Objective To explore the role of ocular vestibular evoked myogenic potential (oVEMP) and unilateral centrifugation subjective visual vertical (UC-SVV) tests in evaluating the utricular function of patients with Meniere’s disease (MD) at different clinical stages. Methods A total of 97 unilateral MD patients at Shandong Provincial ENT Hospital from July 2019 to September 2021 were selected. All patients underwent oVEMP, UC-SVV, and pure tone audiometry tests. MD patients were classified into clinical stages 1, 2, 3, and 4, with stages 1 and 2 defined as early stage and stages 3 and 4 as late stage. The results of utricular function tests (abnormal rates of oVEMP, UC-SVV, and oVEMP＋UC-SVV) were compared among patients at different stages. Spearman correlation analysis was used to evaluate the correlation between utricular function and clinical staging. Results Among the 97 MD patients, the abnormal rate of oVEMP was 66.0% (64/97), and the abnormal rate of UC-SVV was 55.7% (54/97). The abnormal rates of oVEMP and oVEMP＋UC-SVV in early-stage patients were significantly lower than those in late-stage patients (P＜0.05), while the difference in UC-SVV abnormal rates between the two groups was not statistically significant. Intra-group comparisons showed that the abnormal rate of oVEMP＋UC-SVV in stage 1 patients was significantly lower than that in stage 2 patients (P＜0.05), without significant difference in the other indices. There were no significant differences among the three indices in stages 3 and 4 patients. Spearman correlation test results indicated that the abnormal rate of oVEMP (r＝0.336, P＝0.001) and the abnormal rate of oVEMP＋UC-SVV (r＝0.301, P＝0.003) were weakly positively correlated with clinical staging, while there was no correlation between the abnormal rate of UC-SVV and clinical staging (r＝0.022, P＝0.832). Conclusions Both oVEMP and UC-SVV tests can assess utricular function in MD patients at different clinical stages. Their combination is helpful of early-stage (stages 1 and 2) MD diagnosis.

Objective To investigate the relationship between CT lung volume parameters(CT-LVP)and pulmonary function grade in patients with idiopathic pulmonary fibrosis(IPF)and its prediction of acute exacerbation.Methods A total of 204 patients with IPF were selected and divided into mild group(67 cases),moderate group(72 cases)and severe group(65 cases)according to the semi-quantitative scoring method of high-resolution computed tomography(HRCT).The correlation between CT-LVP and pul-monary function parameters(PFP)were analyzed.The predictive value of CT-LVP for acute exacerbation in severe IPF was ana-lyzed.Results The whole lung volume(WLV),normal lung volume(NLV)and normal lung volume percentage(NLV%)in severe group were lower than those in mild and moderate groups,whereas interstitial lung disease volume(ILDV)and interstitial lung disease volume percentage(ILDV%)were higher than those in mild and moderate groups,with statistical significance(P<0.05).WLV,NLV,ILDV,NLV%,ILDV%showed strong correlations with forced expiratory volume in 1 second percentage(FEV1%),forced expiratory volume in 1 second to forced vital capacity ratio(FEV1/FVC),diffusing capacity of the lung for carbon monoxide percent-age(DLCO%),and residual volume to total lung capacity ratio(RV/TLC).Receiver operating characteristic(ROC)curve analysis showed that the combination of WLV,NLV,ILDV,NLV%and ILDV%had higher accuracy in predicting acute exacerbation,area under the curve(AUC)>0.75(P<0.05).Conclusion CT-LVP is closely related to PFP,and the accuracy of CT-LVP combination in predicting acute exacerbation is high,which provides a theoretical basis for preventing acute exacerbation of IPF.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

