Rheumatoid arthritis （RA） is a common chronic systemic autoimmune disease with synovitis as the main manifestation， which often causes joint swelling and pain or even deformity. It is considered to be an incurable lifelong disease. Although the current Western medicine treatment can alleviate the progression of the disease， it has the clinical limitations of liver injury， cardiovascular complications， and other adverse reactions， along with easy recurrence. Traditional Chinese medicine （TCM） has a long history and has the advantages of individualized treatment and fewer adverse reactions. It can effectively relieve the symptoms of joint swelling and pain in RA patients and slow down the progression of bone destruction， which has attracted wide concern in the medical community. Janus kinase （JAK）/signal transducer and activator of transcription （STAT） signaling pathway is an important intracellular pathway involved in cell proliferation， differentiation， apoptosis， immune regulation， and other biological behaviors， and plays an important role in the pathophysiological process of RA. In recent years， many studies have confirmed that TCM monomers and compounds can inhibit inflammation and angiogenesis by regulating the JAK/STAT signaling pathway， induce apoptosis and inhibit proliferation of fibroblast-like synoviocytes （FLS）， regulate immune response， and thus exert an effect in the treatment of RA. However， there is still a lack of comprehensive and systematic induction and overview. Therefore， by searching the relevant literature in China National Knowledge Infrastructure （CNKI） and PubMed databases from 2009 to 2024， this study described the mechanism of the JAK/STAT signaling pathway in the occurrence and development of RA and summarized the research progress of TCM monomers and compounds in regulating the JAK/STAT signaling pathway in RA intervention. The study aims to provide new ideas and strategies for the clinical treatment of RA with TCM and the research and development of new drugs.

OBJECTIVE To evaluate the efficacy and safety of immune checkpoint inhibitors （ICIs） combined with neoadjuvant chemotherapy in the treatment of early triple-negative breast cancer （TNBC）. METHODS Randomized controlled trials （RCTs） comparing ICIs combined with neoadjuvant chemotherapy （experimental group） versus neoadjuvant chemotherapy alone （control group） were retrieved from PubMed， Cochrane Library， Embase， Web of Science， CNKI， Wanfang Data， and VIP databases， as well as relevant studies published at oncology academic conferences. The search period was from database inception to June 30， 2025. After literature screening， data extraction， and quality assessment， a meta-analysis was performed by using RevMan 5.4 software. RESULTS A total of 6 RCTs involving 3 786 patients were finally included. The meta-analysis results showed that the experimental group had superior event-free survival [HR＝0.73， 95%CI （0.62， 0.85）， P＜0.000 1]， overall survival [HR＝0.69， 95%CI （0.57， 0.84）， P＝0.000 3]， and pathological complete response （pCR） [OR＝1.57， 95%CI （1.37， 1.80）， P＜0.000 01] compared to the control group. The incidence of ≥grade 3 adverse event （AE）， severe AE （SAE）， and ≥ grade 3 immune-related adverse event （irAE） in the experimental group was significantly higher than that in the control group. There was no statistically significant difference between the two groups in the incidence of any AE or any irAE （P＞0.05）. Subgroup analysis revealed that， regardless of programmed cell death ligand 1 expression status （negative or positive），the pCR in the experimental group was significantly higher than that in the control group （P＜0.05）. Additionally， the pCR of the patients with positive lymph nodes in the experimental group was significantly higher to that in the ontrol group （P＜0.05）. There was no statistically significant difference in pCR between the two groups with negative lymph nodes （P＝0.09）. CONCLUSIONS ICIs combined with neoadjuvant chemotherapy can significantly improve event-free survival and overall survival in patients with TNBC， providing patients with long-term survival benefits. However， the risk of ≥ grade 3 AE， SAE and ≥ grade 3 irAE has increased.

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.

