[摘 要] 目的：探讨胰岛素样生长因子2 mRNA结合蛋白3（IGF2BP3）、尿苷二磷酸-葡萄糖醛酸脱羧酶1（UXS1）在肝细胞癌（HCC）中的表达特征、预后价值及两者协同作用的分子机制。方法：整合UALCAN、cBioPortal、ENCORI、TISCH2、GDSC等公共数据库的转录组数据，对IGF2BP3和UXS1进行表达、预后评估、功能富集及药物敏感性等分析。收集GEO数据库的单细胞RNA测序（scRNA-seq）数据，分析细胞通信、单细胞代谢评分，系统解析IGF2BP3-UXS1轴在HCC中的具体作用。结果：IGF2BP3、UXS1在HCC组织中均显著高表达，且高表达患者总生存期显著缩短（均P < 0.05）。采用CRISPP技术敲除IGF2BP3或UXS1后，多种HCC细胞的增殖能力受到明显抑制。scRNA-seq分析揭示了IGF2BP3、UXS1在肝细胞等细胞类型中的广泛表达分布，前者在细胞分化晚期上调，后者则在细胞分化早、中期高表达。IGF2BP3、UXS1高表达组均显著激活了MIF通路，同时IGF2BP3的高表达削弱了成纤维细胞的相互作用，而UXS1的高表达则增强了T细胞的信号转导功能。IGF2BP3与UXS1在表达相关性中存在显著的正相关（r = 0.432，P < 0.05）。沉默IGF2BP3结合位点会导致UXS1表达水平变化（F = 0.333）。功能富集分析提示，IGF2BP3与UXS1协同调控能量代谢、蛋白质翻译等生物学过程。在IGF2BP3或UXS1高表达的细胞亚群中，发现两者与多个糖代谢相关通路存在显著关联。IGF2BP3、UXS1高表达的患者对优普色替等药物表现出显著的敏感性，还对药物那维托克等表现出显著的耐药性。结论： IGF2BP3、UXS1在HCC中高表达，两者通过调控糖代谢重编程的协同作用促进HCC恶性生物学行为。

Objective To explore the impact of early discharge guidance,based on an intelligent education system,on postoperative pain management,functional recovery,and discharge readiness in lung cancer patients.Methods A total of 170 lung cancer patients were selected from Jinhua Municipal Central Hospital from July 2022 to June 2023.According to the time of admission,patients admitted between July to November 2022 were assigned to control group(n=82),while patients admitted between December 2022 to June 2023 were assigned to observation group(n=88).Control group received routine perioperative health education,while observation group received additional intelligent education system.Following outcomes were compared between two groups:Time to first ambulation after surgery,pain numeric rating scale(NRS)scores on postoperative 1 to 3 days and on day of discharge,performance on 2-minute step test on day of discharge,and readiness for hospital discharge scale(RHDS).Results Time to first ambulation post operative in observation group was shorter than that in control group.NRS scores at 72 hours post operative and on day of discharge were lower in observation group compared to control group.Number of steps completed in 2-minute step test in observation group was higher than that in control group.Additionally,RHDS scores in observation group was higher than that in control group,and all differences were statistically significant(P＜0.05).Conclusion The discharge planning advancement driven by the intelligent education system significantly improved early postoperative ambulation,reduced postoperative pain,enhanced physical function,and increased discharge readiness in lung cancer patients,thereby effectively promoting postoperative recovery.