Objective:To explore the regulatory mechanism of voltage-dependent anion channel 1(VDAC1) on the proliferation, migration and invasion of lung adenocarcinoma(LUAD) cells.Methods:This study employed a combination of bioinformatics and experimental validation methods, conducting bioinformatics analysis and cytological experimental validation in the central laboratory of the School of Medicine, Anhui University of Science and Technology from February 2023 to August 2024.Clinical histological specimen validation was performed using immunohistochemistry, and a retrospective analysis was conducted on 5 cases of lung adenocarcinoma and adjacent samples from Huai′an First People′s Hospital affiliated with Nanjing Medical University. The TCGA network database was analyzed for the expression pattern, prognostic value, and functional enrichment of VDAC1 in LUAD. A549 cells with VDAC1 knockdown and H1650 cells with VDAC1 overexpression were established through lentiviral transfection. The expression difference of VDAC1 protein in LUAD and adjacent tissue specimens was detected by immunohistochemistry.The effects of VDAC1 on the proliferation, migration, and invasion capabilities were explored through CCK8 assay, scratch healing assay, and Transwell assay.The activation levels of epithelial-mesenchymal transition (EMT) marker proteins, cell cycle-dependent kinases, and molecules in the PI3K/AKT/mTOR signaling pathway were detected by Western blot.Results:Bioinformatics analysis revealed that VDAC1 was highly expressed in LUAD cells ( P<0.000 1) and was an independent risk factor for LUAD ( P<0.000 1). Functional enrichment analysis showed significant enrichment of the PI3K/AKT/mTOR, G2M checkpoint, and P53 signaling pathways ( P<0.001). Compared to adjacent control tissues, the expression level of VDAC1 protein is higher in lung adenocarcinoma tissues.Overexpression of VDAC1 promoted the proliferation ( P<0.000 1), migration, and invasion( P<0.01) of H1650 cells, while knockdown of VDAC1 inhibited the proliferation ( P<0.000 1), migration, and invasion ( P<0.05) of A549 cells.Western Blot experiments showed that compared to the control group, the expression levels of vimentin (1.10±0.11 vs 2.39±0.15, P<0.001), N-cadherin (0.94±0.12 vs 2.72±0.06, P<0.001), CDK1 (0.93±0.04 vs 1.53±0.03, P<0.000 1), CDK2 (1.04±0.13 vs 2.29±0.06, P<0.001), CDK4 (0.90±0.03 vs 2.00±0.11, P<0.01), p-PI3K (1.08±0.13 vs 1.85±0.12, P<0.01), and p-AKT (1.03±0.11 vs 1.69±0.06, P<0.001) were increased in H1650 cells overexpressing VDAC1, while E-cadherin expression decreased (2.18±0.14 vs 0.997±0.11, P<0.001).In contrast, in A549 cells with VDAC1 knockdown, the expression levels of vimentin (1.70±0.26 vs 0.97±0.09, P<0.05), N-cadherin (1.98±0.25 vs 1.03±0.06, P<0.05), CDK1 (1.13±0.03 vs 0.95±0.02, P<0.01), CDK2 (2.29±0.12 vs 0.92±0.10, P<0.001), CDK4 (1.71±0.096 vs 1.12±0.11, P<0.01), p-PI3K (1.67±0.09 vs 0.97±0.03, P<0.001), and p-AKT (1.53±0.04 vs 1.02±0.03, P<0.000 1) decreased, while E-cadherin expression increased (1.04±0.04 vs 1.85±0.26, P<0.05). Conclusions:VDAC1 may promote the proliferation, migration, and invasion of LUAD cells by activating EMT and cyclin-dependent kinases through the PI3K/AKT/mTOR pathway.

