ObjectiveTo investigate the effect of Danggui Shaoyaosan on ferroptosis in the rat model of non-alcoholic fatty liver disease （NAFLD） and explore the underlying mechanism based on the nuclear factor E₂-related factor 2 （Nrf2）/solute carrier family 7 member 11 （SLC7A11）/glutathione peroxidase 4 （GPX4） signaling pathway. MethodsThe sixty SD rats were randomly grouped as follows： control， model， Yishanfu （0.144 g·kg^-1）， and low-， medium-， and high-dose （2.44， 4.88， and 9.76 g·kg^-1， respectively） Danggui Shaoyaosan. A high-fat diet was used to establish the rat model of NAFLD. After 12 weeks of modeling， rats were treated with corresponding agents for 4 weeks. Then， the body weight and liver weight were measured， and the liver index was calculated. At the same time， serum and liver samples were collected. The levels or activities of total cholesterol （TC）， triglycerides （TG）， alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， and Fe²⁺ in the serum and TC， TG， free fatty acids （FFA）， malondialdehyde （MDA）， superoxide dismutase （SOD）， glutathione peroxidase （GPX）， and Fe²⁺ in the liver were measured. Hematoxylin-eosin staining and oil red O staining were employed to observe the pathological changes in the liver. Immunofluorescence was used to assess the reactive oxygen species （ROS） content in the liver. Mitochondrial morphology was observed by transmission electron microscopy. The protein levels of Nrf2， SLC7A11， GPX4， transferrin receptor 1 （TFR1）， and divalent metal transporter 1 （DMT1） in the liver were determined by Western blot. ResultsCompared with the control group， the model group showed increases in the body weight， liver weight， liver index， levels or activities of TC， TG， ALT， AST， and Fe²⁺ in the serum， levels of TC， TG， FFA， MDA， Fe²⁺， and ROS in the liver， and protein levels of TFR1 and DMT1 in the liver （P<0.01）， and decreases in the activities of SOD， GPX and the protein levels of Nrf2， SLC7A11， and GPX4 in the liver （P<0.05， P<0.01）. Meanwhile， the liver tissue in the model group presented steatosis， iron deposition， mitochondrial shrinkage， and blurred or swollen mitochondrial cristae. Compared with the model group， all doses of Danggui Shaoyaosan reduced the body weight， liver weight， liver index， levels or activities of TC， TG， ALT， AST， and Fe²⁺ in the serum， levels of TC， TG， FFA， MDA， Fe²⁺， and ROS in the liver， and protein levels of TFR1 and DMT1 in the liver （P<0.01）， while increasing the activities of SOD and GPX and the protein levels of Nrf2， SLC7A11， and GPX4 in the liver （P<0.01）. Furthermore， Danggui Shaoyaosan alleviated steatosis， iron deposition， and mitochondrial damage in the liver. ConclusionDanggui Shaoyaosan may inhibit lipid peroxidation and ferroptosis by activating the Nrf2/SLC7A11/GPX4 signaling pathway to treat NAFLD.

Primary pulmonary nuclear protein of the testis (NUT) midline carcinoma (NMC) is a rare and highly aggressive thoracic malignancy that poses significant diagnostic and therapeutic challenges in clinical practice. This tumor is characterized by its heterogeneous clinical presentations and poor prognosis, often evading accurate initial diagnosis. In this study, we present two cases of primary pulmonary NMC treated with an integrated therapeutic approach combining anti-angiogenic agents, platinum-based chemotherapy, and radiotherapy. This multimodal strategy achieved survival durations of 32 and 13 months, respectively, surpassing the currently reported median survival of advanced NMC. Through a systematic literature review of reported cases, we have summarized the currently used diagnostic methods and treatment modalities for NMC. Our findings suggest that multimodal therapy incorporating anti-angiogenic treatment may offer superior clinical outcomes compared to conventional monotherapy regimens, particularly for patients who are not eligible for surgery. This comprehensive investigation enhances our understanding of NMC management by elucidating diagnostic pitfalls through histopathological correlation and proposing an effective therapeutic combination that demonstrates improved survival outcomes. By providing valuable insights into the diagnosis and treatment of primary pulmonary NMC, we hope to contribute to the development of more effective strategies for managing this rare and aggressive malignancy.
Humans ; Angiogenesis Inhibitors/therapeutic use* ; Carcinoma/therapy* ; Combined Modality Therapy ; Lung Neoplasms/diagnosis* ; Nuclear Proteins ; Oncogene Proteins ; Neoplasm Proteins