Objective To investigate the effect of mulberry anthocyanin on the morphology and func-tion of vascular endothelial cells(VEC)and its possible mechanism at the level of autophagy.Methods VEC were cultured in vitro and divided into 5.5/0 mmol/L control group,11/0.125,22/0.250,33/0.500,44/1.000,55/2.000 mmol/L high glucose/high fat groups.The cell functional levels and autophage levels in each group were detected.The optimal high glucose/high lipid concentration was selected as the VEC function inju-ry model group.10,25,50 μmol/L mulberry anthocyanins were added into the model group for processing and divided into the low,middle and high concentrations of mulberry anthocyanin groups.The effects of mulberry anthocyanin on the morphology,function and autophagy of VEC in high sugar and high fat stress were ob-served.Then the autophagy regulator(rapamycin)was added to study its action mechanism.HE staining was used to observe the number and morphology of cells,the CCK-8 assay was used to detect the viability of VEC,the flow cytometry was used to detect the level of reactive oxygen species(ROS)in VEC,the Western blot was used to detect the expression level of Beclin-1 and p62 proteins in VEC,and the kit method was used to detect the level of nitric oxide(NO)and endothelin-1(ET-1)in VEC.Results Compared with the control group,the number and morphology of cells in the middle and high concentrations of high glucose/high fat groups were changed,the cell viability,p62,NO levels were significantly decreased(P<0.05),while the ROS,ET-1,and Beclin-1 expression levels were increased significantly(P<0.05).Compared with the model group,the number of cells in the mulberry anthocyanin groups was increased,morphology was improved,the cellular viability,p62 and No levels were significantly increased,and ROS,Beclin-1 and ET-1 levels were significantly decreased(P<0.05).Compared with the high concentration mulberry anthocyanin group,the cells number was decreased af-ter adding rapamycin,the morphology changed to be irregular,the NO level was decreased,and the ET level was increased(P<0.05).Compared with the control group,the p-phosphatidylinositol 3-kinase(PI3K)and p-protein kinase B(Akt)relative expression levels in the model group were significantly decreased(P<0.05);compared with the model group,the p-PI3K and p-Akt relative expression levels in the high concentration mulberry anthocyanin group were significantly increased(P<0.05).Conclusion Mulberry anthocyanin could in-hibit autophagy by activating the PI3K/Akt/mammalian target of rapamycin(mTOR)signaling pathway and improve the morphology and function of VEC under high glucose and lipid stress.

OBJECTIVE To investigate the effect and mechanism of Jingangteng capsules in the treatment of non-alcoholic fatty liver disease （NAFLD）. METHODS Thirty-two SD rats were randomly divided into normal group and modeling group. The modeling group was fed a high-fat diet to establish a NAFLD model. The successfully modeled rats were then randomly divided into model group， atorvastatin group[positive control， 2 mg/（kg·d）]， and Jingangteng capsules low- and high-dose groups [0.63 and 2.52 mg/（kg·d）]， with 6 rats in each group. The pathological changes of the liver were observed by hematoxylin-eosin staining and oil red O staining. Enzyme-linked immunosorbent assay was performed to determine the serum levels of triglycerides （TG）， total cholesterol （TC）， high-density lipoprotein cholesterol （HDL-C）， low-density lipoprotein cholesterol （LDL-C）， alanine transaminase （ALT）， aspartate transaminase （AST）， tumour necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， IL-6， IL-18. 16S rDNA amplicon sequencing and metabolomics techniques were applied to explore the effects of Jingangteng capsules on gut microbiota and metabolisms in NAFLD rats. Based on the E-mail：591146765@qq.com metabolomics results， Western blot analysis was performed to detect proteins related to the nuclear factor kappa-B （NF-κB）/NOD-like receptor family protein 3 （NLRP3） signaling pathway in the livers of NAFLD rats. RESULTS The experimental results showed that Jingangteng capsules could significantly reduce the serum levels of TG， TC， LDL-C， AST， ALT， TNF-α， IL-1β， IL-6， IL-18， while increased the level of HDL-C， and alleviated the hepatic cellular steatosis and inflammatory infiltration in NAFLD rats. They could regulate the gut microbiota disorders in NAFLD rats， significantly increased the relative abundance of Romboutsia and Oscillospira， and significantly decreased the relative abundance of Blautia （P＜0.05）. They also regulated metabolic disorders primarily by affecting secondary bile acid biosynthesis， fatty acid degradation， O-antigen nucleotide sugar biosynthesis， etc. Results of Western blot assay showed that they significantly reduced the phosphorylation levels of NF-κB p65 and NF-κB inhibitor α， and the protein expression levels of NLRP3， caspase-1 and ASC （P＜0.05 or P＜0.01）. CONCLUSIONS Jingangteng capsules could improve inflammation， lipid accumulation and liver injury in NAFLD rats， regulate the disorders of gut microbiota and metabolisms， and inhibit NF-κB/NLRP3 signaling pathway. Their therapeutic effects against NAFLD are mediated through the inhibition of the NF-κB/NLRP3 signaling pathway.

