Ischemia-reperfusion injury of solid organs is a common complication during transplantation, but its mechanism remains unclear and there are no effective prevention and treatment methods. Rejection is a common immune response of the graft, which is classified into hyperacute rejection, acute rejection and chronic rejection. Rejection and ischemia-reperfusion injury of solid organs may share some common mechanisms, and further research on their correlation may provide strategies for the prevention and treatment of ischemia-reperfusion injury of solid organs. This article mainly reviews the association between rejection and ischemia-reperfusion injury of solid organs.

Dry eye disease(DED)is a common ocular surface disorder worldwide, primarily characterized by a loss of homeostasis of the tear film, and frequently associated with meibomian gland dysfunction(MGD), decreased tear film stability, ocular discomfort, and visual impairment. In recent years, factors such as the widespread use of digital devices,the aging population, and environmental changes have contributed to a significant increase in its global prevalence, making it a major public health concern. Red light therapy(RLT), also known as low-level laser therapy(LLLT)or photobiomodulation(PBM), is a non-invasive treatment that utilizes low-energy red or near-infrared light to irradiate tissues. It exerts photobiomodulatory effects to promote cellular repair and functional recovery. This therapy has demonstrated considerable potential in treating various ocular conditions. Its broader clinical application could improve therapeutic outcomes, alleviate patient discomfort and financial burden, and reduce the consumption of healthcare resources, thereby yielding significant socio-economic benefits. This paper systematically reviews the multifaceted mechanisms and application prospects of RLT in managing DED, including its anti-inflammatory effects, improvement of meibomian gland function, promotion of conjunctival goblet cell repair, and alleviation of visual fatigue, aiming to provide a theoretical foundation and practical reference for its clinical adoption.

Lung cancer is a leading cause of cancer-related morbidity and mortality worldwide. Coupled with the substantial workload, the clinical management of lung cancer is challenged by the critical need to efficiently and accurately process increasingly complex medical information. In recent years, large language models (LLMs) technology has undergone explosive development, demonstrating unique advantages in handling complex medical data by leveraging its powerful natural language processing capabilities, and its application value in the field of lung cancer diagnosis and treatment is continuously increasing. The paper systematically analyzes that the exceptional potential of LLMs in lung cancer auxiliary diagnosis, tumor feature extraction, automatic staging, progression/outcome analysis, treatment recommendations, medical documentation generation, and patient education. However, they face critical technical and ethical challenges including inconsistent performance in complex integrated decision-making (e.g., TNM staging, personalized treatment suggestions) and "black box" opacity issues, along with dilemmas such as training data biases, model hallucinations, data privacy concerns, and cross-lingual adaptation challenges ("data colonization"). Future directions should prioritize constructing high-quality multimodal corpora specific to lung cancer, developing interpretable and compliant specialized models, and achieving seamless integration with existing clinical workflows. Through dual drivers of technological innovation and ethical standardization, LLMs should be prudently advanced for holistic lung cancer management processes, ultimately promoting efficient, standardized, and personalized diagnosis and treatment practices.

Objective: The cross sectional study aimed to identify predominant co-occurrence patterns among six common mental health issues in college students, so as to provide empirical basis for designing targeted interventions. Methods: From October 2024, a total of 9 837 students from 4 universities in Xiangtan City, Hunan Province, participated in the current study by multistage random cluster sampling method. Participants completed self report measures, including the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7 item Scale (GAD-7), Young s Internet Addiction Diagnostic Questionnaire, the Adolescent Insomnia Symptom Self rating Scale, the Ottawa Self injury Inventory, and the Brief Community Assessment of Psychic Experiences Questionnaire. Demographic and co-occurrence characteristics were first compared using Chi square or trend Chi-square tests, followed by application of the Apriori algorithm to mine association rules for primary co-occurrence patterns. Results: The detection rate of co-occuring the common mental health issues was 46.44%. The detection rate was significantly higher in female than in male students (50.42%, 43.61%; χ 2=44.46) and in students from rural versus urban areas (47.22%, 44.60%; χ 2=5.67) (both P <0.05). Significant differences were observed among freshmen, sophomores, juniors, and seniors (46.63%, 48.35%, 45.05% , 43.66%, respectively; χ 2=9.22, P <0.05), although no statistically significant trend was detected ( χ 2 trend =3.75, P = 0.05 ). Association rule mining identified “anxiety + depression” “anxiety + psychotic experiences + depression” and “anxiety + sleep disorder + depression” as the combinations with the highest support. In addition, “anxiety+depression+Internet addiction+psychotic experiences =>sleep disorder (>= refered to the occurrence of the latter item under the condition that the former item occurs)” and “anxiety + depression+Internet addiction=>sleep disorder” were combinations with relatively high confidence. Conclusions Co-occurrence of these mental health issues among college students is high and exhibits diverse patterns. Strategies to address this burden should prioritize integrated interventions that target these specific combinations of factors.

