Objective To investigate the effect of bone metabolic markers on sarcopenia in elderly patients with type 2 diabetes mellitus (T2DM). Methods A total of 412 patients with T2DM in the department of endocrinology of Nanjing Central Hospital from May 2020 to June 2025 were selected as the research subjects. According to Asian Working Group for Sarcopenia (AWGS) in 2019, these patients were evaluated for skeletal muscle mass index (ASMI), muscle strength, and muscle function, and were divided into a sarcopenia group (84 cases) and a non-sarcopenia group (328 cases). The glucolipid metabolic indexes were detected in both groups of patients, and the bone metabolic markers were evaluated, including procollagen type 1 N-terminal peptide (P1NP), beta-C-terminal telopeptide of type 1 collagen (β-CTX), and 25-hydroxy vitamin D [25-(OH)D]. The factors influencing the occurrence of sarcopenia in T2DM patients were analyzed by logistic regression analysis, and the diagnostic values of bone metabolic markers on sarcopenia in patients with T2DM were assessed by ROC curve. Results The levels of P1NP and 25-(OH)D were lower, while β-CTX level was higher in the sarcopenia group compared to the non-sarcopenia group, with statistical differences (P<0.05). After logistic correlation analysis, it was found that P1NP, β-CTX and 25-(OH)D were all influencing factors for the occurrence of sarcopenia in T2DM patients. ROC curve analysis suggested that combined detection of PINP, β-CTX, and 25-(OH)D had higher diagnostic value, with an area under the curve up to 0.805. Conclusion The abnormal expression of bone metabolic markers is associated with the increased risk of sarcopenia in patients with T2DM. The detection of serum bone metabolic markers expression level is of certain significance for the assessment of diabetes-related sarcopenia.

ObjectiveTo investigate the application of central auditory testing combined with electroencephalographic features in the early screening of mild cognitive impairment due to Alzheimer's disease. MethodsA convenience sampling method was used to conduct a field survey in the Qixia District of Nanjing City, Jiangsu Province, from July to September, 2025. A total of 40 older adults diagnosed as mild cognitive impairment due to Alzheimer's disease and 23 cognitively normal older adults were recruited. Auditory N-back and dichotic listening paradigms were employed for assessment, while the scores of Montreal Cognitive Assessment Beijing Version (MoCA-BJ) and 32-channel electroencephalogram (EEG) data were simultaneously collected. Binary logistic regression analysis was applied to identify predictive indicators, receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC) was calculated. ResultsThe total score of dichotic listening was positively correlated with overall cognitive function (r = 0.475, P < 0.01), while right-ear advantage showed negative correlations with overall cognition, visuospatial ability, abstract reasoning, and delayed recall (r < -0.276, P < 0.05). Task performance across all conditions of the N-back task was positively correlated with overall cognitive function (r > 0.249, P < 0.05). Regarding EEG features, δ and θ band power and power peaks were positively correlated with delayed recall (r > 0.258, P < 0.05), whereas (α+θ)/(α+β) and θ/(α+β) were positively correlated with naming ability and visuospatial executive function, respectively (r > 0.261, P < 0.05). The results of the binary logistic regression analysis showed that the total score of binaural dichotic listening, the accuracy of 1-back task, the average power of δ waves, and the ratio of θ/(α+β) were independent influencing factors for mild cognitive impairment due to Alzheimer's disease (P < 0.05). The ROC analysis indicated that the AUC for auditory task performance and EEG features were 0.845 and 0.735 respectively, and when combined, the AUC increased to 0.862. ConclusionThe screening model based on the integration of auditory task performance and EEG features can be used in the early identification of mild cognitive impairment due to Alzheimer's disease.

Objective To evaluate the current situation of disease control in middle-aged and elderly patients with chronic obstructive pulmonary disease (COPD) and analyze the relationship with disease cognition. Methods Among the 360 middle-aged and elderly COPD patients diagnosed and treated in our hospital from January 2022 to June 2024 were retrospectively selected as research subjects, and the COPD Assessment Test Questionnaire (CAT), COPD Patient Knowledge Questionnaire (BCKQ) and the hampion Health Belief Model Scale were used to evaluate disease control, disease cognition and health beliefs in COPD patients. The Pearson chi-square test was used to analyze the relationship between disease control level and disease cognition and health beliefs in older patients with COPD. Results A total of 360 middle-aged and elderly COPD patients, 112 were in the complete control group, 189 were in the partial control group, and 59 were in the uncontrolled group, the disease control rate was 83.61%. The differences in disease cognitive scores, severity cognition, susceptibility cognition, disorder cognition, benefit cognition, health motivation, self-efficacy score and total health belief scores in middle-aged and elderly COPD patients with different disease control conditions are statistically significant. The scores of the complete control group were higher than those of partial control group and uncontrolled group, and the scores of partial control group were higher than those of the uncontrolled group (P <0.05). The disease control level of middle-aged and elderly patients with COPD is positively correlated with disease cognitive level and health belief in all dimensions. The higher the disease control level, the higher the disease cognitive level and health belief in the patient . Conclusions Middle-aged and elderly COPD patients still have insufficient awareness of the disease, and the level of disease control needs to be improved. There is a significant correlation between disease cognition, health beliefs and the level of disease control, and the improved cognitive level may help to improve the disease management and control effect. For middle-aged and elderly COPD patients, the community can provide health education courses, personalized health guidance and self-management training to enhance their awareness of diseases, so as to improve the long-term management of COPD and the quality of life of patients.

