Objective To investigate the effect of osthole(Ost)on neuroinflammation in IS rats by regulating the HMGB1-RAGE signaling pathway.Methods After rat IS model was established with middle cerebral artery occlusion by intraluminal suture,40 model rats were grouped into model group,low-and high-dose Ost(Ost-L and Ost-H)groups,and Ost-H+recombinant rHMGB1(Ost-H+rHMGB1)group,with 10 rats in each groups.Another 10 rats served as sham operation group.Zea-Longa scoring was used to evaluate the neurological function.Serum nerve growth factor(NGF)and LDH levels,and hippocampal TNF-α,IL-10,and IL-1β contents were detected by ELISA.Triphenyltetrazolium chloride staining,Nissl staining,and TUNEL staining were applied respectively to observe the volume of cerebral infarction,hippocampal morphology,and apoptosis in hippocampal tissue cells.The activity of superoxide dismutase(SOD)in the hip-pocampus was detected by hydroxylamine assay,and that of catalases(CAT)was by ammonium molybdate.The content of malonic dialdehyde(MDA)was determined by thiobarbituric acid method.Western blotting was used to measure the protein expression of cleaved Caspase-3,HMGB1,RAGE,NF-κB,and p-NF-κB in brain tissue.Results The model group showed obvious damage in the hippocampal tissues,higher neurological function score,increased stroke volume percentage,serum LDH level and hippocampal TNF-α and IL-1βlevels,elevated neuronal apoptot-ic rate and MDA content,and up-regulation of cleaved Caspase-3,HMGB1,RAGE,and p-NF-κB/NF-κB proteins,while decreased serum NGF level,hippocampal IL-10 content and SOD and CAT activities when compared with the sham group(P＜0.05).Low-and high-dose Ost treatment re-sulted in obviously declined damage in the hippocampal tissue,decreased neurological function score,lower stroke volume percentage,reduced serum LDH level and hippocampal tissue TNF-αand IL-1β contents,lower neuronal apoptotic rate and MDA content,and down-regulated cleaved Caspase-3,HMGB1,RAGE,and p-NF-κB/NF-κB protein,while raised serum NGF level,hipp-ocampal IL-10 content and SOD and CAT activities when compared with the model group(265.84±34.76 pg/ml and 394.52±41.68 pg/ml vs 187.56±23.54 pg/ml,P＜0.05;41.84±5.67 pg/ml and 68.57±8.39 pg/ml vs 16.73±3.52 pg/ml,P＜0.05;87.49±12.53 U/mg and 109.86±14.67 U/mg vs 52.73±8.46 U/mg,P＜0.05;45.38±5.72 U/mg and 67.43±8.91 U/mg vs 21.54±3.47 U/mg,P＜0.05).rHMGB1 could alleviate the improvement effect of Ost on nerve damage in IS rats.Conclusion Ost can attenuate neuroinflammation,oxidative stress,and neuronal apoptosis in IS rats,which may be through its inhibiting the HMGB1-RAGE signaling pathway.

One-step nucleic acid amplification(OSNA)technology is a molecular diagnostic technology that assesses the metastatic status of lymph nodes by detecting the expression level of cytokeratin 19 mRNA in sentinel lymph nodes(SLNs).It is characterized by its rapidity,ac-curacy,semi-quantitative nature,and high reproducibility,thereby providing comprehensive lymph node diagnostic information for clinical physicians.It is of great significance regarding avoiding secondary axillary lymph node dissection(ALND)or excessive ALND.The de-escala-tion treatment pattern for breast cancer is the current therapeutic strategy pursued by surgeons.SLN biopsy(SLNB)can help patients re-ceive more precise and personalized treatment,thereby reducing unnecessary treatment intensity and side effects while ensuring thera-peutic efficacy.This article reviews the application of OSNA detection in SLNB.