ObjectiveTo explore the establishment of a rat model of diabetic macrovascular atherosclerosis （DMA） with Qi and Yin deficiency syndrome induced by high-fat diet， streptozotocin （STZ）， and Yin-depleting herbs， and to evaluate its biological characteristics. MethodsForty SD rats were randomly divided into a blank group （n=10） and a modeling group （n=30）. Except for the blank group， rats in the model group were fed a high-fat diet for 4 weeks， followed by intraperitoneal injection of STZ （30 mg·kg^-1） to establish a diabetic model. Twenty-four successfully modeled diabetic rats were randomly divided into a model group （n=7）， a Qi and Yin deficiency syndrome group （n=8）， and a counter-syndrome group （n=9）. Except for the model group， rats received intragastric administration of Yin-depleting herbs （1.2 g·kg^-1） for 8 weeks. The counter-syndrome group was further treated with Shenqi compound formula （1.69 g·kg^-1） for an additional 8 weeks. General condition and body weight were recorded， and syndrome-related indicators were assessed， including precordial temperature， skin moisture content， grip strength， open-field test performance， and tongue appearance. Serum levels of vascular endothelial growth factor （VEGF）， endothelin-1 （ET-1）， vascular cell adhesion molecule-1 （VCAM-1）， insulin-like growth factor-1 （IGF-1）， and monocyte chemotactic protein-1 （MCP-1） were measured by enzyme-linked immunosorbent assay （ELISA）. Fasting blood glucose， blood lipids， hemorheological parameters， and coagulation function were analyzed using an automatic biochemical analyzer. Vascular ultrasound and hematoxylin-eosin （HE） staining were used to evaluate vascular lesions. ResultsIn terms of syndrome manifestations， compared with the blank group， body weight increased rapidly during the first 5 weeks in the model， Qi and Yin deficiency， and counter-syndrome groups. After STZ injection combined with Yin-depleting herbal administration at week 5， body weight decreased significantly （P<0.01） and continued to decline until the end of the experiment. Rats exhibited decreased activity， irritability， coarse and yellowish fur with obvious shedding， polydipsia， polyphagia， frequent urination， and dry stools， which were most pronounced in the Qi and Yin deficiency group. Grip strength decreased， peak activity time occurred earlier， total distance in the open-field test was reduced， and residence time was prolonged. Precordial temperature decreased （P<0.01）， while paw temperature increased （P<0.05）， and skin moisture and oil content were reduced （P<0.05， P<0.01）. In terms of disease-related indicators， compared with the blank group， fasting blood glucose was significantly increased （>16.7 mmol·L^-1） in the model and Qi and Yin deficiency groups， and blood lipid levels were significantly elevated （P<0.05）. Vascular-related factors ET-1， MCP-1， VCAM-1， and VEGF were significantly increased （P<0.05，P<0.01）， while IGF-1 was significantly decreased （P<0.01）. Pathological examination of the aortic valve showed valvular thickening and structural disorganization. Carotid artery examination revealed discontinuity of the intima， foam cell accumulation beneath the intima， disordered smooth muscle arrangement， and widened intercellular spaces. Compared with the model group， ET-1， MCP-1， and VEGF levels were significantly decreased in both the Qi and Yin deficiency group and the counter-syndrome group. The reductions in ET-1 and MCP-1 were more pronounced in the Qi and Yin deficiency group （P<0.01）， while the decrease in VCAM-1 was more significant in the counter-syndrome group （P<0.05）. Compared with the blank group， the Qi and Yin deficiency group showed significantly prolonged activated partial thromboplastin time （APTT）， thrombin time （TT）， and prothrombin time （PT） （P<0.01）. The erythrocyte deformability index （TK）， erythrocyte sedimentation rate， erythrocyte electrophoresis index， and whole blood low-shear viscosity all showed increasing trends. Vascular ultrasound revealed reduced arterial blood flow velocity， increased vascular resistance， and intimal thickening without plaque formation. The aortic intima showed no obvious overall thickening， with only occasional localized thickening and foam cell presence， and carotid artery injury was observed. ConclusionA rat model of DMA with Qi and Yin deficiency syndrome was successfully established using high-fat diet feeding combined with STZ injection and Yin-depleting herbal administration. Shenqi compound formula effectively alleviated Qi and Yin deficiency syndrome， regulated glucose and lipid metabolism， improved hemorheological and coagulation function， reduced vascular lesion severity， and demonstrated potential for early prevention and treatment of DMA.