Objective To investigate the clinical efficacy of the traditional Chinese medicine(TCM)throat opening and brightening method in treating unilateral vocal cord paralysis(UVCP).Methods Sixty patients with UVCP were prospectively collected and randomly assigned to two groups:the Chinese herbal medicine group(trea-ted with Buyang Huanwu Decoction,n=30)and the throat opening and brightening method group(treated with TCM throat opening and brightening method,n=30).The clinical studies that had utilized injection laryngoplasty for the treatment of UVCP(historical control group).Evaluation indicators included the voice handicap index-10(VHI-10),GRBAS-G,objective acoustic measurements of voice(vocal intensity,F0,shimmer,jitter,HNR),and aerodynamic measurements(maximum phonation time,MPT).Results Before treatment,no significant differences were observed between the two groups in all the evaluation indicators(P＞0.05).Post-treatment,the throat open-ing and brightening method group demonstrated significant improvements in VHI-10,GRBAS-G,shimmer,jitter,HNR,and MPT compared to pre-treatment values(P＜0.01),and these improvements were superior to those in the Chinese herbal medicine group.Pre-treatment VHI-10,GRBAS-G,and shimmer scores in the throat opening and brightening method group were significantly higher than those in the historical literature group(P＜0.01).Af-ter treatment,no significant differences were noted in any assessed parameters between the two groups(P＞0.05).Conclusion The TCM throat opening and brightening method significantly enhances phonatory function and quality of life in patients with UVCP,showing comparable efficacy to injection laryngoplasty.

Objective To explore the protective effect of Bilobalide on retinal ganglion cells(RGCs)in rats with op-tic nerve injury and its mechanism.Methods Sixty rats were randomly selected from 75 Sprague-Dawley rats to establish an optic nerve crush injury model.The 60 successfully modeled rats were then randomly divided into a model group,and low-,medium-,and high-dose Bilobalide groups,with 15 rats in each group.Another 15 rats served as the sham-operated group,undergoing optic nerve exposure without crushing.Rats in the low-,medium-,and high-dose Bilobalide groups were intraperitoneally injected with 5,10 and 20 mg·kg-1 Bilobalide,respectively,once daily for 7 days.Rats in the sham-operated and model groups were intraperitoneally injected with an equal volume of normal saline once daily for 7 days.The superoxide dismutase(SOD)activity and malondialdehyde(MDA)content in the retinal tissue of rats in each group were measured.Immunofluorescence staining was used to assess RGCs proliferation.Hematoxylin-eosin(HE)stai-ning was used to observe histopathological changes in the retinal structure.TUNEL staining was used to detect RGCs apop-tosis.Immunofluorescence staining was used to observe the activation state of retinal microglia.Western blot was used to detect the expression of growth-associated protein 43(GAP43)and proteins related to the extracellular signal-regulated ki-nase 1/2(ERK1/2)pathway.Results Compared with the sham-operated group,the model group showed significantly decreased SOD activity and increased MDA content in the retinal tissue(all P＜0.05),a significant decrease in RGCs densi-ty(P＜0.05),significant increases in the apoptosis rate and microglial activation ratio(all P＜0.05),and significant downregulation of p-ERK1/2 and GAP43 protein expression(all P＜0.05).Histomorphology revealed edema and vacuola-tion in the ganglion cell layer,disordered arrangement of RGCs,and thinning of the inner nuclear layer and outer nuclear layer in the model group.After intervention with various doses of Bilobalide,all the above indices were significantly im-proved(all P＜0.05):SOD activity increased,MDA content decreased,RGCs density recovered,RGCs apoptosis rate and microglial activation decreased,the expressions of p-ERK1/2 and GAP43 were upregulated,the structural damage to each retinal layer was alleviated,showing a dose-dependent recovery.Conclusion Bilobalide can exert a protective effect on RGCs after optic nerve injury through multiple mechanisms,including alleviating oxidative stress,inhibiting apoptosis and microglial overactivation,promoting axonal regeneration,and activating the ERK1/2 signaling pathway.