Objective To investigate the effect of osthole(Ost)on neuroinflammation in IS rats by regulating the HMGB1-RAGE signaling pathway.Methods After rat IS model was established with middle cerebral artery occlusion by intraluminal suture,40 model rats were grouped into model group,low-and high-dose Ost(Ost-L and Ost-H)groups,and Ost-H+recombinant rHMGB1(Ost-H+rHMGB1)group,with 10 rats in each groups.Another 10 rats served as sham operation group.Zea-Longa scoring was used to evaluate the neurological function.Serum nerve growth factor(NGF)and LDH levels,and hippocampal TNF-α,IL-10,and IL-1β contents were detected by ELISA.Triphenyltetrazolium chloride staining,Nissl staining,and TUNEL staining were applied respectively to observe the volume of cerebral infarction,hippocampal morphology,and apoptosis in hippocampal tissue cells.The activity of superoxide dismutase(SOD)in the hip-pocampus was detected by hydroxylamine assay,and that of catalases(CAT)was by ammonium molybdate.The content of malonic dialdehyde(MDA)was determined by thiobarbituric acid method.Western blotting was used to measure the protein expression of cleaved Caspase-3,HMGB1,RAGE,NF-κB,and p-NF-κB in brain tissue.Results The model group showed obvious damage in the hippocampal tissues,higher neurological function score,increased stroke volume percentage,serum LDH level and hippocampal TNF-α and IL-1βlevels,elevated neuronal apoptot-ic rate and MDA content,and up-regulation of cleaved Caspase-3,HMGB1,RAGE,and p-NF-κB/NF-κB proteins,while decreased serum NGF level,hippocampal IL-10 content and SOD and CAT activities when compared with the sham group(P＜0.05).Low-and high-dose Ost treatment re-sulted in obviously declined damage in the hippocampal tissue,decreased neurological function score,lower stroke volume percentage,reduced serum LDH level and hippocampal tissue TNF-αand IL-1β contents,lower neuronal apoptotic rate and MDA content,and down-regulated cleaved Caspase-3,HMGB1,RAGE,and p-NF-κB/NF-κB protein,while raised serum NGF level,hipp-ocampal IL-10 content and SOD and CAT activities when compared with the model group(265.84±34.76 pg/ml and 394.52±41.68 pg/ml vs 187.56±23.54 pg/ml,P＜0.05;41.84±5.67 pg/ml and 68.57±8.39 pg/ml vs 16.73±3.52 pg/ml,P＜0.05;87.49±12.53 U/mg and 109.86±14.67 U/mg vs 52.73±8.46 U/mg,P＜0.05;45.38±5.72 U/mg and 67.43±8.91 U/mg vs 21.54±3.47 U/mg,P＜0.05).rHMGB1 could alleviate the improvement effect of Ost on nerve damage in IS rats.Conclusion Ost can attenuate neuroinflammation,oxidative stress,and neuronal apoptosis in IS rats,which may be through its inhibiting the HMGB1-RAGE signaling pathway.

One-step nucleic acid amplification(OSNA)technology is a molecular diagnostic technology that assesses the metastatic status of lymph nodes by detecting the expression level of cytokeratin 19 mRNA in sentinel lymph nodes(SLNs).It is characterized by its rapidity,ac-curacy,semi-quantitative nature,and high reproducibility,thereby providing comprehensive lymph node diagnostic information for clinical physicians.It is of great significance regarding avoiding secondary axillary lymph node dissection(ALND)or excessive ALND.The de-escala-tion treatment pattern for breast cancer is the current therapeutic strategy pursued by surgeons.SLN biopsy(SLNB)can help patients re-ceive more precise and personalized treatment,thereby reducing unnecessary treatment intensity and side effects while ensuring thera-peutic efficacy.This article reviews the application of OSNA detection in SLNB.