BACKGROUND:Urolithin B plays an important role in regulating the body's immune response and has antioxidant,anti-cancer and anti-inflammatory properties.Notably,urolithin B has been reported to have inhibitory effects on osteoclast differentiation of Raw 264.7 cells.However,a more comprehensive understanding of its specific mechanism of action in the context of osteoclast differentiation in bone is worth exploring.Systematic research on the regulatory mechanisms of osteoclast overactivation can help to explore new therapeutic targets,screen and develop safer and more effective therapeutic drugs,and provide new ideas to block the overactivation of osteoclasts. OBJECTIVE:By establishing an in vitro osteoclast differentiation model using bone marrow-derived macrophages,to investigate the effect of urolithin B on nuclear factor-κB receptor-activating factor ligand-mediated osteoclast differentiation and to systematically analyze its mechanism of action. METHODS:(1)The safe working concentration of urolithin B was screened by cell counting kit-8 method.(2)Different concentrations of urolithin B(0,12.5,25,and 50 μmol/L)were used to intervene with the osteoclast differentiation of bone marrow-derived macrophages,and the number of osteoclasts and the size of osteocytes were observed using tartrate-resistant acid phosphatase staining.(3)Different concentrations of urolithin B(0,12.5,25,and 50 μmol/L)were used to intervene with the osteoclast differentiation of bone marrow-derived macrophages,and the relative expression levels of osteoclast-specific genes were detected using real-time fluorescence quantitative PCR.(4)The effect of urolithin B on the P65 and ERK signaling pathways of bone marrow-derived macrophages was observed by western blot.(5)The effect of urolithin B on the key transcription factors nuclear factor of activated T cells 1 and c-Fos in the osteoclastic differentiation of bone marrow-derived macrophages was detected by western blot. RESULTS AND CONCLUSION:50 μmol/L or lower concentration of urolithin B had no effect on the proliferation of bone marrow-derived macrophages but significantly inhibited osteoclastic differentiation of bone marrow-derived macrophages.Urolithin B mainly inhibited osteoclastic differentiation of bone marrow-derived macrophages in pre-medium term.Urolithin B down-regulated the relative expression levels of osteoclast specific genes in bone marrow-derived macrophages.50 μmol/L urolithin B inhibited the phosphorylation levels of P65 and ERK in bone marrow-derived macrophages,which led to the inhibition of osteoclast formation.50 μmol/L urolithin B inhibited the expression of key transcription factors nuclear factor of activated T cells 1 and c-Fos in bone marrow-derived macrophages into osteoclasts.To conclude,urolithin B inhibits bone marrow-derived macrophages from differentiating into osteoclasts by suppressing the expression of downstream osteoclastogenic-related signature genes and downregulating the expression of the important osteoclastogenic transcription factors,nuclear factor of activated T cells 1 and c-Fos,via the P65/ERK signaling axis.

AIM: To investigate the efficacy of pars plana vitrectomy(PPV)with or without inner limiting membrane(ILM)peeling in refractory diabetic macular edema.METHODS:Totally 80 patients with refractory diabetic macular edema were retrospectively selected and assigned into groups according to the treatment method. Among them, 38 patients treated with PPV were included as group A, and 42 patients treated with PPV combined with ILM peeling were included as group B. The relevant data of patients in the two groups were collected, and the efficacy of the two groups was compared.RESULTS: At 1, 3, and 6 mo after surgery, the best corrected visual acuity(BCVA), central macular thickness(CMT), and severity of macular edema in the group B were all superior to those in the group A(all P<0.05). At 6 mo after the surgery, the incidence of complications in the group B was 12%, with no prominent difference compared to 18% of the group A(P>0.05).CONCLUSION:PPV combined with or without ILM peeling can improve visual function and relieve macular edema in patients with refractory diabetic macular edema. However, the combination of PPV and ILM peeling is superior to PPV alone in improving vision and relieving macular edema, and does not increase postoperative complications.