Objective:To investigate the therapeutic outcomes of patients with horseshoe kidney and hydronephrosis under different surgical approaches and with or without isthmus division.Methods:This study is a retrospective case series research. A retrospective analysis was conducted on the clinical data of 23 patients with horseshoe kidney and hydronephrosis who underwent pyeloplasty at the Department of Urology, the First Affiliated Hospital of Zhengzhou University from January 2016 to December 2023. Among them, there were 11 males and 12 females, with an age of (33±15) years (range:7 to 64 years). Patients underwent preoperative examinations, including ultrasonography of the urinary system, intravenous urography, CT urography, or magnetic resonance urography. Retrograde urography or antegrade ureteropyelography was performed when necessary to clarify the degree of hydronephrosis, the location and length of ureteral stricture. For patients with severe hydronephrosis, a ureteral stricture segment >2 cm, a thick renal isthmus in horseshoe kidney, and markedly variant vasculature, open surgery or robotic surgery is preferred. For those with mild to moderate hydronephrosis, a ureteral stricture segment <2 cm, a thin renal isthmus in horseshoe kidney, and no significant vascular variations, laparoscopic surgery is the first choice. The decision to perform isthmectomy should be made based on a comprehensive intraoperative assessment, including the vascular supply to the isthmus, the degree of surrounding adhesions, and the thickness of the isthmus. Perioperative parameters and complications were recorded and analyzed, and regular follow-up was conducted for all patients.Results:All surgeries were successfully completed. Surgical approaches included open surgery in 4 cases, laparoscopic surgery in 14 cases, and robot-assisted laparoscopic surgery in 5 cases. The operative time for open surgery, laparoscopic surgery and robot-assisted laparoscopic surgery was (125±12) minutes (range: 112 to 141 minutes), (122±50) minutes (range: 60 to 233 minutes), and (130±36) minutes (range: 76 to 174 minutes), respectively. The blood loss ( M(IQR)) was 100 (25) ml (range: 50 to 100 mL) for open surgery, 35 (30) ml (range: 10 to 100 mL) for laparoscopic surgery, and 20 (10) ml (range: 20 to 50 ml) for robot-assisted laparoscopic surgery. Among 15 patients who underwent isthmus division with pyeloplasty (division group), the operation time was (138±42) minutes (range: 73 to 233 minutes), with blood loss of 50 (80) ml (range: 20 to 100 ml). For 8 patients in the non-division group who only underwent pyeloureteroplasty, the operation time was (98±27) minutes (range: 60 to 135 minutes), with blood loss of 20 (50) ml (range: 10 to 100 ml). The follow-up time of patients after surgery was 16.0 (49.0) months (range: 1.7 to 84.2 months), with a surgical success rate of 100%. Among the 8 patients in the non-division group, all demonstrated significant improvement in hydronephrosis severity compared to preoperative conditions. Notably, 6 patients who previously experienced frequent lower back pain showed no recurrence of symptoms after ureteral stent removal. In the division group of 15 patients, both subjective symptoms and hydronephrosis severity were markedly reduced. Conclusion:For patients with horseshoe kidney and hydronephrosis, the choice of surgical approach and isthmus management strategy should be determined based on a comprehensive consideration of the etiology of hydronephrosis, the degree of ureteral stricture, anatomical abnormalities, and vascular variations.

Objective:To investigate the efficacy of a predictive model for differentiating benign and malignant renal tumors based on CT radiomic features and clinical features.Methods:A retrospective study was conducted on 1 395 patients with renal tumors admitted to the First Affiliated Hospital of Zhengzhou University from December 2011 to December 2021, including 842 males and 553 females. The median age was 55 (44, 59) years, and the median tumor diameter was 3.6 (2.7, 4.6) cm. All patients underwent contrast-enhanced CT scaning before surgery, and radiomic features were extracted from non-contrast, arterial, and venous phase images. Prediction models for distinguishing benign and malignant renal tumors were constructed using five machine learning algorithms (logistic regression, support vector machine, neural network, random forest, and extreme gradient boosting), and these models were then ensembled to construct a stacking classifier. All patients underwent partial nephrectomy, and they were divided into a training group (941 cases, December 2011 to June 2020) and a validation group (454 cases, July 2020 to December 2021) based on the date of surgery. A clinical-radiomic model was developed by combining the result of stacking classifier, clinical features and CT report results, and its predictive performance was evaluated in the validation group.Results:The radiomic signature based on the combined features and five machine learning algorithms(AUC 0.835-0.844) showed higher accuracy in predicting benign and malignant renal tumors compared to single phases (AUC 0.744-0.831). After integrating the five machine learning algorithms, the AUC of the three-phase combined radiomic model in the validation group improved to 0.847(95% CI 0.802-0.892). The clinical-radiomic model, incorporating radiomic features, clinical features, and CT report results, achieved a significantly higher AUC in the validation group compared to radiologists [0.919(95% CI 0.889-0.950)vs. 0.835(95% CI 0.786-0.883), P<0.01]. Conclusions:The predictive model integrating CT radiomics features, clinical characteristics, and CT report results demonstrates excellent discriminative ability in distinguishing benign and malignant renal tumors.