The elderly are a high-risk group for cardiovascular diseases, and as they age, the function of the cardiovascular system gradually declines, leading to a significant increase in the risk of illness.The decline in cardiopulmonary function, abnormal blood pressure, metabolic issues such as blood lipids and glucose, and elevated levels of inflammatory factors are the main factors affecting cardiovascular health in the elderly.Resistance training, as an effective form of exercise intervention, can improve the cardiopulmonary function of the elderly, regulate abnormal states of indicators such as blood pressure, blood glucose, and blood lipids, and reduce the potential threat of inflammation to health.The article analyzes the effects of different training intensities, frequencies, and durations, which can provide a scientific basis for the cardiovascular health management of the elderly.

Objective To identify high-risk factors for healthcare-associated infection(HAI)in patients in inten-sive care units(ICUs),and develop a quick response(QR)code-based APP prediction tool.Methods Information of inpatients in general ICUs of three hospitals in Guizhou Province from January to December 2024 were collected.Risk factors were analyzed with a logistic regression model.QR code-based APP was constructed and validated.Results A total of 1 782 patients in general ICUs of three hospitals in Guizhou Province in 2024 were included in the analysis,out of which 410 were HAI cases,and the incidence of HAI was 23.01％.Multivariate logistic regre-ssion analysis results of HAI in ICU inpatients showed that regional gross domestic product(GDP)≥58 685 Yuan,performing pathogen culture during this hospitalization,history of diabetes mellitus,history of cancer,length of hospital stay ≥7 days before infection,and duration of persistent fever＞5 days before infection were independent risk factors for HAI in ICU patients(all P＜0.05).The discrimination of the model(area under the receiver operating characteristic curve[AUC]of 0.841),calibration(Brier score of 0.129),and clinical effectiveness(net benefit of 11.4％when the risk threshold was 5％-74％)all performed well.Conclusion The QR code-based APP prediction tool is of great significance for scientific research transformation and precise HAI control.

Background and purpose:Internal mammary sentinel lymph node biopsy(IMSLNB)is a minimally invasive diagnostic technique for regional lymph nodes in breast cancer,which can provide accurate lymph staging and guide adjuvant treatment decision,but its clinical application has been controversial.The purpose of this study was to investigate the prognosis of IMSLNB in early breast cancer.Methods:In this study,a retrospective cohort of 7 949 patients with breast cancer from January 1,2016 to December 31,2021 was analyzed.After applying propensity score matching,the patients were divided into IMSLNB group and no-IMSLNB group,and the regional recurrence-free survival(RRFS),local recurrence-free survival(LRFS),distant metastasis-free survival(DMFS),disease-free survival(DFS)and overall survival(OS)of the two groups were compared.This study was approved by the Clinical Research Ethics Committee of the Affiliated Tumor Hospital of Shandong First Medical University(approval number:SDTHEC20130324).Results:A total of 990 patients were included in the final analysis(330 in the IMSLNB group and 660 in the no-IMSLNB group).IMSLN metastasis was found in 54 patients in the IMSLNB group,including 47 patients with axillary lymph node(ALN)metastasis and 7 patients with IMSLN metastasis only.The IMSLN transfer rate was 16.4%.The median follow-up of 41 months showed that the IMSLNB group demonstrated better 3-year DFS[98.4%vs 94.2%,hazard ratio(HR)=0.509;95%CI:0.312-0.828,P=0.007]and 5-year DFS(92.5%vs 87.3%,HR=0.214,95%CI:0.206-0.222,P=0.011)compared with no-IMSLNB group.However,no significant differences were observed in 3-year OS(99.1%vs 99.4%,HR=0.618,95%CI:0.231-1.655,P=0.338)or 5-year OS(98.5%vs 99.1%,HR=0.52,95%CI:0.51-0.53,P=0.392)between the two groups.The 3-year RRFS in the IMSLNB group was better compared with the no-IMSLNB group(99.09%vs 97.73%,HR=0.066;95%CI:0.061-0.071,P=0.048),while no significant differences were observed in 3-year LRFS(99.70%vs 98.19%,HR=0.209;95%CI:0.201-0.217,P=0.130)or DMFS(95.76%vs 96.06%,HR=0.865,95%CI:0.858-0.872,P=0.820)between the two groups.The exploratory subgroup analysis of DFS revealed that patients in the following subgroups could significantly benefit from IM-SLNB(P＜0.05):diagnosis age(≤50 years),premenopausal status,BMI(≤24),lymphovascular invasion(LVI,present),tumor location(lateral),molecular subtype[hormone receptor positive(HR+)/human epidermal growth factor receptor 2 negative(HER2-)],histological type(invasive ductal carcinoma),and axillary lymph node status(positive).Conclusion:IMSLNB can provide more accurate regional lymph node staging for early breast cancer,help optimize adjuvant radiotherapy strategies,and improve patients'DFS and RRFS.It can be promoted as a minimally invasive staging technique for regional lymph nodes.