Objective To explore the factors affecting social frailty in elderly patients with mild ischemic stroke and conduct interpretable analysis to provide references for the implementation of targeted intervention.Methods Using convenience sampling method,elderly mild ischemic stroke patients treated in a tertiary A hospital in Tangshan from September 2022 to August 2023 were selected as the survey subjects according to whether social weakness and no social weakness occurred 6 months after discharge.General Information Questionnaire,Chronic Illness Resources Survey,Family Care Index Questionnaire,Instrumental Activities of Daily Living Scale,Mini-Mental State Examination,International Physical Activity Questionnaire Short Form,and Social Frailty Scale were uesd to investigate.Univariate analysis,random forest-feature recurrence elimination screening variables were used to construct random forest models,and SHAP values were introduced for influencing factor analysis.Results A total of 818 elderly patients with mild ischemic stroke were included,and 110 patients were lost at 6 months,and 708 patients(86.55％)finally completed the survey.The prediction accuracy of random forest model was 0.828 and 0.807 in the training set and test set.The SHAP interpretability analysis results showed that impaired self-care ability,sedentary behavior,and the number of combined chronic diseases were positively associated with social weakness,ideal utilization of chronic disease resources,good family care and social weakness;the importance of characteristics was self-care ability,chronic disease resource utilization,family care,sedentary behavior,and combined chronic diseases.Conclusion The influencing factors of social frailty in elderly patients with mild ischemic stroke are complex,so medical staff should pay attention to the social function of elderly patients with mild ischemic stroke,and reduce the risk of social frailty by formulating personalized intervention measures.

Objective To develop and validate a risk prediction model for social dysfunction in middle-aged and elderly patients with ischemic stroke.Methods A non-matched case-control study was conducted among ischemic stroke patients admitted to the neurology department of a tertiary hospital in Tangshan between August 2022 and March 2023.Patients who developed social dysfunction within 3 months after discharge were assigned to a case group,while those without it were assigned to a control group.Multivariate logistic regression was used to identify significant predictors and construct a nomogram-based prediction model.The model's discrimination and calibration were assessed using the area under the receiver operating characteristic curve(AUC)and the Hosmer-Lemeshow test.Internal validation was performed via bootstrap resampling,and clinical utility was evaluated using decision curve analysis.Results Logistic regression identified the following as significant risk factors for social dysfunction(P＜0.05):male gender,age≥60 years,primary education or below,rural residence,income＜3 000,cognitive impairment,low disability acceptance,poor self-management ability,suboptimal utilization of chronic disease resources,low future-oriented coping,and high cumulative ecological risk.The nomogram achieved an AUC of 0.874,with a sensitivity of 79.4％and specificity of 80.7％.The Hosmer-Lemeshow test indicated good calibration(x2=3.631,P=0.88).Conclusion The developed nomogram provides an effective tool for predicting the risk of social dysfunction in middle-aged and elderly ischemic stroke patients,facilitating early identification of high-risk individuals.

