Objective To study the correlation between Periostin, interleukin-33 (IL-33), and chronic cough after thoracoscopic lobectomy in patients with coronary artery bypass grafting (CABG) combined with lung cancer. Methods A total of 102 lung cancer and coronary heart disease patients at Tianjin Chest Hospital from January 2022 to January 2024 were prospectively enrolled, and they were divided into a chronic cough group (n=42) and a non-chronic cough group (n=60) based on whether chronic cough occurred after surgery. Serum levels of Periostin and IL-33 were measured on the 1st, 7th, and 14th days post-lobectomy. The Pearson method was employed to analyze the correlation between Periostin and IL-33 levels and the severity of cough. Univariate and multivariate logistic regression analyses were conducted to identify factors influencing the occurrence of chronic cough. Additionally, receiver operating characteristic (ROC) curve analysis was utilized to assess the potential value of serum Periostin and IL-33 levels in predicting postoperative chronic cough. Results In patients with chronic cough, the peripheral blood Periostin and IL-33 levels measured on days 7 and 14 were significantly higher than those in patients with non-chronic cough, and the interactions between the two groups and at different time points were significant (P<0.001). The degree of cough was positively correlated with the levels of Periostin and IL-33 on days 7 and 14 (P<0.05), but had no significant correlation with the levels on day 1 (P>0.05). In patients with lung cancer, after thoracoscopic lobectomy, Periostin [OR=1.619, 95%CI (1.295, 2.025)] and IL-33 [OR=1.831, 95%CI (1.216, 2.758)] on day 7 and Periostin [OR=1.952, 95%CI (1.306, 2.918)] and IL-33 [OR=1.742, 95%CI (1.166, 2.603)] on day 14 were identified as risk factors for chronic cough. ROC curve analysis showed that the sensitivity of Periostin on day 7 was 69.05%, the specificity was 71.67%, and the area under the curve (AUC) was 0.756 [95%CI (0.616, 0.893)]. The sensitivity of Periostin on day 14 increased to 71.43% and the specificity was 76.67%, AUC was 0.762 [95%CI (0.633, 0.898)]. At the same time, the critical value of IL-33 on day 7 was 45.03 pg/mL, the sensitivity and specificity were both 83.33%, the AUC was 0.884 [95%CI (0.789, 0.980)], and the critical value of IL-33 on day 14 was 56.01 pg/mL, the sensitivity was 85.71%, the specificity was 80.00%, and the AUC was 0.899 [95%CI (0.799, 0.999)]. Joint logistic regression analysis of Periostin and IL-33 levels on days 7 and 14 showed showed that the sensitivity was 95.24%, the specificity was 95.00%, and the AUC reached 0.993 [95%CI (0.979, 1.000)]. Conclusion Periostin and IL-33 levels, measured at various time points, are abnormally elevated following thoracoscopic lobectomy in patients with combined CABG and lung cancer. These levels significantly correlate with cough severity. Given their predictive potential for chronic cough, these markers are deemed valuable biomarkers.

Objective: Intrathyroid thymic carcinoma（ITTC） is a rare thyroid tumor that lacks typical clinical manifestations and imaging features, making preoperative diagnosis challenging.The primary treatment for ITTC is radical surgery; however, the effectiveness of adjuvant radiotherapy and chemotherapy post-surgery is not well-established. This paper presents a case of ITTC , analyzing the clinical data and correlating it with the literature to explore the clinical manifestations, diagnostic approach, treatment, and prognosis of ITTC.
Humans ; Prognosis ; Thymoma ; Thymus Neoplasms/diagnosis* ; Thyroid Neoplasms/pathology*