ObjectiveTo evaluate the clinical efficacy and safety of acupuncture in treating severe Bell's palsy and to explore its potential mechanism by investigating the effect on serum levels of glial cell line-derived neurotrophic factor （GDNF） and nerve growth factor （NGF）. MethodsA randomized， subject-blinded， sham-acupuncture controlled trial was conducted. A total of 130 patients with severe Bell's palsy were randomly allocated into a treatment group or a control group at a 1∶1 ratio. Both groups received conventional western medicine. In addition， the treatment group received acupuncture， while the control group received sham acupuncture， with each session lasting 30 minutes. The treatment course lasted 8 weeks for both groups， followed by a follow-up assessment at week 12. The primary outcome was the proportion of patients achieving House-Brackmann （H-B） grade Ⅱ or lower at week 8. Secondary outcomes included Sunnybrook facial grading system scores at week 0， 4， 8， and 12， the time to satisfactory recovery（the time required to achieve H-B grade≤Ⅱ）， distribution of H-B grades and facial disability index （FDI） scores including the physical function subscale （FDIP） and social/well-being function subscale （FDIS） scores at week 0， 4， 8， and 12， and serum GDNF and NGF levels at week 0， 4， and 8. Adverse events and participants' self-assessments of treatment efficacy were also recorded. ResultsA total of 122 participants completed the study， including 62 in the treatment group and 60 in the control group. An intention-to-treat （ITT） analysis was performed， and missing data were handled using the last observation carried forward （LOCF） method. The proportion of patients achieving H-B grade ≤grade Ⅱ at week 8 was 78.5% （51/65） in the treatment group， significantly higher than 49.2% （32/65） in the control group （P＜0.05）. The Sunnybrook scores， FDIP and FDIS scores increased， while H-B grades decreased at week 4， 8， and 12 in both groups compared to week 0； moreover， improvements in all outcome measures were significantly greater in the treatment group than in the control group （P＜0.05）. The median time to satisfactory recovery was 6 weeks （95%CI： 5.697-6.303） in the treatment group， significantly shorter than 12 weeks （95%CI： 8.314-15.686） in the control group （P＜0.05）. Serum levels of GDNF and NGF were significantly higher in the treatment group at weeks 4 and 8 （P＜0.05）. No serious acupuncture-related adverse events occurred in either group. Adverse events were reported in 5 patients （7.69%） in the treatment group and 4 patients （6.15%） in the control group， with no statistically significant difference between groups （P＞0.05）. Patients' self-assessment of treatment efficacy after 8 weeks treatment was significantly better in the treatment group （P＜0.05）. ConclusionAcupuncture can effectively improve facial nerve function and shorten recovery time in patients with severe Bell's palsy， with a favorable safety profile. The therapeutic mechanism may be associated with the upregulation of serum GDNF and NGF levels.

Objective To investigate the effects and underlying mechanisms of total flavonoids of sarcandra glabra(TFFSG)on bone marrow mesenchymal stem cells(BMSCs)and their derived exosomes in immune thrombo-cytopenia(ITP),with a focus on promoting megakaryocyte differentiation and maturation.Methods BMSCs induced by rabbit anti-rat platelet serum(APS)were divided into five groups:a blank control group,an ITP-BMSCs model group,and three TFFSG intervention groups with low(1.95 μg/mL),medium(3.90 μg/mL),and high doses(7.80 μg/mL).The apoptosis rates and the expression levels of apoptosis-related proteins-B-cell lymphoma 2(Bcl-2),Bcl-2-associated X protein(BAX),and Cysteinyl aspartate-specific proteinase-3(Caspase-3)-were assessed.Exosomes were isolated from the blank control group(NC-BMSCs-Exos),the ITP-BMSCs model group(ITP-BMSCs-Exos),and the medium-dose TFFSG group(TFFSG-BMSCs-Exos).Each group's exosomes(5 μg/mL)were co-cultured with megakaryocytic lineage Dami cells for 96 hours.Flow cytometry was employed to evaluate the expression of megakaryocytic differentiation markers(CD41a,CD42b,CD61)and the proportion of polyploid cells(≥4 N)in each group.Western Blot analysis was conducted to examine the expression of p-MEK1/2,MEK1/2,p-ERK1/2,and ERK1/2 across all groups.Results Compared with the ITP-BMSCs model group,the apoptosis rates in all TFFSG intervention groups were significantly reduced(P<0.01).In the medium-and high-dose TFFSG groups,BAX and Caspase-3 expression levels were markedly downregulated,whereas Bcl-2 expression was upregulated(P<0.05,P<0.01).Compared with the ITP-BMSCs-Exos group,the TFFSG-BMSCs-Exos group demonstrated increased expression of CD41a+,CD42b+,and CD61+,a higher proportion of polyploid cells(≥4 N)(P<0.05),as well as elevated ratios of p-MEK1/2 to MEK1/2 and p-ERK1/2 to ERK1/2(P<0.05).Conclusion TFFSG inhibits apopto-sis of ITP-state BMSCs in vitro and promotes megakaryocyte differentiation and polyploidization maturation through BMSC-derived exosomes by activating the MEK1/2-ERK1/2 signaling pathway.