Recent studies have demonstrated that the malignant proliferation and continuous progression of lymphoma are highly dependent on enhanced lipid metabolism. Consequently, targeting lipid metabolism pathways have emerged as a promising direction for lymphoma treatment. This paper reviews the fatty acid metabolism, cholesterol metabolism, and phospholipid metabolism in lymphoma, thereby providing novel insights for its therapeutic strategies.

Objective To observe the clinical efficacy of regulating conception vessel and unblocking governor vessel electroacupuncture in the treatment of cancer-related fatigue(CRF)of middle-to-advanced stage cervical cancer,and to explore its effect on inflammatory factors.Methods A total of 122 patients with a definitive diagnosis of CRF of middle-to-advanced stage cervical cancer admitted to the wards and outpatient clinics of Cangzhou Central Hospital from August 2021 to August 2023 were selected for the study.The patients were randomly divided into the control group and the observation group according to the random number table method,with 61 cases in each group.The patients in both groups were given conventional symptomatic treatments such as gastric protection and anti-vomiting since the day of action of chemotherapy.The control group was treated with Dexamethasone Tablets,and the observation group was treated with regulating conception vessel and unblocking governor vessel electroacupuncture on the basis of the control group,the course of treatment covered 21 days.After three weeks of treatment,the clinical efficacy of the two groups was evaluated.The changes in the traditional Chinese medicine(TCM)syndrome scores,Piper's Fatigue Scale(PFS)scores,Karnofsky Performance Status(KPS)scores,and Functional Assessment of Cancer Therapy-General(FACT-G)scores of the patients in the two groups before and after treatment were observed.The changes in interleukin 6(IL-6),hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor α(TNF-α),and T-lymphocyte subsets indicators[CD3+,CD4+,CD8+,CD4+/CD8+]were compared between the patients in the two groups before and after treatment.Results(1)The total effective rate was 95.08%(58/61)in the observation group and 77.05%(47/61)in the control group.The efficacy of the observation group was superior to that of the control group,the difference being statistically significant(P<0.05).(2)After treatment,the TCM syndrome scores of patients in the two groups were significantly improved(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(3)After treatment,the PFS scores of patients in the two groups were improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(4)After treatment,the serum IL-6,hs-CRP,and TNF-α levels of patients in the two groups were significantly improved(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(5)After treatment,the CD3+,CD4+,CD8+,CD4+/CD8+of patients in the two groups were significantly improved(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(6)After treatment,the KPS scores and FACT-G scores of patients in the two groups were significantly improved(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).Conclusion Regulating conception vessel and unblocking governor vessel electroacupuncture in the treatment of CRF of middle-to-advanced stage cervical cancer can effectively alleviate the fatigue of patients,inhibit the release of inflammatory factors,regulate the immune function,and improve the physical condition of patients,so as to improve the quality of life of patients.

China emerges as a major country in nuclear energy development and the application of nuclear and radiologic technology. The diagnosis and treatment of acute radiation syndrom (ARS) caused by external irradiation represent a core function in the country′s medical rescue of nuclear and radiological emergencies. Clinically, ARS manifests hematopoietic, gastrointestinal, cutaneous, and central nervous system syndromes, with specific clinical manifestations, signs, severity, and prognosis strongly correlated with radiation dose. China has established a number of national and provincial centers for treating radiation-induced damage. Nevertheless, most medical staff have limited experience in ARS treatment. This consensus presents a summary of recent experience in treating ARS of China. In combination with recommendations from international organizations such as the World Health Organization (WHO), this consensus proposes key evidence of critical clinical issues of ARS, covering all links in the rescue of external irradiation-induced ARS. Initially, clinical diagnosis, syndromes, and severe degrees should be determined based on clinical symptoms and dose estimates. It is necessary to normalize clinical treatment measures for hematopoietic recovery, gastrointestinal injury treatment, infection control, symptomatic treatment, and multi-organ function preservation. To this end, this consensus offers cautions. This consensus provides principles of treatment with traditional Chinese medicine, psychological intervention, and follow-up. Additionally, it highlights multidisciplinary collaboration. It is recommended that this consensus be applied in relevant treatment centers.