Objective:To evaluate the safety and efficacy of radiofrequency ablation（RFA）in the treatment of papillary thyroid microcarcinoma（PTMC）near and remote from the thyroid capsule.Methods:The clinical data，ultrasound images，ablation parameters and postoperative follow-up metrics were prospectively collected from 130 patients with pathologically confirmed PTMC in the Second Affiliated Hospital of Xi'an Jiaotong University who underwent RFA treatment between January 2023 and December 2024. According to whether the nodule margin was ≤ 2 mm from the thyroid capsule，the patients were divided into the subcapsular group（60 cases）and the remote from the capsule group（70 cases）. The clinical data，ablation parameters，complication rate，absorption of ablation lesions，tumor recurrence and metastasis were compared between the two groups.Results:The success rates of RFA in both groups were 100%. There was a statistically significant difference between the two groups at baseline in the location of nodules（ χ2=13.266， P=0.001）. After 12 months of routine follow-up，the incidence of complications was 5.00%（3/60）in the subcapsular group and 1.43%（1/70）in the remote from the capsule group，all complications recovered within 1 month，with no statistically significant difference（ P=0.407）. There were no significant changes in thyroid function［including free triiodothyronine（FT3），free thyroxine（FT4）and thyroid-stimulating hormone（TSH）］before and one month after RFA in the two groups（all P>0.05）. A statistically significant difference in the volume reduction rate（VRR）between the two groups was observed only when maximum diameter ≤ 5?mm at the 1st and 3rd months（all P<0.05）. For the remaining postoperative follow-up periods，there were no statistically significant differences in ablation zone volume or VRR between the two groups（all P>0.05）. At the final follow-up，for lesions with maximum diameter ≤ 5?mm，the tumor disappearance rate was 100% in both the subcapsular and remote from the capsule groups. For lesions with maximum diameter >5 mm，the rates were 78.4%（29/37）and 89.7%（26/29）in the respective groups，with no statistically significant difference between the two groups（ χ2 = 1.489， P =0.222）.There was no local tumor progression，lymph node metastasis or distant metastasis in either group. Conclusions:RFA is a safe and effective treatment for subcapsular PTMC，demonstrating comparable efficacy to that for PTMC located remote from the thyroid capsule.

BACKGROUND:The role of microRNA-214 in osteoporosis has been reported both at home and abroad,whereas the interrelationship between microRNA-214 and osteoarthritic articular cartilage and subchondral bone degeneration is unclear. OBJECTIVE:To investigate the relationship between microRNA-214 and cartilage and subchondral bone degeneration in mice with knee osteoarthritis. METHODS:Thirty C57BL/6J mice were randomly grouped:Experiment 1:sham operation group and medial meniscus destabilization group (n=3 per group) underwent hematoxylin-eosin staining and qPCR to detect changes in microRNA-214 gene expression;Experiment 2:sham operation group,medial meniscus destabilization group,medial meniscus destabilization+null-loaded adenovirus group (null-loaded group),and medial meniscus destabilization+microRNA-214 antagonist overexpression adenovirus group (antagonist group;n=6 per group). Cartilage tissues were taken from each group 4 weeks after surgery,and stained with hematoxylin-eosin,safranin O-fast green,and toluidine blue. qPCR and western blot were used to detect the expression of related factors in articular cartilage. RESULTS AND CONCLUSION:(1) In Experiment 1,hematoxylin-eosin staining results showed that cartilage degeneration was visible in the medial meniscus destabilization group compared with the sham operation group. qPCR assay results showed that microRNA-214 was expressed in all the samples,and the expression level of microRNA-214 in cartilage samples of the medial meniscus destabilization group was significantly higher than that of the sham operation group (P<0.05). (2) In Experiment 2,the results of hematoxylin-eosin staining,safranin O-fast green staining,and toluidine blue staining showed that the degree of cartilage degeneration in the antagonist group was significantly reduced compared with the medial meniscus destabilization group. Adenovirus-validated PCR assay showed that the microRNA-214 expression level in cartilage tissue was higher in the null-loaded group than in the antagonist group (P<0.05). (3) In Experiment 2,X-ray results showed typical osteoarthritis imaging changes in the medial meniscus destabilization group and null-loaded group,while the degree of degenerative joint lesions was relatively mild in the antagonist group. The results of microcomputed tomography showed that after injection of microRNA-214 antagonist,trabecular structure model index became smaller in the antagonist group,and the data were better than those of the medial meniscus destabilization group and null-loaded group. (4) In Experiment 2,western blot results showed that The relative expression levels of cartilage-associated factor type Ⅱ collagen α1,sex-determining region Y-box 9,Runt-associated transcription factor 2,and osteopontin in cartilage specimens of the medial meniscus destabilization group and the null-loaded group were lower than that in the sham operation group and the antagonist group (P<0.05),whereas the relative expression level of matrix metalloproteinase 13 was higher in the medial meniscus destabilization group and the null-loaded group than the sham operation group and the antagonist group (P<0.05). (5) In Experiment 2,PCR results indicated that the relative mRNA expression of tumor necrosis factor-α and interleukin-6 was relatively higher in the medial meniscus destabilization group and null-loaded group,but relatively lower in the antagonist group,as compared with the sham operation group (P<0.05). The relative mRNA expression of tumor necrosis factor-α and interleukin-6 was also higher in the medial meniscus destabilization group and the null-loaded group compared with the antagonist group (P<0.05). To conclude,the expression level of microRNA-214 in articular cartilage was elevated in the mouse osteoarthritis model,suggesting that the elevated expression level of microRNA-214 is closely related to osteoarthritis;and injection of microRNA-214 antagonist into the knee joint cavity of the mouse osteoarthritis model could delay articular cartilage degradation,promote subchondral bone remodeling,and ameliorate the progression of osteoarthritis.