Cervical chondrocutaneous branchial remnants (CCBRs) are a rare congenital benign abnormality resulting from branchial arch dysplasia, characterized primarily by the presence of ectopic exophytic cartilaginous tissue in the neck present at birth. In July 2024, a case of CCBRs was treated at Plastic Surgery Hospital, Chinese Academy of Medical Sciences, involving a 7-year-and-10-month-old female patient. At birth, a bean-sized, rod-shaped, firm mass was noted on the left side of her neck, which progressively grew to the size of a corn kernel, measuring approximately 1.0 cm×1.2 cm. No significant local tenderness, redness, swelling, or ulceration was observed. Comprehensive examinations revealed no associated comorbidities. The patient underwent surgical excision of the neck mass. Postoperative pathological examination with hematoxylin-eosin (HE) staining revealed elastic cartilage in the central region of the lesion. The neck incision healed primarily, and no subsequent reappearance of the lesion was observed during the four-month follow-up. This article summarized the diagnostic and therapeutic process of this patient with CCBRs, and through a comprehensive literature review, highlighted that CCBRs represent one of the superficial markers of branchial arch dysplasia, with surgical excision being the primary treatment. Given that branchial arch abnormalities may be associated with structural or functional anomalies in other organs, a thorough systemic evaluation is recommended prior to surgery. Notwithstanding the absence of concomitant malformations detected on initial evaluation, continuous long-term follow-up monitoring is recommended to mitigate the risk of potential diagnoses being overlooked.

Objective To explore the protective effect and possible mechanism of modified Shenqi Dihuang Decoction on podocytes in db/db mice based on ROS/NLRP3/GSDMD signaling pathway.Methods Fifty 8-week-old male db/db mice(SPF grade)were randomly divided into the model group,losartan group and TCM low-,medium-and high-dosage groups,with 10 mice in each group.Ten heterozygous db/m mice served as the blank group.Interventions were administered respectively for 12 weeks.The body mass,random blood glucose,serum creatinine,blood urea nitrogen and 24 h urinary protein content were detected,HE,PAS,PASM,Masson and Sirius red staining was used to observe the morphology of renal tissue,transmission electron microscopy was used to observe the ultrastructure of renal tissue,fluorescent probes were used to observe the release of ROS in renal tissue,immunofluorescence staining was used to detect the expression of Nephrin,NLRP3,Cleaved Caspase-1 and GSDMD-N in renal tissue,and Western blot was used to detect the expression of NLRP3,Cleaved Caspase-1,GSDMD-N,IL-1β,IL-18,Nephrin,Podocin,PODXL,WT-1 and Desmin proteins.Results Compared with the blank group,the body mass and random blood glucose of the model group mice significantly increased(P<0.05),and the contents of serum creatinine,blood urea nitrogen and 24 h urinary protein were significantly increased(P<0.05);glomerular hypertrophy,dilation of renal glomeruli and tubules,thickening of basement membrane,matrix proliferation in mesangial area,abnormal deposition of collagen fibers in renal interstitium,accompanied by damage to renal tubular epithelial structure and focal glomerulosclerosis,significant increase in type Ⅰ collagen deposition,extensive fusion of podocyte processes,and scattered electron dense material in the basement membrane or subepithelial layer;the ROS content in renal tissue significantly increased(P<0.05),and the protein expression of NLRP3,Cleaved Caspase-1,GSDMD-N,IL-1β,IL-18 and Desmin significantly increased(P<0.05),the protein expression of Nephrin,Podocin,PODXL and WT1 significantly decreased(P<0.05).Compared with the model group,the body mass and random blood glucose of mice in each dosage of TCM group were relatively stable,the contents of serum creatinine,blood urea nitrogen and 24 h urinary protein decreased;the pathological damage to renal tissue was reduced,the ultrastructure of podocytes was improved,and the density of podocytes increased;the ROS content decreased,and the protein expression of NLRP3,Cleaved Caspase-1,GSDMD-N,IL-1β,IL-18 and Desmin decreased,while the protein expression of Nephrin,Podocin,WT1 and PODXL increased.With the dosage of modified Shenqi Dihuang Decoction increased,the improvement effect gradually strengthened,and the differences in TCM high-dose group was statistically significant(P<0.05).Conclusion Modified Shenqi Dihuang Decoction can protects podocytes in db/db mice,potentially by modulating the ROS/NLRP3/GSDMD signaling pathway.