Objective To investigate the clinical efficacy of the traditional Chinese medicine(TCM)throat opening and brightening method in treating unilateral vocal cord paralysis(UVCP).Methods Sixty patients with UVCP were prospectively collected and randomly assigned to two groups:the Chinese herbal medicine group(trea-ted with Buyang Huanwu Decoction,n=30)and the throat opening and brightening method group(treated with TCM throat opening and brightening method,n=30).The clinical studies that had utilized injection laryngoplasty for the treatment of UVCP(historical control group).Evaluation indicators included the voice handicap index-10(VHI-10),GRBAS-G,objective acoustic measurements of voice(vocal intensity,F0,shimmer,jitter,HNR),and aerodynamic measurements(maximum phonation time,MPT).Results Before treatment,no significant differences were observed between the two groups in all the evaluation indicators(P＞0.05).Post-treatment,the throat open-ing and brightening method group demonstrated significant improvements in VHI-10,GRBAS-G,shimmer,jitter,HNR,and MPT compared to pre-treatment values(P＜0.01),and these improvements were superior to those in the Chinese herbal medicine group.Pre-treatment VHI-10,GRBAS-G,and shimmer scores in the throat opening and brightening method group were significantly higher than those in the historical literature group(P＜0.01).Af-ter treatment,no significant differences were noted in any assessed parameters between the two groups(P＞0.05).Conclusion The TCM throat opening and brightening method significantly enhances phonatory function and quality of life in patients with UVCP,showing comparable efficacy to injection laryngoplasty.

Objective To explore the protective effect of Bilobalide on retinal ganglion cells(RGCs)in rats with op-tic nerve injury and its mechanism.Methods Sixty rats were randomly selected from 75 Sprague-Dawley rats to establish an optic nerve crush injury model.The 60 successfully modeled rats were then randomly divided into a model group,and low-,medium-,and high-dose Bilobalide groups,with 15 rats in each group.Another 15 rats served as the sham-operated group,undergoing optic nerve exposure without crushing.Rats in the low-,medium-,and high-dose Bilobalide groups were intraperitoneally injected with 5,10 and 20 mg·kg-1 Bilobalide,respectively,once daily for 7 days.Rats in the sham-operated and model groups were intraperitoneally injected with an equal volume of normal saline once daily for 7 days.The superoxide dismutase(SOD)activity and malondialdehyde(MDA)content in the retinal tissue of rats in each group were measured.Immunofluorescence staining was used to assess RGCs proliferation.Hematoxylin-eosin(HE)stai-ning was used to observe histopathological changes in the retinal structure.TUNEL staining was used to detect RGCs apop-tosis.Immunofluorescence staining was used to observe the activation state of retinal microglia.Western blot was used to detect the expression of growth-associated protein 43(GAP43)and proteins related to the extracellular signal-regulated ki-nase 1/2(ERK1/2)pathway.Results Compared with the sham-operated group,the model group showed significantly decreased SOD activity and increased MDA content in the retinal tissue(all P＜0.05),a significant decrease in RGCs densi-ty(P＜0.05),significant increases in the apoptosis rate and microglial activation ratio(all P＜0.05),and significant downregulation of p-ERK1/2 and GAP43 protein expression(all P＜0.05).Histomorphology revealed edema and vacuola-tion in the ganglion cell layer,disordered arrangement of RGCs,and thinning of the inner nuclear layer and outer nuclear layer in the model group.After intervention with various doses of Bilobalide,all the above indices were significantly im-proved(all P＜0.05):SOD activity increased,MDA content decreased,RGCs density recovered,RGCs apoptosis rate and microglial activation decreased,the expressions of p-ERK1/2 and GAP43 were upregulated,the structural damage to each retinal layer was alleviated,showing a dose-dependent recovery.Conclusion Bilobalide can exert a protective effect on RGCs after optic nerve injury through multiple mechanisms,including alleviating oxidative stress,inhibiting apoptosis and microglial overactivation,promoting axonal regeneration,and activating the ERK1/2 signaling pathway.