With the widespread adoption of low-dose CT screening and the extensive application of high-resolution CT, the detection rate of sub-centimeter lung nodules has significantly increased. How to scientifically manage these nodules while avoiding overtreatment and diagnostic delays has become an important clinical issue. Among them, lung nodules with a consolidation tumor ratio less than 0.25, dominated by ground-glass shadows, are particularly worthy of attention. The therapeutic challenge for this group is how to achieve precise and complete resection of nodules during surgery while maximizing the preservation of the patient's lung function. The "watershed topography map" is a new technology based on big data and artificial intelligence algorithms. This method uses Dicom data from conventional dose CT scans, combined with microscopic (22-24 levels) capillary network anatomical watershed features, to generate high-precision simulated natural segmentation planes of lung sub-segments through specific textures and forms. This technology forms fluorescent watershed boundaries on the lung surface, which highly fit the actual lung anatomical structure. By analyzing the adjacent relationship between the nodule and the watershed boundary, real-time, visually accurate positioning of the nodule can be achieved. This innovative technology provides a new solution for the intraoperative positioning and resection of lung nodules. This consensus was led by four major domestic societies, jointly with expert teams in related fields, oriented to clinical practical needs, referring to domestic and foreign guidelines and consensus, and finally formed after multiple rounds of consultation, discussion, and voting. The main content covers the theoretical basis of the "watershed topography map" technology, indications, operation procedures, surgical planning details, and postoperative evaluation standards, aiming to provide scientific guidance and exploration directions for clinical peers who are currently or plan to carry out lung nodule resection using the fluorescent microscope watershed analysis method.

Objective:To compare the effect of repeated transcranial magnetic stimulation (rTMS) targeting the M1 hand area, the M1 lower limb area, or the sciatic nerve on the motor functioning and ability in the activities of daily living of persons after a spinal cord injury (SCI).Methods:This was a retrospective analysis of data describing 86 hospitalized SCI patients. They were divided into four groups based on where the rTMS was applied: an M1 hand area group ( n=22), an M1 lower limb area group ( n=20), a sciatic nerve group ( n=24), and a control group ( n=20) who never received rTMS. In addition to conventional medication and rehabilitation training, the M1 hand area group, the M1 lower limb area group and the sciatic nerve group received 10Hz rTMS over the named area for 4 weeks. Before and after the treatment, the Spinal Cord Independence Measure (SCIM) total scores, SCIM indoor activity (SCIM12) sub-scores, Modified Barthel Index (MBI) scores, and lower extremity motor (LEMS) scores were compared among the four groups. Results:After the treatment, the average SCIM, SCIM12, MBI, and LEMS scores had improved significantly in all four groups. The average SCIM [10.00(4.00, 24.75] and MBI scores [12.00(6.75, 31.50)] of the M1 hand area group were then significantly better than the control group′s averages [3.50(0.00, 9.50) and 7.50(1.25, 17.75)]. There was also significantly greater improvement in the average LEMS score of the M1 hand area group [2.00(0.00, 10.00)] compared with both the sciatic nerve group [0.00(0.00, 2.00)] and the control group [0.00(0.00, 1.75)].Conclusions:High-frequency rTMS stimulation of the M1 hand area significantly promotes the recovery of lower limb motor function and self-care ability after an SCI. It is more effective than stimulating the M1 lower limb area or the sciatic nerve.

Iron is an essential trace element in the human body, crucial in maintaining normal physiological functions. Recent studies have identified iron ions as a significant factor in initiating the ferroptosis process, a novel mode of programmed cell death characterized by iron overload and lipid peroxide accumulation. The iron metabolism pathway is one of the primary mechanisms regulating ferroptosis, as it maintains iron homeostasis within the cell. Numerous studies have demonstrated that abnormalities in iron metabolism can trigger the Fenton reaction, exacerbating oxidative stress, and leading to cell membrane rupture, cellular dysfunction, and damage to tissue structures. Therefore, regulation of iron metabolism represents a key strategy for ameliorating ferroptosis and offers new insights for treating diseases associated with iron metabolism imbalances. This review first summarizes the mechanisms that regulate iron metabolic pathways in ferroptosis and discusses the connections between the pathogenesis of various diseases and iron metabolism. Next, we introduce natural and synthetic small molecule compounds, hormones, proteins, and new nanomaterials that can affect iron metabolism. Finally, we provide an overview of the challenges faced by iron regulators in clinical translation and a summary and outlook on iron metabolism in ferroptosis, aiming to pave the way for future exploration and optimization of iron metabolism regulation strategies.