Objective To develop a three-dimensional(3D)deep neural network based preoperative classification model for coronary computed tomography angiography(CTA)in atrial fibrillation patients,and to explore the effects of transfer learning on the performance of medical image classification models,thereby providing preoperative decision support for catheter ablation to advance atrial fibrillation treatment toward precision and personalization.Methods Utilizing 3D ConvNet and 3D ResNet as backbone network,the three-dimensional classification features were extracted from coronary CTA sequences.The publicly available pre-trained weights were used for transfer learning.The model performance was evaluated through metrics such as confusion matrix,classification accuracy,and area under the curve(AUC).A comparative analysis was also conducted to evaluate the performance differences between the transfer learning model and the initialized training model.Results Transfer learning yielded significant performance improvements over the initialized training models,attaining AUC improvement of 9.1%-16.7%and accuracy enhancement of 6.2%-23.5%.Among all models,3D-ResNet18 model with MedicalNet pre-training weights performed the best,achieving an AUC of 0.77 and an accuracy of 0.71.Conclusion The proposed three-dimensional deep network enhanced by transfer learning can effectively identify atrial fibrillation patients requiring additional ablation besides pulmonary vein isolation through preoperative coronary CTA,which will assist clinicians in optimizing surgical strategies and improving treatment outcomes,thereby reducing long-term postoperative recurrence rates.

Objective:To evaluate the efficacy of two different approaches:direct anterior approach(DAA)and posterolateral approach(PLA)in total hip arthroplasty(THA).Methods:This study adopted a retrospective cohort study design,included to analyse 128 cases of THA patients who were received in our hospital from January 2021 to January 2024.Patients were divided into PLA group(n=61)and DAA group(n=67)according to different approach methods.Perioperative indicators,Harris hip joint function score,anteversion and abduction angles of acetabular prosthesis and incidence of complications were compared between the two groups.Results:Compared with PLA group,DAA group had longer surgical time,less intraoperative blood loss,shorter surgical incision length and shorter postoperative hospital stay(P＜0.05).Compared with the PLA group at 1 month(T2)to 6 months(T4)after surgery,DAA group had higher Harris hip joint function score(P＜0.05).Conclusion:Compared with PLA,DDA is used in THA,although the surgery time is longer,it can achieve a similar recovery effect in anteversion and abduction angles,which helps to shorten the surgical incision length and postoperative hospital stay,reduce intraoperative blood loss and achieve better hip joint function recovery.

Kv1.3,a voltage-gated potassium channel,is highly expressed in T lymphocytes,the nervous system,and vascular smooth muscle cells.It plays a critical role in membrane excitability and electrical signal transduction,serving as an important target for studying T-cell function and providing a promising direction for developing therapeutics against autoimmune and inflammatory diseases.Therefore,the de-velopment of specific inhibitors of Kv1.3 channel has emerged as a novel therapeutic strategy for these disorders.In this study,we isolated and purified a novel Kv1.3-inhibitory peptide toxin,LmKTx13,from the venom of the scorpion Lychas mucronatus using reversed-phase high-performance liquid chroma-tography(RP-HPLC).LmKTx13 consists of 38 amino acid residues,including six cysteines that form three disulfide bonds.Whole-cell patch-clamp recordings revealed that LmKTx13 potently inhibited Kv1.3 with an IC50 of 7.92±3.0 nmol/L.Selectivity analysis showed that 2 μmol/L LmKTx13 also in-hibited Kv1.2 and Kv1.7,but exhibited no significant effects on other potassium channel subtypes or voltage-gated sodium channels.Further investigation into the mechanism demonstrated that LmKTx13 acts as a pore-blocking inhibitor of Kv1.3.By analyzing the effects of LmKTx13 on Kv1.3 channel gating ki-netics and performing sequence alignment of the pore regions of Kv1.3 and Kv1.5,we constructed site-directed mutants and identified the pore region of Kv1.3 as the critical binding site for LmKTx13.Key residues involved in the interaction included T425,G427,and H451.In summary,we discovered a no-vel pore-blocking Kv1.3 inhibitor,LmKTx13,from L.mucronatus venom,which exhibits high affinity and selectivity for Kv1.3.These findings highlight its potential as a potential lead molecule for developing Kv1.3-targeted therapeutics.