In recent years,a growing body of research has demonstrated that acupuncture can be used to effectively treat a diverse range of diseases,including functional gastrointestinal disorders,cardiovascular diseases,as well as anxiety and depression,through the modulation of the paraventricular hypothalamic nucleus(PVN).Acupuncture may exert its therapeutic effect either by modulating specific neurons within the PVN,such as corticotropin releasing hormone(CRH)neurons,or by regulating the release of hormones,such as oxytocin(OXT)and vasopressin(VP),and the activity of neural circuits associated with the PVN.This review summarizes the mechanisms by which PVN is involved in acupuncture treatment,including its regulatory mechanisms in gastrointestinal diseases,cardiovascular diseases,and negative emotions and pain.Future research should be conducted to further explore the precise mechanisms by which acupuncture regulates PVN to treat diseases,focusing on clarifying the specific processes of signaling pathway transduction,and exploring the specific effects of acupunture of different acupoint combinations and stimulation frequencies and intensity on PVN.

Objective To investigate the clinical efficacy of Xiaoluo Granules combined with an-tituberculosis drugs in the treatment of patients with cervical lymph node tuberculosis.Methods A retrospective analysis was conducted on the clinical data of 118 patients with cervical lymph node tu-berculosis who were treated in our hospital from January 2021 to January 2023.The patients were di-vided into control group(57 patients receiving conventional antituberculosis drug treatment)and ob-servation group(61 patients receiving Xiaoluo Granules combined with antituberculosis drug treat-ment)based on their treatment methods.The efficacy,traditional Chinese medicine(TCM)symptom scores,peripheral blood T-cell subsets,and type 1/type 2 helper T cell(Th1/Th2)-related cytokine levels,including tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-10(IL-10),and interferon-γ(IFN-γ),were compared between the two groups.Results After 6 months of treat-ment,the total effective rate in the observation group was higher than that in the control group(P＜0.05).After 6 months of treatment,the scores for pain,low fever,fatigue,anorexia,and night sweats decreased in both groups,and the scores for these symptoms in the observation group were lower than those in the control group(P＜0.05).After 6 months of treatment,CD3+,CD4+,and CD4+/CD8+increased,while CD8+decreased in both groups.Additionally,CD3+,CD4+,and CD4+/CD8+were higher,while CD8+was lower in the observation group than those in the control group(P＜0.05).After 6 months of treatment,TNF-α,IL-6,and IFN-γ levels decreased,while IL-10 levels increased in both groups.Furthermore,TNF-α,IL-6,and IFN-γ levels were lower in the observa-tion group than in the control group,while IL-10 levels were higher(P＜0.05).Conclusion Xia-oluo Granules combined with antituberculosis drugs can significantly improve the efficacy in the treatment of cervical lymph node tuberculosis and enhance immune function by upregulating CD3+,CD4+,CD4+/CD8+,and IL-10 levels and downregulating CD8+,TNF-α,IL-6,and IFN-γ levels.

Objective To develop an enteral nutrition management system for critically ill patients and assess its application outcomes to standardize enteral nutrition management.Methods Based on relevant guidelines and indicator systems,a management system for enteral nutrition in critically ill patients was constructed,consisting of 4 modules:nutritional screening and assessment,nutritional implementation,nutritional monitoring,and statistical analysis.A convenience sampling method was used to select enteral nutrition patients and healthcare staff from the ICU of a tertiary hospital in Ningbo.Data from January to February 2024 served as an experimental group,while data from January to February 2023 constituted a control group.The 2 groups were compared regarding nutritional risk screening rate,feeding interruption rate,completion rate of the enteral nutrition plan,and incidence of complications.At the same time,the system's effectiveness was assessed by healthcare professionals using the clinical nursing information system effectiveness evaluation form.Results The study included 111 patients in the experimental group and 101 patients in the control group.The experimental group exhibited a significantly higher nutritional risk screening rate and enteral nutrition plan completion rate,as well as significantly lower feeding interruption rate and incidence of mechanical complications compared to the control group(P＜0.05).The system received a high effectiveness rating,with an average score of 104.73±9.34.Conclusion The application of the enteral nutrition management system effectively improves the nutritional risk screening rate and completion rate of enteral nutrition plans,while reducing both the feeding interruption rate and the incidence of mechanical complications.Healthcare staff highly rated the system.

Tumor-associated neutrophils(TAN)are key components of the tumor microenvironment(TME)that exert dual regulatory roles in tumor progression through highly heterogeneous functional phenotypes.This review systematically addresses the dynamic balance of TAN in pro-tumor and anti-tumor mechanisms:TAN can directly kill tumor cells or collaborate with immune cells to activate anti-tumor re-sponses;however,in contrast,they can accelerate tumor progression by promoting angiogenesis,remodeling the extracellular matrix,and mediating immune evasion.Studies have shown that the functional heterogeneity of TAN is precisely regulated by multiple signaling net-works within the TME,and that the plasticity transformation of different subsets directly influences tumor progression.In-depth analyses of TAN subset characteristics,transformation mechanisms,and their clinical relevance will provide a theoretical basis for the development of inhibitors targeting pro-tumor neutrophils as well as advance the establishment of precise patient selection strategies for TAN subtype-based immunotherapy.