Chronic thromboembolic pulmonary hypertension(CTEPH)is a severe form of pulmonary hypertension(PH),and is classified as the fourth major category of pulmonary arterial hypertension.CTEPH is primarily caused by chronic thrombosis,leading to the obstruction of blood flow in the pulmonary arteries and result ing in a sustained increase in pulmonary artery pressure.The unclear pathogenesis of CTEPH,however,means that its early diagnosis is challenging,treatment options are limited,and prognosis assessment is often inaccurate.In-depth research into these mechanisms will thus improve our understanding of the pathophysiological processes of CTEPH,and also provide a theoretical basis for developing new therapeutic strategies.This review focuses on the current method of establishing CTEPH rat models and their advantages and disadvantages,offering researchers a reference for selecting and constructing CTEPH rat models.

Objective To explore the effect and potential mechanisms of cynarin on septic cardiomyopathy.Methods Seventy-eight male C57BL/6mice were divided into three groups using a random number table method:control group,model group,and treatment group,with 26mice in each group.The treatment group received daily intraperitoneal injections of cynarin at a dose of 25 mg/(kg·d)for 7days,while control group and model group received daily intraperitoneal injections with the same amount of saline.One hour after the in-traperitoneal injection of cynarin on the 7th day,the model group and treatment group were intraperitoneally injected with lipopolysaccha-ride(LPS)at a dose of 10mg/kg to induce septic cardiomyopathy.12hours later,6mice were randomly selected from each group to test cardiac function,and the remaining mice were monitored for 7-day survival.Hematoxylin-eosin staining was used to observe the histo-logical structure of mouse myocardium;Enzyme linked immunosorbent assay were used to detect the levels of inflammatory factors,mark-ers of myocardial injury,markers of myocardial oxidative stress;determination of tissue iron content by the colourimetric method;real-time fluorescence quantitative polymerase chain reaction(RT-qPCR)was used to detect the mRNA levels of myocardial inflammatory factors;Terminal Deoxynucleotidyl Transferase-Mediated dUTP Nick End Labeling(TUNEL)staining was used to detect the apoptosis of cardiac myocytes;Dihydroethidium(DHE)staining was used to detect the levels of reactive oxygen species;and Western blot was used to detect the protein expression levels of B-cell lymphoma-2(Bcl-2),Bcl-2-Associated X(Bax),glutathione peroxidase 4(GPX4),recombinant solute carrier family 7,member 11(SLC7A11),ferritin heavy chain 1(FTH1),transferrin receptor(TFR),kelch-like ECH associated protein 1(Keap1),nuclear factor erythroid 2-related factor 2(Nrf2)protein expression levels.Results Compared with the control group,mice in the model group had lower left ventricular ejection fraction and short-axis shortening rate,higher lactate dehydrogenase and creatine kinase-MB,higher content and mRNA expression of inflammatory factors,decreased survival,significant myocardial pathological damage and increased apoptotic cells,enhanced oxidative stress,inhibition of myocardial GPX4,SLC7A11,FTH1 and Nrf2 expression,and up-regulation of TFR,Keap1 expression,and increased iron content(P＜0.05);Compared with the model group,mice in the treatment group had increased survival rate,significantly improved cardiac dysfunction and myocardial injury,and reduced inflammatory injury,apoptosis and oxidative stress,as well as up-regulated expression of GPX4,SLC7A11,FTH1 and Nrf2,suppressed expression of TFR and Keap1,and decreased iron content(P＜0.05).Conclusion Cynarin may alleviate inflam-mation,apoptosis and oxidative stress by inhibiting Keap1/Nrf2-mediated ferroptosis,and protect septic cardiomyopathy.