Objective To identify high-risk factors for healthcare-associated infection(HAI)in patients in inten-sive care units(ICUs),and develop a quick response(QR)code-based APP prediction tool.Methods Information of inpatients in general ICUs of three hospitals in Guizhou Province from January to December 2024 were collected.Risk factors were analyzed with a logistic regression model.QR code-based APP was constructed and validated.Results A total of 1 782 patients in general ICUs of three hospitals in Guizhou Province in 2024 were included in the analysis,out of which 410 were HAI cases,and the incidence of HAI was 23.01％.Multivariate logistic regre-ssion analysis results of HAI in ICU inpatients showed that regional gross domestic product(GDP)≥58 685 Yuan,performing pathogen culture during this hospitalization,history of diabetes mellitus,history of cancer,length of hospital stay ≥7 days before infection,and duration of persistent fever＞5 days before infection were independent risk factors for HAI in ICU patients(all P＜0.05).The discrimination of the model(area under the receiver operating characteristic curve[AUC]of 0.841),calibration(Brier score of 0.129),and clinical effectiveness(net benefit of 11.4％when the risk threshold was 5％-74％)all performed well.Conclusion The QR code-based APP prediction tool is of great significance for scientific research transformation and precise HAI control.

Background and purpose:Internal mammary sentinel lymph node biopsy(IMSLNB)is a minimally invasive diagnostic technique for regional lymph nodes in breast cancer,which can provide accurate lymph staging and guide adjuvant treatment decision,but its clinical application has been controversial.The purpose of this study was to investigate the prognosis of IMSLNB in early breast cancer.Methods:In this study,a retrospective cohort of 7 949 patients with breast cancer from January 1,2016 to December 31,2021 was analyzed.After applying propensity score matching,the patients were divided into IMSLNB group and no-IMSLNB group,and the regional recurrence-free survival(RRFS),local recurrence-free survival(LRFS),distant metastasis-free survival(DMFS),disease-free survival(DFS)and overall survival(OS)of the two groups were compared.This study was approved by the Clinical Research Ethics Committee of the Affiliated Tumor Hospital of Shandong First Medical University(approval number:SDTHEC20130324).Results:A total of 990 patients were included in the final analysis(330 in the IMSLNB group and 660 in the no-IMSLNB group).IMSLN metastasis was found in 54 patients in the IMSLNB group,including 47 patients with axillary lymph node(ALN)metastasis and 7 patients with IMSLN metastasis only.The IMSLN transfer rate was 16.4%.The median follow-up of 41 months showed that the IMSLNB group demonstrated better 3-year DFS[98.4%vs 94.2%,hazard ratio(HR)=0.509;95%CI:0.312-0.828,P=0.007]and 5-year DFS(92.5%vs 87.3%,HR=0.214,95%CI:0.206-0.222,P=0.011)compared with no-IMSLNB group.However,no significant differences were observed in 3-year OS(99.1%vs 99.4%,HR=0.618,95%CI:0.231-1.655,P=0.338)or 5-year OS(98.5%vs 99.1%,HR=0.52,95%CI:0.51-0.53,P=0.392)between the two groups.The 3-year RRFS in the IMSLNB group was better compared with the no-IMSLNB group(99.09%vs 97.73%,HR=0.066;95%CI:0.061-0.071,P=0.048),while no significant differences were observed in 3-year LRFS(99.70%vs 98.19%,HR=0.209;95%CI:0.201-0.217,P=0.130)or DMFS(95.76%vs 96.06%,HR=0.865,95%CI:0.858-0.872,P=0.820)between the two groups.The exploratory subgroup analysis of DFS revealed that patients in the following subgroups could significantly benefit from IM-SLNB(P＜0.05):diagnosis age(≤50 years),premenopausal status,BMI(≤24),lymphovascular invasion(LVI,present),tumor location(lateral),molecular subtype[hormone receptor positive(HR+)/human epidermal growth factor receptor 2 negative(HER2-)],histological type(invasive ductal carcinoma),and axillary lymph node status(positive).Conclusion:IMSLNB can provide more accurate regional lymph node staging for early breast cancer,help optimize adjuvant radiotherapy strategies,and improve patients'DFS and RRFS.It can be promoted as a minimally invasive staging technique for regional lymph nodes.