Objective To explore the impact of early discharge guidance,based on an intelligent education system,on postoperative pain management,functional recovery,and discharge readiness in lung cancer patients.Methods A total of 170 lung cancer patients were selected from Jinhua Municipal Central Hospital from July 2022 to June 2023.According to the time of admission,patients admitted between July to November 2022 were assigned to control group(n=82),while patients admitted between December 2022 to June 2023 were assigned to observation group(n=88).Control group received routine perioperative health education,while observation group received additional intelligent education system.Following outcomes were compared between two groups:Time to first ambulation after surgery,pain numeric rating scale(NRS)scores on postoperative 1 to 3 days and on day of discharge,performance on 2-minute step test on day of discharge,and readiness for hospital discharge scale(RHDS).Results Time to first ambulation post operative in observation group was shorter than that in control group.NRS scores at 72 hours post operative and on day of discharge were lower in observation group compared to control group.Number of steps completed in 2-minute step test in observation group was higher than that in control group.Additionally,RHDS scores in observation group was higher than that in control group,and all differences were statistically significant(P＜0.05).Conclusion The discharge planning advancement driven by the intelligent education system significantly improved early postoperative ambulation,reduced postoperative pain,enhanced physical function,and increased discharge readiness in lung cancer patients,thereby effectively promoting postoperative recovery.

Objective To explore the influencing factors of disability degree in elderly hospitalized patients with disability and the correlations of disability with malnutrition and sarcopenia. Methods A total of 234 elderly hospitalized patients with disability were selected as study subjects. The Activities of Daily Living (ADL) scale, Mini-nutritional Assessment Short Form (MNA-SF), and Sarcopenia Five-item Criteria with calf circumference (SARC-CalF) were used to investigate the status of disability, nutrition, and sarcopenia in patients. The clinical characteristics of different types of patients were compared, and correlations of disability with malnutrition and sarcopenia were analyzed using Pearson correlation analysis. Multiple linear regression analysis was used to explore the influencing factors of the degree of disability in patients. Results Of the 234 patients, 46.58%(109/234) had mild disability, 45.30%(106/234) had moderate disability, and 8.12%(19/234) had severe disability. The results of Pearson correlation analysis showed that the degree of disability (ADL score) in elderly hospitalized patients with disability was significantly correlated with the degree of malnutrition (MNA-SF score) and sarcopenia (SARC-CalF score) (r=0.177, -0.193, P=0.007, 0.003). Multiple linear regression analysis showed that malnutrition and sarcopenia were influencing factors of the degree of disability in elderly hospitalized patients with disability (P < 0.05). Conclusion There are correlations of disability with malnutrition and sarcopenia in elderly hospitalized patients with disability. The risk of exacerbation of disability is significantly increased in patients with malnutrition and sarcopenia. Therefore, clinicians need to identify high-risk patients as early as possible and provide targeted intervention measures.