Objective:To investigate the interaction between non-alcoholic fatty liver disease (NAFLD) and overweight/obesity on the risk of mild cognitive impairment (MCI) in elderly individuals.Methods:This cross-sectional study was based on the Hubei Memory and Aging Cohort Study (HMACS). Cluster random sampling was used to select 5 661 elderly individuals aged≥65 years in Wuhan from 2018 to 2023. Standardized neuropsychological assessments and clinical examinations results were collected. The NAFLD was diagnosed by abdominal ultrasound. The logistic regression analysis was used to analyze the association of NAFLD and overweight/obesity with MCI. The impacts of interaction between NAFLD and overweight/obesity on the risk of MCI were analyzed using both multiplicative and additive models.Results:Among the 5 661 elderly individuals included in the analysis, 2 563 were male and 3 098 were female, with a mean age of (72.24±5.51) years. A total of 2 239 participants (39.6%) resided in rural areas, 2 841 (50.2%) were overweight/obesity, 2 390 (42.2%) had NAFLD, and 1 694 (29.9%) were diagnosed with MCI. The risk of MCI in elderly individuals with NAFLD and overweight/obesity was 2.975 times ( OR=2.975, 95% CI: 2.489-3.557, P<0.001) of that in non-overweight/obese individuals without NAFLD. There was a multiplicative interaction between NAFLD and overweight/obesity on MCI ( OR=1.508, 95% CI: 1.169-1.944, P=0.002). NAFLD and overweight/obesity had an additive interaction effect on the risk of MCI, and the relative excess risk of interaction, attributable proportion of interaction and the synergy index was 1.099 (95% CI: 0.630-1.593), 0.369 (95% CI: 0.222-0.487), 2.256 (95% CI: 1.457-3.492), respectively. Conclusion:There is an interaction between NAFLD and overweight/obesity in elderly individuals, and the co-existence of NAFLD and overweight/obesity increases the risk of MCI in this population.

Alzheimer′s disease (AD) is one of the most common neurodegenerative diseases. As the global population ages, incidence, morbidity and mortality of AD have increased significantly. The core pathological features of AD include β-amyloid (Aβ) deposition and phosphorylated tau aggregation, resulting in neuronal damage, abnormal mental behavior, and cognitive decline. In recent years, research breakthroughs have not only deepened the Aβ cascade hypothesis and the pathological theory of tau protein, but also made important progress in the fields of neuroimmune regulation, "microbiota-gut-brain" axis, genetic factors, especially the ApoEε4 allele. At the same time, AD has been continuously enriched in blood, cerebrospinal fluid and imaging markers, and sensitivity of markers has been improved and detection tends to be non-invasive. Therapeutic strategies for AD include traditional drugs, novel drugs targeting Aβ/tau protein, and non-pharmacological interventions such as cognitive training, non-invasive brain stimulation and exercise. This review systematically expounds the pathological mechanism, biomarkers, and treatment strategies of AD, aiming to provide a scientific basis for the establishment of a biomarker-based precision diagnosis and treatment paradigm.

OBJECTIVES: To analyze the distribution of Y chromosome azoospermia factor (AZF) microdeletions and their association with testicular development in male pediatric patients with congenital reproductive system disorders, including hypospadias, cryptorchidism, and disorders of sex development (DSD). METHODS: A prospective cohort study was conducted on pediatric patients admitted to the Department of Urology of Shanghai Children's Hospital from November 2021 to December 2023. The observation group included boys with hypospadias, cryptorchidism, or DSD, while the control group comprised boys with phimosis, indirect inguinal hernia, or hydrocele. Blood samples were collected for AZF microdeletion analysis using multiplex PCR to detect 15 sequence-tagged sites. Testicular ultrasound was performed to record testicular position and volume. Propensity score matching (PSM) was used to balance the groups. After matching, testicular volume differences were assessed. Stratified analyses compared testicular volume among children with AZF microdeletions, the control group, and children without micro-deletions in observation group. RESULTS: A total of 493 children were enrolled (observation group: 463; control group: 30). No Y chromosome microdeletions were detected in the control group. Four boys in the observation group had AZF microdeletions: one with cryptorchidism (AZFc+AZFd), one with isolated hypospadias (AZFc), and two with DSD (one with AZFb+AZFc+AZFd and one with AZFa). Ultrasonography measured 888 testicles. After PSM, testicular volume was significantly smaller in the observation group than in the control group (P<0.01). Stratified analysis revealed that among children under 9 years, those with AZF microdeletions tended to be older but had smaller testicular volumes compared to the control group and those without microdeletions in the observation group, although differences were not statistically significant (all P>0.05). Among children over 9 years, ages were comparable, but children with AZF microdeletions had smaller testicular volumes than the other two groups (statistical analysis was not performed due to small sample size). CONCLUSIONS The prevalence of Y chromosome microdeletions is higher in male children with congenital reproductive system disorders compared to the general population, particularly in those with DSD. Hypospadias, cryptorchidism, DSD, and AZF microdeletions may be associated with delayed testicular development in these children.