Objective To investigate the effects of electroacupuncture at"Zusanli"(ST36)on type 3 innate lymphoid cells(ILC3s)secreting interleukin(IL)-22 and intestinal cholinergic neurons in the colon of mice with inflammatory bowel disease(IBD),and to explore the mechanisms underlying electroacupuncture-mediated amelioration of IBD.Methods Twenty-four male C57BL/6J mice were divided into a normal group(n=8)and a modeling group(n=16)using the random number table method.The modeling group received 4％dextran sulfate sodium solution ad libitum for 7 days to establish the IBD model.On the fourth day after modeling,the modeling group was divided into a model group and an electroacupuncture group using the random number table method,with eight mice per group.Electroacupuncture intervention was applied bilaterally at"Zusanli"(ST36)in mice of the electroacupuncture group,once daily for 20 min each time,for seven consecutive days.After intervention,stool characteristics and occult blood were assessed.The disease activity index(DAI)of mice in each group was scored,and colon length was measured.The morphology of the colon tissue in mice was observed using hematoxylin-eosin staining,and the histopathological score was determined.A cytometric bead array was used to detect the contents of IL-1β,tumor necrosis factor-α(TNF-α),and IL-6 in colon tissue.Flow cytometry was used to determine the IL-22+ILC3s proportion in lamina propria lymphocytes of colon tissue.The content of IL-22 in colon tissue was detected using an enzyme-linked immunosorbent assay.Immunofluorescence was used to detect the number of choline acetyltransferase(ChAT)+/cellular Fos(c-Fos)+co-labeled neurons in colon tissue.Results Compared with the normal group,mice in the model group exhibited different degrees of loose stools,strongly positive fecal occult blood test,elevated DAI scores,shortened colon length,increased colon histopathological score;increased contents of IL-1β,TNF-α,and IL-6 in colon tissue;and a decreased IL-22+ILC3s proportion in lamina propria lymphocytes of colon tissue(P＜0.05).Compared with the model group,mice in the electroacupuncture group exhibited improved fecal traits,weakly positive fecal occult blood test,decreased DAI score,increased colon length,reduced colon histopathological score;decreased contents of IL-1β,TNF-α,and IL-6 in colon tissues;an increased IL-22+ILC3s proportion in lamina propria lymphocytes of colon tissue;increased IL-22 content in colon tissue;and increased ChAT+/c-Fos+co-labeled neurons in colon tissue(P＜0.05).Conclusion Electroacupuncture at"Zusanli"(ST36)can significantly ameliorate colonic damage and reduce inflammatory responses in IBD mice,and its mechanism may be related to the activation of intestinal cholinergic neurons and the enhancement of colonic ILC3s function.