This study aims to investigate the protective effect of naringenin(Nar)on cadmium(Cd)-induced liver injury in chickens and its regulatory role in endoplasmic reticulum stress(ERS)and autophagy.Forty-eight 1-day-old Hyland Brown egg roosters were divided into four groups:The control group,the Cd group(150 mg/kg CdCl2),the Nar group(250 mg/kg Nar),and the Cd+Nar group(150 mg/kg CdCl2+250 mg/kg Nar),and the rearing period was 60 days.On the 60th day,6 chickens were randomly selected from each group,and after fasting for 24 hours,blood was collected via vein and then removed from the neck and executed,the livers were collected and organ coefficients were calculated,changes in the content of liver function-related indexes were de-termined,pathological sections were made and observed,and the expression of mRNA and protein of related genes were detected by fluorescence quantitative PCR and Western blot method.The re-sults showed that Cd treatment resulted in a highly significant decrease(P＜0.01)in body mass,a highly significant increase(P＜0.01)in liver coefficient,a highly significant increase(P＜0.01)in serum levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),and lactate dehydrogenase(LDH)levels were highly significantly increased(P＜0.01),hepatic antioxidant capacity was highly significantly reduced(P＜0.01),and ERS-related genes(GRP-78,PERK,eIF-2α,CHOP,ATF-4,ATF-6)and autophagy-related genes(Atg-5,Beclin-1,LC3)mRNA expression was highly significantly up-regulated(P＜0.01),and the expression of mRNA for p62 was highly significantly reduced(P＜0.01).After the addition of Nar,Cd-induced liver injury was significantly alleviated,liver function indexes improved,hepatic antioxidant capacity was highly significantly el-evated(P＜0.01),mRNA expression of ERS-related genes(GRP-78,PERK,eIF-2α,CHOP,ATF-4,ATF-6)and autophagy-related genes(Atg-5,Beclin-1,LC3)was highly significantly decreased(P＜0.01)and mRNA expression of P62 was highly significantly increased(P＜0.01).This study suggests that Nar has potential in alleviating Cd-induced liver damage in chickens through the reg-ulation of ERS and autophagy,providing theoretical support for its application in livestock health.