Inflammatory lung diseases are cur-rently a major challenge threatening human health and life.Imbalanced inflammation and excessive in-flammation can lead to tissue damage and trigger the occurrence and development of systemic dis-eases.Anti-inflammatory treatment is of vital im-portance for improving patient survival and quality of life.In recent years,significant progress has been made in the exploration and research of drug targeting strategies,effectively addressing issues such as slow onset,low bioavailability,and rapid in vivo clearance rates during drug delivery.Drug tar-geting can increase local drug concentrations,re-duce dosing frequency,and mitigate side effects.This review primarily elaborates on the classifica-tion and characteristics of inflammatory lung dis-eases.It comprehensively reviews targeted drug de-livery strategies for inflammatory lung diseases from three perspectives:local targeting,passive tar-geting,and active targeting.Furthermore,it dis-cusses the prospects and challenges of drug target-ed therapy for lung diseases,potentially providing new research and application ideas for the target-ed treatment of inflammatory lung diseases.

Objective To investigate the value of the nomogram model based on the apparent diffusion coefficient(ADC)value of the cervical spinal cord in predicting neurological recovery after cervical spondylotic myelopathy(CSM).Methods One hundred CSM patients undergoing decompression surgery were prospectively enrolled.All patients underwent conventional cervical spine MRI and sagittal position non-shared incentive diffusion weighted imaging(ZOOM-DWI)examination before surgery.The improvement rate of neurological function was calculated according to the modified Japanese Orthopaedic Association(mJOA)score before and 6 months after surgery and divided into the good improvement group(60 patients)and the poor improvement group(40 patients)according to the improvement rate.Independent risk factors for postoperative outcomes were determined by univariate and multivariate logistic regression.Then the prediction model based on the clinical-imaging feature(model 1)and clinical-imaging feature-ADC value(model 2)were established,the receiver operating characteristic(ROC)curve was drawn,and the DeLong test was performed to compare the discrimination efficiency of the two models.A nomogram,calibration curve,and clinical decision curve were drawn for model 2.Results Age,body mass index(BMI),diabetes mellitus,T2 hyperintense,cross-sectional area,and ADC values at the disc level of different segments were independent risk factors affecting the outcome of CSM.The area under the curve(AUC)of the ROC curve constructed by model 2(AUC=0.933)was higher than that of model 1(AUC=0.864).The DeLong test showed that the difference between the two models was statistically significant(P＜0.05).The nomogram,calibration curve,and decision curve analysis(DCA)of model 2 showed that it had good differentiation,accuracy,and clinical value.Conclusion The nomogram model based on ADC value can effectively predict the outcome of postoperative neurological recovery in CSM patients.

BACKGROUND:Spinal osteosarcoma is a rare and highly aggressive malignant tumor.Most existing studies are based on small sample sizes and have inconsistent results,making it difficult to provide reliable clinical guidance.Especially in China,due to the low incidence of spinal osteosarcoma and limited related research,clinicians lack effective prognostic tools during treatment.OBJECTIVE:To construct and validate a nomogram model for predicting the survival of spinal osteosarcoma patients based on the Surveillance,Epidemiology,and End Results(SEER)database,providing scientific evidence for clinical decision-making,particularly for optimizing treatment plans for Chinese patients.METHODS:This study conducted a retrospective analysis of patient data diagnosed with spinal osteosarcoma from the SEER database between 2000 and 2021.First,independent prognostic factors associated with specific mortality from spinal osteosarcoma were identified through univariate and multivariate Cox proportional hazards models.Subsequently,these independent prognostic factors were used to construct a nomogram model for predicting survival rates of spinal osteosarcoma patients using the"rms"package in RStudio.The model's discrimination was assessed using the C-index.Predictive ability was validated through receiver operating characteristic curves and area under the curve values.Calibration was evaluated by calibration plots,and clinical value was measured using decision curve analysis.Additionally,Kaplan-Meier survival analysis was performed to assess the rationality of the nomogram groupings.RESULTS AND CONCLUSION:(1)The final model included six variables:chemotherapy,tumor size,histological type,grade,race,and surgical intervention.(2)The C-indices of the model in the training and validation sets were 0.685 and 0.673,respectively,indicating good discrimination.(3)Calibration curves showed high consistency between predicted survival probabilities and actual survival probabilities.(4)Decision curve analysis indicated that the model provided significant net benefits across a wide range of mortality risks.(5)Kaplan-Meier survival analysis revealed significant differences in prognosis between high-risk and low-risk groups.(6)The constructed nomogram model accurately predicts the 1-year,2-year,and 3-year survival rates of spinal osteosarcoma patients,demonstrating high clinical applicability.This model not only provides an effective survival prediction tool for American patients but also offers important insights for optimizing treatment plans for spinal osteosarcoma patients in China.Future research should further validate the model's applicability in different populations and explore the impact of novel treatment methods on the prognosis of spinal osteosarcoma,aiming to improve the survival rates and quality of life of patients in China.