way analysis,and Auto Dock Tools software was used for molecular docking.Finally,the results of molecular docking by examining the expression of key target genes and downstream genes such as those related to the PI3K-AKT pathway and the autophagy pathway were experimentally valida-ted.Results:Animal experiment results showed that compared to the CON group,the CCL4 group of mice exhibited disrupted liver architecture,hepatocyte steatosis,vacuolization,and extensive in-flammatory cell infiltration.These characteristics were ameliorated by drug treatment groups with the HRS-H group demonstrating superior effects compared to the HRS-L group.RT-qPCR results from mouse livers showed significantly increased relative expression of TNF-α and INOS mRNA compared to the CON group in the CCL4 group(P＜0.01),and significantly increased IL-1β mR-NA relative expression(P＜0.05).Compared to the CCL4 group,the HRS-H group showed signifi-cantly decreased TNF-α,INOS,and IL-1β mRNA relative expressions(P＜0.01).155 potential tar-gets for HRS in alleviating liver damage were identified through network pharmacology,with top-ranked key target points including STAT3,SRC,PIK3R1,PIK3CA,AKT1,HSP90A11,EGFR,and ESR.Key active ingredients included Tetramethoxyluteolin,Hispidulin,Eupafolin,Kaempferol,and Eupaformonin.GO enrichment analysis yielded 940 entries,and KEGG enrichment analysis yielded 177 biological pathways.Molecular docking results showed a strong binding ability between the main components of HRS and key target points.RT-qPCR results showed increasing trends for EGFR,PI3KCA,HSP90A11,and NF-κB mRNA compared to the CON group in the CCL4 group,significantly increased AKT1 mRNA relative expression(P＜0.05),significant decreases in ULK1,ATG5,LC3B,and ATG7 mRNA relative expressions(P＜0.05),and extremely significant decreases in PTEN,ATG13,BECLIN-1,ATG16L1,ATG12,ATG4B,and ATG3 mRNA relative expressions(P＜0.01).Compared to the CCL4 group,the HRS-H group showed significantly de-creased PI3KCA,HSP90A11,and NF-κB mRNA relative expressions(P＜0.05),extremely signif-icantly decreased EGFR,AKT1,and mTOR mRNA relative expressions(P＜0.01),increased ULK1 relative expression trends,significantly increased PTEN,ATG16L1,ATG5,LC3B,and ATG7 mRNA relative expressions(P＜0.05),extremely significantly increased ATG13,BECLIN-1,ATG12,ATG4B,and ATG3 mRNA relative expressions(P＜0.01).Conclusion:The HRS ex-erts hepatoprotective effects through multi-component,multi-pathway approaches,with alleviating inflammation and promoting hepatocyte autophagy through PI3K-AKT pathway likely being im-portant mechanisms for its protective effects.

Objective:To evaluate the efficacy of an etoposide (Vp16) -intensified conditioning regimen in allogeneic hematopoietic stem cell transplantation (allo-HSCT) for the treatment of relapsed/refractory acute myeloid leukemia (AML).Method:A retrospective analysis was conducted on the clinical data of 27 recipients with relapsed/refractory AML who underwent allo-HSCT using a Vp16-intensified conditioning regimen at Aerospace Center Hospital from January 2019 to January 2022. Transplantation-related complications and treatment outcomes were observed. Kaplan-Meier survival analysis was used to assess the overall survival (OS) and disease-free survival (DFS) rates.Result:Among the 27 recipients, there were 14 males and 13 females, with a median age of 41 years (range: 12~55 years). Except for one recipient who experienced primary graft failure, the remaining 26 recipients achieved hematopoietic reconstitution. The median neutrophil and platelet engraftment times were 13 days (range: 9~20 days) and 13.5 days (range: 11~33 days), respectively. Regimen-related toxicity (RRT) was mainly gastrointestinal toxicity and oral mucositis, and no deaths were attributed to RRT. A total of 12 recipients (44.44%) developed acute graft-versus-host disease (aGVHD), of whom 3 cases (11.11%) had grade III~IV aGVHD. Chronic GVHD (cGVHD) occurred in 13 recipients (48.15%), including 8 cases (29.63%) of extensive cGVHD. The median follow-up time after transplantation was 17 months (range: 1~48 months). Fifteen recipients (55.56%) survived without disease, while 12 recipients (44.44%) died— 9 due to relapse and 3 due to transplant-related complications. The 1-year overall survival and DFS rates were 74.07% and 59.26%, respectively; the 2-year overall survival and DFS rates were 59.26% and 55.56%, respectively. The 2-year relapse rate and transplant-related mortality (TRM) were 33.33% and 11.11%, respectively.Conclusion:The Vp16-intensified conditioning regimen in allo-HSCT appears to be a viable treatment option for patients with relapsed/refractory AML, offering favorable efficacy and manageable safety.