Objective:To explore the regulatory mechanism of voltage-dependent anion channel 1(VDAC1) on the proliferation, migration and invasion of lung adenocarcinoma(LUAD) cells.Methods:This study employed a combination of bioinformatics and experimental validation methods, conducting bioinformatics analysis and cytological experimental validation in the central laboratory of the School of Medicine, Anhui University of Science and Technology from February 2023 to August 2024.Clinical histological specimen validation was performed using immunohistochemistry, and a retrospective analysis was conducted on 5 cases of lung adenocarcinoma and adjacent samples from Huai′an First People′s Hospital affiliated with Nanjing Medical University. The TCGA network database was analyzed for the expression pattern, prognostic value, and functional enrichment of VDAC1 in LUAD. A549 cells with VDAC1 knockdown and H1650 cells with VDAC1 overexpression were established through lentiviral transfection. The expression difference of VDAC1 protein in LUAD and adjacent tissue specimens was detected by immunohistochemistry.The effects of VDAC1 on the proliferation, migration, and invasion capabilities were explored through CCK8 assay, scratch healing assay, and Transwell assay.The activation levels of epithelial-mesenchymal transition (EMT) marker proteins, cell cycle-dependent kinases, and molecules in the PI3K/AKT/mTOR signaling pathway were detected by Western blot.Results:Bioinformatics analysis revealed that VDAC1 was highly expressed in LUAD cells ( P<0.000 1) and was an independent risk factor for LUAD ( P<0.000 1). Functional enrichment analysis showed significant enrichment of the PI3K/AKT/mTOR, G2M checkpoint, and P53 signaling pathways ( P<0.001). Compared to adjacent control tissues, the expression level of VDAC1 protein is higher in lung adenocarcinoma tissues.Overexpression of VDAC1 promoted the proliferation ( P<0.000 1), migration, and invasion( P<0.01) of H1650 cells, while knockdown of VDAC1 inhibited the proliferation ( P<0.000 1), migration, and invasion ( P<0.05) of A549 cells.Western Blot experiments showed that compared to the control group, the expression levels of vimentin (1.10±0.11 vs 2.39±0.15, P<0.001), N-cadherin (0.94±0.12 vs 2.72±0.06, P<0.001), CDK1 (0.93±0.04 vs 1.53±0.03, P<0.000 1), CDK2 (1.04±0.13 vs 2.29±0.06, P<0.001), CDK4 (0.90±0.03 vs 2.00±0.11, P<0.01), p-PI3K (1.08±0.13 vs 1.85±0.12, P<0.01), and p-AKT (1.03±0.11 vs 1.69±0.06, P<0.001) were increased in H1650 cells overexpressing VDAC1, while E-cadherin expression decreased (2.18±0.14 vs 0.997±0.11, P<0.001).In contrast, in A549 cells with VDAC1 knockdown, the expression levels of vimentin (1.70±0.26 vs 0.97±0.09, P<0.05), N-cadherin (1.98±0.25 vs 1.03±0.06, P<0.05), CDK1 (1.13±0.03 vs 0.95±0.02, P<0.01), CDK2 (2.29±0.12 vs 0.92±0.10, P<0.001), CDK4 (1.71±0.096 vs 1.12±0.11, P<0.01), p-PI3K (1.67±0.09 vs 0.97±0.03, P<0.001), and p-AKT (1.53±0.04 vs 1.02±0.03, P<0.000 1) decreased, while E-cadherin expression increased (1.04±0.04 vs 1.85±0.26, P<0.05). Conclusions:VDAC1 may promote the proliferation, migration, and invasion of LUAD cells by activating EMT and cyclin-dependent kinases through the PI3K/AKT/mTOR pathway.