This study aims to investigate the protective effect of naringenin(Nar)on cadmium(Cd)-induced liver injury in chickens and its regulatory role in endoplasmic reticulum stress(ERS)and autophagy.Forty-eight 1-day-old Hyland Brown egg roosters were divided into four groups:The control group,the Cd group(150 mg/kg CdCl2),the Nar group(250 mg/kg Nar),and the Cd+Nar group(150 mg/kg CdCl2+250 mg/kg Nar),and the rearing period was 60 days.On the 60th day,6 chickens were randomly selected from each group,and after fasting for 24 hours,blood was collected via vein and then removed from the neck and executed,the livers were collected and organ coefficients were calculated,changes in the content of liver function-related indexes were de-termined,pathological sections were made and observed,and the expression of mRNA and protein of related genes were detected by fluorescence quantitative PCR and Western blot method.The re-sults showed that Cd treatment resulted in a highly significant decrease(P＜0.01)in body mass,a highly significant increase(P＜0.01)in liver coefficient,a highly significant increase(P＜0.01)in serum levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),and lactate dehydrogenase(LDH)levels were highly significantly increased(P＜0.01),hepatic antioxidant capacity was highly significantly reduced(P＜0.01),and ERS-related genes(GRP-78,PERK,eIF-2α,CHOP,ATF-4,ATF-6)and autophagy-related genes(Atg-5,Beclin-1,LC3)mRNA expression was highly significantly up-regulated(P＜0.01),and the expression of mRNA for p62 was highly significantly reduced(P＜0.01).After the addition of Nar,Cd-induced liver injury was significantly alleviated,liver function indexes improved,hepatic antioxidant capacity was highly significantly el-evated(P＜0.01),mRNA expression of ERS-related genes(GRP-78,PERK,eIF-2α,CHOP,ATF-4,ATF-6)and autophagy-related genes(Atg-5,Beclin-1,LC3)was highly significantly decreased(P＜0.01)and mRNA expression of P62 was highly significantly increased(P＜0.01).This study suggests that Nar has potential in alleviating Cd-induced liver damage in chickens through the reg-ulation of ERS and autophagy,providing theoretical support for its application in livestock health.

Objective:To conduct a scope review of relevant studies on the application of virtual reality (VR) technology in breast cancer patients, identifying the basic content of interventions, outcome indicators, and application effects, with the aim of providing a reference for clinical healthcare professionals applying this technology.Methods:Based on the research methodology for scope reviews, a computer search was conducted in Chinese and English databases, including China National Knowledge Infrastructure, Wanfang Database, VIP, China Biology Medicine disc, PubMed, Web of Science, Cochrane Library, and Embase, with the search period extending to August 31, 2023. A categorical analysis of the included literature was conducted.Results:A total of 15 articles were included, primarily discussing the effects of VR technology on breast cancer patients' physical health, psychological well-being, cognitive function, and quality of life. Intervention frequencies were mainly once or twice daily, or twice weekly, with intervention durations ranging from 10 to 90 minutes and intervention periods from 2 to 12 weeks. VR interventions were found to improve physical function, psychological health, and cognitive function to some extent, increase patient rehabilitation adherence and satisfaction, and improve quality of life.Conclusions:VR technology can be an effective tool to support the treatment of breast cancer patients. However, the design of intervention protocols needs improvement. Future large-sample, multi-center, long-term follow-up randomized controlled trials are needed to verify the application effects of VR technology for breast cancer patients and promote its clinical application.

Objective To develop and validate a risk prediction model for social dysfunction in middle-aged and elderly patients with ischemic stroke.Methods A non-matched case-control study was conducted among ischemic stroke patients admitted to the neurology department of a tertiary hospital in Tangshan between August 2022 and March 2023.Patients who developed social dysfunction within 3 months after discharge were assigned to a case group,while those without it were assigned to a control group.Multivariate logistic regression was used to identify significant predictors and construct a nomogram-based prediction model.The model's discrimination and calibration were assessed using the area under the receiver operating characteristic curve(AUC)and the Hosmer-Lemeshow test.Internal validation was performed via bootstrap resampling,and clinical utility was evaluated using decision curve analysis.Results Logistic regression identified the following as significant risk factors for social dysfunction(P＜0.05):male gender,age≥60 years,primary education or below,rural residence,income＜3 000,cognitive impairment,low disability acceptance,poor self-management ability,suboptimal utilization of chronic disease resources,low future-oriented coping,and high cumulative ecological risk.The nomogram achieved an AUC of 0.874,with a sensitivity of 79.4％and specificity of 80.7％.The Hosmer-Lemeshow test indicated good calibration(x2=3.631,P=0.88).Conclusion The developed nomogram provides an effective tool for predicting the risk of social dysfunction in middle-aged and elderly ischemic stroke patients,facilitating early identification of high-risk individuals.