Lung cancer is the deadliest form of cancer globally, with millions of new cases diagnosed each year. Although rapid advancements in surgical techniques, targeted therapies, and immunotherapy have significantly improved patient outcomes, the overall 5-year survival rate remains disappointingly low. Recent studies have highlighted the vital role of gut microbiota in maintaining host health and its close association with the onset and progression of lung cancer through various mechanisms. This article provides a systematic analysis of the role of gut microbiota in lung cancer, focusing on its immunomodulatory and metabolic functions, as well as its potential applications in treatment, while also exploring its prospects for clinical use.
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Humans ; Lung Neoplasms/therapy* ; Gastrointestinal Microbiome ; Animals

OBJECTIVES: To investigate the protective effects of dexmedetomidine (DEX) against heat stress (HS)-induced oncosis in human skeletal muscle cells (HSKMCs) and its underlying mechanisms. METHODS: A HSKMC model of HS-induced oncosis were established by 43 ℃ water bath for 4 h, and the effects of treatments with 30 μmol/L DEX, ML385 (a Nrf2 inhibitor) +DEX, si-Nrf2+HS, and si-Nrf2+DEX prior to modeling on cell viability was assessed using CCK-8 assay. Oncosis characteristics were evaluated using transmission electron microscopy and Annexin V-FITC/PI flow cytometry. The oxidative stress markers (GSH, GSH-Px, MDA, SOD and ROS), mitochondrial membrane potential, energy metabolism, and inflammatory cytokines (TNF-α, IL-6 and IL-1β) in the cells were quantified using standard kits, and the expressions of porimin, caspase-3 and Nrf2 pathway proteins were analyzed using Western blotting and qRT-PCR. RESULTS: HS induced typical oncotic features in HSKMCs including organelle swelling and cytoplasmic vacuolization. DEX pretreatment significantly attenuated these changes, reduced Annexin V⁺/PI⁺ cell ratio and cellular porimin expression, and lowered the levels of ROS and MDA while restoring GSH and SOD levels. DEX pretreatment also significantly increased the mitochondrial membrane potential and ATP level, upregulated the expressions of Nrf2, p-Nrf2, HO-1 and NQO1, and suppressed the expressions of TNF-α, IL-6 and IL-1β. The protective effects of DEX were obviously attenuated by interventions with ML385 or si-Nrf2. CONCLUSIONS DEX mitigates HS-induced HSKMC oncosis by activating the Nrf2/HO-1 pathway to relieve oxidative stress, mitochondrial dysfunction, and inflammatory responses.
Humans ; Dexmedetomidine/pharmacology* ; NF-E2-Related Factor 2/metabolism* ; Oxidative Stress/drug effects* ; Heat-Shock Response/drug effects* ; Signal Transduction/drug effects* ; Membrane Potential, Mitochondrial ; Muscle, Skeletal/cytology* ; Heme Oxygenase-1/metabolism* ; Apoptosis/drug effects*

Since the beginning of the 21st century, the severe respiratory infectious diseases worldwide [such as severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), influenza A H1N1 and novel coronavirus infection have attracted wide attention from all walks of life due to their superior pathogenicity and transmissibility. Aerosols-carrying pathogens are the main transmission route of many severe respiratory infectious diseases, which can lead to severe respiratory failure and even acute respiratory distress syndrome (ARDS) in infected individuals. Mechanical ventilation is the primary treatment for ARDS, and the small tidal volume, appropriate level of positive end-expiratory pressure based lung protective ventilation strategy can effectively reduce the incidence of ventilator-induced lung injury (VILI). However, in the process of clinical treatment, it is sometimes necessary to briefly disconnect the connection between the artificial airway and the ventilator circuit, which will not only cause the residual aerosol in the respiratory system to spill out and pollute the surrounding environment, increase the risk of nosocomial infection including medical staff, but also interfere with the implementation of lung protective ventilation strategy and aggravate ventilator-induced lung injury. In addition, studies have shown that a lot of medical staff have nosocomial infections, especially staff involved in tracheal intubation, extubation and other airway related operations. In addition to enhancing personal protective measures, it is crucial to safeguard healthcare workers from aerosol contamination and minimize associated risks during airway management. At present, there are few researches on the temporary sealing of airway lines and ventilator system, and there is a lack of clear guidance. This review summarizes the research status in related fields to provide a reference for corresponding solutions and programs.
Humans ; Respiratory Distress Syndrome/etiology* ; Respiration, Artificial ; Ventilator-Induced Lung Injury/prevention & control* ; Severe Acute Respiratory Syndrome ; COVID-19 ; Clinical Relevance