Objective To investigate the relationship between CT lung volume parameters(CT-LVP)and pulmonary function grade in patients with idiopathic pulmonary fibrosis(IPF)and its prediction of acute exacerbation.Methods A total of 204 patients with IPF were selected and divided into mild group(67 cases),moderate group(72 cases)and severe group(65 cases)according to the semi-quantitative scoring method of high-resolution computed tomography(HRCT).The correlation between CT-LVP and pul-monary function parameters(PFP)were analyzed.The predictive value of CT-LVP for acute exacerbation in severe IPF was ana-lyzed.Results The whole lung volume(WLV),normal lung volume(NLV)and normal lung volume percentage(NLV%)in severe group were lower than those in mild and moderate groups,whereas interstitial lung disease volume(ILDV)and interstitial lung disease volume percentage(ILDV%)were higher than those in mild and moderate groups,with statistical significance(P<0.05).WLV,NLV,ILDV,NLV%,ILDV%showed strong correlations with forced expiratory volume in 1 second percentage(FEV1%),forced expiratory volume in 1 second to forced vital capacity ratio(FEV1/FVC),diffusing capacity of the lung for carbon monoxide percent-age(DLCO%),and residual volume to total lung capacity ratio(RV/TLC).Receiver operating characteristic(ROC)curve analysis showed that the combination of WLV,NLV,ILDV,NLV%and ILDV%had higher accuracy in predicting acute exacerbation,area under the curve(AUC)>0.75(P<0.05).Conclusion CT-LVP is closely related to PFP,and the accuracy of CT-LVP combination in predicting acute exacerbation is high,which provides a theoretical basis for preventing acute exacerbation of IPF.

The Expert Consensus on Clinical Application of Qinbaohong Zhike Oral Liquid in Treatment of Acute Bronchitis and Acute Attack of Chronic Bronchitis （GS/CACM 337-2023） was released by the China Association of Chinese Medicine on December 13^th， 2023. This expert consensus was developed by experts in methodology， pharmacy， and Chinese medicine in strict accordance with the development requirements of the China Association of Chinese Medicine （CACM） and based on the latest medical evidence and the clinical medication experience of well-known experts in the fields of respiratory medicine （pulmonary diseases） and pediatrics. This expert consensus defines the application of Qinbaohong Zhike oral liquid in the treatment of cough and excessive sputum caused by phlegm-heat obstructing lung， acute bronchitis， and acute attack of chronic bronchitis from the aspects of applicable populations， efficacy evaluation， usage， dosage， drug combination， and safety. It is expected to guide the rational drug use in medical and health institutions， give full play to the unique value of Qinbaohong Zhike oral liquid， and vigorously promote the inheritance and innovation of Chinese patent medicines.

OBJECTIVE To investigate the current status of self-medication behaviors and the demand preferences for pharmaceutical services among residents in Xining， providing a basis for developing pharmaceutical service intervention strategies tailored to regional characteristics. METHODS A self-designed questionnaire， developed based on literature review and revised after expert panel discussion and a pre-survey， was used to conduct anonymous surveys among residents purchasing medicines at 12 retail pharmacies in Xining area from April 2023 to April 2024. Descriptive analysis， Chi-square test， and Spearman correlation analysis were employed to analyze the characteristics and influencing factors of residents’ self-medication behaviors， and pharmaceutical service needs. RESULTS A total of 859 valid questionnaires were collected， with 605 respondents （70.43%） reporting self-medication behaviors. The primary reason for self-medication was mild symptoms （46.94%）. The main conditions treated were gastrointestinal discomfort （38.51%） and cold， fever， headache （35.37%）. Chinese patent medicines were the most commonly used （58.68%）. Drug selection relied mainly on recommendations by pharmacy staff （52.07%）， and retail pharmacies were the primary source of medicines （65.95%）. Dosage and administration were determined primarily by referring to the drug package insert （67.27%）， while a minority relied on personal experience （9.92%）. Notably， 20.33% of respondents never read the package insert before medication， with a higher tendency observed among ethnic minorities， farmers， and individuals with chronic diseases （P＜0.05）. While 65.29% of respondents reported partially understanding the insert content， those aged ≥60 years， ethnic minorities， and individuals with chronic diseases qhsrmyy-28） were more likely to report being completely unable to understand it （P＜0.05）. Self-medication was “often effective” for 52.73% of respondents， whereas 7.77%“ often experienced adverse drug reactions”； farmers were more prone to poor efficacy or adverse reactions （P＜0.05）. A majority （72.89%） of respondents residents believed it necessary to learn about self- medication knowledge， and 47.11% preferred to obtain pharmaceutical services through WeChat public accounts or mobile applications （APP）. CONCLUSIONS Self-medication is common among residents in Xining area. Issues such as neglecting to read package inserts and relying on personal experience are evident. It is essential to develop science popularization programs suitable for the characteristics of the local population and utilize digital platforms like WeChat public accounts and APP to disseminate self- medication knowledge， thereby enhancing residents’ awareness and capacity for rational medication use.