Based on network pharmacology,molecular docking,and experimental validation,this study explored the mechanisms of Geranium wilfordii Maxim(GWM)in the treatment of liver injury.Mice were randomly divided into a control group(CON group),a model group(CCl4 group),a high-dose drug group(GWM-H group),and a low-dose group(GWM-L group).The liv-er injury model in mice was induced by CCl4,and liver tissue pathological morphology was ob-served,along with the measurement of the relative gene expression levels of liver inflammatory factors.Active ingredients of traditional Chinese medicine and target information of Chinese medi-cine and diseases were obtained through databases such as TCMSP,PubChem,Swiss Target Pre-diction,Super-PRED,Gene Cards,and DisGeNET.Intersecting the targets of liver injury,necropto-sis,and drugs yielded potential drug targets.String database was used for protein-protein interac-tion(PPI)analysis of the potential targets.Furthermore,Cytoscape was utilized to construct a net-work diagram of"drug-disease-active ingredient-intersection target,"Wei Sheng Xin was used for GO and KEGG pathway analysis.Molecular docking was performed using MOE software,and the results of molecular docking were experimentally validated to detect the expression of key targets in the RIPK1/RIPK3/MLKL signaling pathway.Animal experiments showed that compared to the CON group,the CCl4 group of mice exhibited a significant increase in liver organ index(P＜0.05),markedly elevated serum AST activity(P＜0.05),and a highly significant increase in ALT activity(P＜0.01).Pathological examination revealed chaotic liver lobules,severe hepatocyte steatosis,ex-tensive hepatocyte necrosis,and inflammatory cell infiltration in the livers of mice in the CCl4 group.In comparison to the CCl4 group,the GWM-H group showed a significant decrease in liver organ index(P＜0.05),while the GWM-L group displayed a downward trend.The GWM-H group exhibited a significant reduction in serum AST activity(P＜0.05),the GWM-L group showed a decreasing trend in serum AST activity,the GWM-H group demonstrated a highly significant de-crease in serum ALT activity(P＜0.01),and the GWM-L group displayed a significant decrease in serum ALT activity(P＜0.05).Histopathological examination revealed that the drug treatment groups could improve CCl4-induced liver injury,with the GWM-H group showing better efficacy than the GWM-L group.RT-qPCR results of liver tissues showed that compared to the CON group,the CCl4 group exhibited a highly significant increase in the relative expression of IL-1βand PGE2 mRNA(P＜0.01),while the mRNA relative expression of COX2 showed an increasing trend.In contrast,compared to the CCl4 group,the GWM-H group showed a remarkably significant decrease in the relative expression of IL-1βmRNA(P＜0.01),a significant decrease in PGE2 mR-NA expression(P＜0.05),and a decreasing trend in COX2 mRNA expression.Through network pharmacology,56 potential targets related to GWM in ameliorating necroptosis-induced liver injury were identified.Key targets,based on degree value,include TNF,Bcl2,HSP90AA1,and Caspase8,while the key components are quercetin,luteolin,kaempferol,and ellagic acid.Functional enrich-ment analysis yielded 2 173 entries for GO and 146 biological pathways for KEGG.Molecular doc-king results indicated a strong binding capacity between the main components of GWM and key targets.RT-qPCR experimental results showed that compared to the CON group,the CCl4 group exhibited a extremely significantly increase in the mRNA relative expression of TNF-α,TNFR1,MLKL(P＜0.01),significantly increase in the mRNA relative expression of FAS,RIPK1,RIPK3 mRNA(P＜0.05),and a significant decrease in Caspase 8 mRNA expression(P＜0.05).The addi-tion of GWM successfully reversed this trend;compared to the CCl4 group,the GWM-H group showed a highly significant decrease in the mRNA relative expression of TNF-α,TNFR1,FAS and MLKL mRNA(P＜0.01),significant decrease in RIPK1,RIPK3 mRNA expression(P＜0.05),and an increasing trend in CASPASE8 mRNA expression.GWM exerts hepatoprotective effects through multiple components and pathways,among which inhibition of the RIPK1/RIPK3/MLKL pathway reduces hepatocyte necroptosis,potentially serving as one of the essential mechanisms for its protective effects.