BACKGROUND:Previous studies found that Semen Ziziphi Spinosae extract prolongs slow-wave sleep and promotes growth hormone secretion in mice by increasing the expression of brain tissue serotonin 1A receptor (5-HT1AR),which binds to serotonin,thus leading to bone growth. Serotonin 1A receptor acts as a protein,and its expression abundance is regulated by miRNAs. The authors hypothesized that Semen Ziziphi Spinosae extract may regulate the expression of 5-HT1AR through miRNAs and thus exert drug effects. OBJECTIVE:To observe the effect of Semen Ziziphi Spinosae extract on bone growth by regulating the miR-7b-3p/5-HT1AR pathway in mouse brain tissue. METHODS:(1) Kunming mice were divided into a normal control group,a drug administration group (gavage administration of Semen Ziziphi Spinosae extract 0.320 mg/g),a positive control group (gavage administration of jujuboside 0.013 mg/g),a Semen Ziziphi Spinosae extract+5-HT1AR selective inhibitor group (8 μg of P-MPPF,a 5-HTIAR selective inhibitor,was injected into the lateral ventricle every day for the last 3 days during the gavage administration of Semen Ziziphi Spinosae extract). After 25 days,the effects of Semen Ziziphi Spinosae extract on bone growth,serum growth hormone level and brain 5-HT1AR expression were observed. (2) Then the chip method was used to observe differentially expressed miRNAs in the brain tissues of growing mice and ordinary mice. PCR validation and dual luciferase reporter gene assay confirmed the regulatory relationship between the screened Mir-7B-3p and 5-HT1AR. (3) Mouse cerebral cortical cells were cultured and identified in vitro,and the effect of Semen Ziziphi Spinosae extract on 5-HT1AR expression in cerebral cortical cells was observed using western blot. (4) Kunming mice were divided into a normal control group,a medication group,a miR-7b-3p inhibitor group,a medication+5-HT1AR inhibitor group,and a positive control group. The expression of 5-HT1AR in brain tissues of mice and the binding activity of 5-HT and 5-HT1AR were observed. (5) Sprague-Dawley rats were divided into a normal control group,a medication group,a miR-7b-3p inhibitor group,a medication+miR-7b-3p mimics group and a positive control group. Changes in slow wave sleep in mice were observed.RESULTS AND CONCLUSION:(1) Semen Ziziphi Spinosae extract could promote the growth of body length and tibia,growth hormone secretion,and brain tissue 5-HT1AR level in mice. (2) The number of differentially expressed miRNAs screened by GeneChip was 16,of which 13 were up-regulated and 3 were down-regulated. Bioinformatics results predicted that down-regulation of miR-7b-3p could regulate 5-HT1AR expression,and dual-luciferase reporter gene experiments confirmed a direct regulatory relationship between the two. (3) Semen Ziziphi Spinosae extract and silencing of miR-7b-3p expression in cerebral cortical cells could cause high expression of 5-HT1AR. After silencing of miR-7b-3p,5-HT1AR expression,binding activity of serotonin and 5-HT1AR and growth hormone secretion in mouse brain tissue were all elevated. After overexpression of miR-7b-3p,5-HT1AR expression,binding activity of serotonin and 5-HT1AR and growth hormone secretion were all reduced. Accordingly,the slow-wave sleep period in mice was also prolonged or shortened. To conclude,Semen Ziziphi Spinosae extract can reduce the level of miR-7b-3p and increase the expression of 5-HT1AR in brain tissue to prolong slow wave sleep and promote the secretion of growth hormone,thereby playing a postive effect on bone growth. These findings provide a scientific basis for the use of Semen Ziziphi Spinosae extract as a potential measure to promote bone growth.

Brain MRI data is characterized by large volumes and susceptibility to noise and artifacts,which pose significant challenges of improving the speed and accuracy of brain tumor detection and analysis due to the tumors'diverse types,shapes,and boundaries that are both similar and highly variable.Therefore,a series of improvements based on YOLOv7 algorithm are proposed for enhancing detection precision and speed:(1)employing partial convolution during feature extraction to reduce the model's parameters and improve overall detection speed;(2)in light of the complex variability of brain tumors,introducing a three-dimensional spatial attention mechanism during feature extraction to enhance the model's focus on critical image features;(3)replacing the original IoU loss function with WIoU to increase the attention to medium-quality anchor boxes during bounding box regression for further improving detection accuracy.Experiments conducted on two public brain tumor datasets,Brain_Tumor and Glioma_of_test,show that the improved model achieves mAP of 96.9%and 92.8%,which are 1.4%and 2.4%higher than the original YOLOv7 model,and the frames per second reach 162.7 and 158.1,showing improvements of 6.4 and 18.2,respectively.These enhancements enable more effective detection of brain tumors in MRI images.