Objective To investigate the expression pattern and potential functional mechanisms of hematological and neurological expressed 1(HN1)in ovarian cancer(OC).Methods The gene expression profiling interactive analysis(GEPIA),Kaplan-Meier plotter,and the University of Alabama at Birmingham Cancer Data Analysis Portal(UALCAN)online databases were utilized to analyze the expression profile of HN1 across pan-cancer datasets,as well as its differential expression and prognostic significance in OC.Co-expressed genes of HN1 were identified based on the cancer genome atlas database,followed by functional enrichment analyses using Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathways.Furthermore,the association between HN1 expression and immune cell infiltration in OC tissues was explored by using R software.Results Analysis of the GEPIA database revealed that HN 1 expression was significantly elevated in 20 types of tumor tissues,including OC,compared to normal tissues(P＜0.05).UALCAN data indicated that HN1 expression was markedly higher in poorly differentiated OC patients(P＜0.05).Kaplan-Meier survival analysis showed that patients with high HN 1 expression had significantly shorter progression-free survival,overall survival,and post-progression survival compared to those with low HN1 expression(P＜0.05).GO and KEGG enrichment analyses suggested that HN1 is mainly involved in the regulation of the cell cycle.Immunological analysis demonstrated that HN 1 expression levels were positively correlated with the infiltration of CD4+Th2 cells and dendritic cells in OC tissues(P＜0.05).Conclusion HN1 is highly expressed in OC and may play a role in tumor progression by regulating cell cycle,promoting epithelial-mesenchymal transition,and modulating immune cell infiltration.HN1 has the potential to serve as a novel biomarker for the diagnosis and targeted therapy of OC.

Oral adenoid cystic carcinoma(OACC)is one of the malignant tumors from the oral cavity,with strong invasion and infiltration ability,and poor prognosis for patients.Studies have shown that epigenetic mechanisms such as DNA methylation,histone modification,non-coding RNAs,and chromatin remodeling are involved in regulating the occurrence,development,invasion,and me-tastasis of OACC.The in-depth research of epigenetic regulatory mechanisms has important clinical significance for the prevention,di-agnosis,and targeted therapy of OACC.This article reviews the epigenetic regulatory mechanisms and new advances in therapeutic re-search of OACC.

Non-inferiority clinical trials are a research paradigm that employs randomized controlled methods to evaluate whether the treatment effect of the experimental group is not inferior to that of the active control group within a predefined acceptable margin. This article systematically summarizes the applicable conditions, key design elements, and statistical analysis methods for non-inferiority trials. By integrating representative case studies in the field of oncology, it elucidates the unique value of non-inferiority designs in balancing benefits and risks and in optimizing therapeutic decisions. Through reviewing theoretical frameworks and addressing common misconceptions in methodological practices, this study aims to provide clear guidance for the standardized design and scientific interpretation of non-inferiority trials, thereby promoting their high-quality application in clinical research.

Objective:To explore potential risk factors for central lymph node metastasis (CLNM) in papillary thyroid microcarcinoma (PTMC).Methods:The clinicopathological data of 304 PTMC patients admitted to Baotou Cancer Hospital from Oct 2021 to Mar 2023 were retrospectively analyzed. The risk factors of CLNM were analyzed using unifactorial and multifactorial regression.Results:The rate of central regional lymph node metastasis in 304 patients with PTMC was 46.7% (142/304). Univariate analysis showed that male, age <45 years, maximum cancerous lesion diameter ≥5 mm, total cancerous lesion diameter ≥9.5 mm, anterior-posterior lesion diameter ≥5 mm, anterior-posterior lesion diameter ratio of cancerous lesions ≥0.48, breaching of thyroid capsule, number of lymph nodes on the side of cancerous lesions ≥5, and antithyroid peroxidase antibody ≤34 IU/ml were associated with CLNM (all P<0.05); Logistic multivariate regression analysis showed that. male, age <45 years, total diameter of cancer foci ≥9.5 mm ( OR=2.052, 95% CI: 1.176-3.581, P=0.011), anteroposterior diameter ratio of cancer foci ≥0.48 ( OR=2.076, 95% CI: 1.161-3.711, P=0.014), number of lymph nodes on the side of cancer foci ≥5, and anti-thyroid peroxidase antibody ≤34 IU/ml were independent risk factors for CLNM. Conclusion:Male, age ,total diameter of cancer foci, anterior-posterior diameter ratio of cancer foci, number of lymph nodes on the side of cancer foci, and anti-thyroid peroxidase antibody level are all independent risk factors for CLNM in patients with PTMC.