Based on network pharmacology,through molecular docking and experimental validation,the study explored the mechanism of the Hypericum japonicum-Rehmannia glutinosa-Salvia ple-beian compound(HRS)in the treatment of liver injury.Mice were randomly divided into a control group(CON group),a model group(CCL4 group),a high-dose drug group(HRS-H group),and a low-dose group(HRS-L group).A mouse liver injury model was established using CCL4 induction,liver tissue pathological morphology was observed,and the relative expression levels of liver in-flammatory cytokine genes was measured.Active ingredients of traditional Chinese medicine and targets related to Chinese medicine and diseases were obtained from databases such as Herb,TCM-SP,PubChem,Swiss Target Prediction,Gene Cards and DisGeNET.The intersection of targets was used to obtain potential drug targets.The potential targets were analyzed for protein-protein inter-action(PPI)using the string database and a network diagram of"drug-active component-intersec-tion target"was constructed using Cytoscape.DAVID database was used for GO and KEGG path-way analysis,and Auto Dock Tools software was used for molecular docking.Finally,the results of molecular docking by examining the expression of key target genes and downstream genes such as those related to the PI3K-AKT pathway and the autophagy pathway were experimentally valida-ted.Results:Animal experiment results showed that compared to the CON group,the CCL4 group of mice exhibited disrupted liver architecture,hepatocyte steatosis,vacuolization,and extensive in-flammatory cell infiltration.These characteristics were ameliorated by drug treatment groups with the HRS-H group demonstrating superior effects compared to the HRS-L group.RT-qPCR results from mouse livers showed significantly increased relative expression of TNF-α and INOS mRNA compared to the CON group in the CCL4 group(P＜0.01),and significantly increased IL-1β mR-NA relative expression(P＜0.05).Compared to the CCL4 group,the HRS-H group showed signifi-cantly decreased TNF-α,INOS,and IL-1β mRNA relative expressions(P＜0.01).155 potential tar-gets for HRS in alleviating liver damage were identified through network pharmacology,with top-ranked key target points including STAT3,SRC,PIK3R1,PIK3CA,AKT1,HSP90A11,EGFR,and ESR.Key active ingredients included Tetramethoxyluteolin,Hispidulin,Eupafolin,Kaempferol,and Eupaformonin.GO enrichment analysis yielded 940 entries,and KEGG enrichment analysis yielded 177 biological pathways.Molecular docking results showed a strong binding ability between the main components of HRS and key target points.RT-qPCR results showed increasing trends for EGFR,PI3KCA,HSP90A11,and NF-κB mRNA compared to the CON group in the CCL4 group,significantly increased AKT1 mRNA relative expression(P＜0.05),significant decreases in ULK1,ATG5,LC3B,and ATG7 mRNA relative expressions(P＜0.05),and extremely significant decreases in PTEN,ATG13,BECLIN-1,ATG16L1,ATG12,ATG4B,and ATG3 mRNA relative expressions(P＜0.01).Compared to the CCL4 group,the HRS-H group showed significantly de-creased PI3KCA,HSP90A11,and NF-κB mRNA relative expressions(P＜0.05),extremely signif-icantly decreased EGFR,AKT1,and mTOR mRNA relative expressions(P＜0.01),increased ULK1 relative expression trends,significantly increased PTEN,ATG16L1,ATG5,LC3B,and ATG7 mRNA relative expressions(P＜0.05),extremely significantly increased ATG13,BECLIN-1,ATG12,ATG4B,and ATG3 mRNA relative expressions(P＜0.01).Conclusion:The HRS ex-erts hepatoprotective effects through multi-component,multi-pathway approaches,with alleviating inflammation and promoting hepatocyte autophagy through PI3K-AKT pathway likely being im-portant mechanisms for its protective effects.

In order to further standardize the vaccination of kidney transplant candidates and recipients in China, the Branch of Organ Transplantation of Chinese Medical Association has organized experts in kidney transplantation and infectious diseases. Based on the "Vaccination of Solid Organ Transplant Candidates and Recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice", and in combination with the clinical reality of infectious diseases and vaccination after organ transplantation in China, as well as referring to relevant recommendations from home and abroad in recent years, these guidelines are formulated from aspects such as epidemiology, types of vaccines, vaccination principles, target population, and specific vaccine administration. The "Guidelines for Vaccination of Kidney Transplant Candidates and Recipients in China" aims to provide theoretical reference for medical workers in the field of kidney transplantation in China, regarding the vaccination of kidney transplant candidates and recipients. It is expected to better guide the vaccination of kidney transplant candidates and recipients, reduce the risk of postoperative infection, and improve survival outcomes.