It is very limited that the benefit of perioperative chemotherapy in early non-small cell lung cancer (NSCLC), and the 5-year survival rate is only 5% higher than surgery. Antibodies that block programmed cell death protein 1/programmed death-ligand 1 significantly improve the survival of advanced NSCLC. The value of immunotherapy in early NSCLC is also being explored. This paper firstly summarized and analyzed the progress of immunotherapy in the perioperative period of NSCLC. Secondly, the safety and feasibility of surgical resection after neoadjuvant immunotherapy were discussed. Finally, the clinical value of different therapeutic efficacy prediction indicators was summarized, in order to clarify the current status of immunotherapy in the perioperative period, so as to improve the clinical benefits of early NSCLC patients.

Objective To evaluate the characteristics of preoperative corneal astigmatism in cataract surgery candi-dates with high myopia.Methods In this observational study,medical records of consecutive patients who underwent cataract surgery in our hospital between January 2014 and December 2023 were reviewed retrospectively.Biometric param-eters of eyes were measured preoperatively by IOL-Master optical biometry.The cataract patients were classified into a high myopia group[defined as axial length(AL)≥26.00 mm]and a control group(normal ALs,22.00 mm ≤ AL ≤25.00 mm).The characteristics of corneal astigmatism were compared between the two groups.Results Among 17 325 cataract pa-tients(17 325 eyes),2 206 patients(2 206 eyes)had high myopia and 13 429 patients(13 429 eyes)had no high myopia.In the high myopia group,1 822 eyes(82.6％)had corneal astigmatism ≥0.50 D,1 138 eyes(51.6％)had corneal astig-matism ≥1.00 D,623 eyes(28.2％)had corneal astigmatism ≥1.50 D and 314 eyes(14.2％)had corneal astigmatism ≥2.00 D.These proportions were significantly higher than those in the control group(71.9％,35.9％,15.9％and 7.3％,re-spectively;all P＜0.001).In the high myopia group,1 340 eyes(60.7％)had moderate astigmatism,147 eyes(6.7％)had high astigmatism and 922 eyes(41.8％)had with-the-rule(WTR)astigmatism.These 3 proportions were all significantly higher than those in the control group(48.9％,3.3％and 28.2％,respectively;all P＜0.001).Among high-myopia pa-tients,the corneal astigmatism was statistically greater in women than that in men(P=0.001),and the proportion of ob-lique astigmatism was higher in women than that in men(19.3％vs.15.8％,P=0.034).The proportion of against-the-rule(ATR)astigmatism increased significantly with age.In the high myopia group,the corneal astigmatism of eyes with WTR,ATR and oblique astigmatism was(1.26±0.85)D,(1.28±0.81)D and(0.89±0.71)D,respectively.They were signifi-cantly greater than those in the control group[(0.82±0.71)D,(1.06±0.68)D and(0.67±0.53)D,respectively;all P＜0.001].In the high myopia group,there were 31.8％,12.3％and 4.1％of eyes with corneal astigmatism ≥1.00 D,≥1.50 D and ≥2.00 D,respectively.All of these 3 proportions were significantly lower than those of eyes with WTR or ATR astig-matism(all P＜0.05).This finding is consistent with the tendency in the control group.Conclusion A significant bur-den of preoperative corneal astigmatism is observed in cataract surgery candidates with high myopia,with more than 50％of the patients having corneal astigmatism ≥1.00 D.The corneal astigmatism of patients with high myopia is significantly greater than that of patients with normal ALs.The proportion of moderate-to-high astigmatism is significantly higher in high-myopia patients than that in patients with normal ALs.

AIM:To investigate the therapeutic effects and potential mechanism of pachymic acid(PA)on li-popolysaccharide(LPS)-induced acute kidney injury(AKI)in mice.METHODS:(1)Genes related to AKI were screened using the DAVID database.Core genes were identified by intersecting related genes and analyzed using Cyto-scape software.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)analyses were performed through the DAVID database for the cross-targets.Molecular docking and activity assays were conducted on the primary core targets.(2)A total of 100 C57BL/6J mice were randomly divided into five groups:normal control(NC),model(LPS),solvent control(LPS+DMSO),and treatment groups(LPS+PA-10 and LPS+PA-20),with 20 mice in each group.The LPS-AKI model was established by intraperitoneal injection of 18 mg/kg LPS.The treatment groups received 10 mg/kg and 20 mg/kg PA,respectively,and the solvent control group was administered an equivalent dose of DMSO.Mice were euthanized 24 h after injection.Serum was collected for biochemical analysis,and Western blot was used to detect neutro-phil gelatinase-associated lipocalin(NGAL),kidney injury molecule-1(KIM-1),caspase-3,cleaved caspase-3,interleu-kin-1β(IL-1β),and monocyte chemoattractant protein-1(MCP-1)protein expression.RT-qPCR was employed to detect inflammatory factor mRNA levels.Molecular docking was used to simulate the optimal binding site of PA to caspase-3.En-zyme activity assays were performed to assess caspase protein activity,and renal lesions were observed via hematoxylin and eosin(HE)staining.Apoptosis was detected by TUNEL staining.RESULTS:(1)Thirty-one potential targets of PA against AKI were identified through network pharmacology.GO and KEGG enrichment analyses indicated that these tar-gets were primarily involved in immune response,inflammatory processes,apoptosis and survival,angiogenesis and hemo-dynamics,oxidative stress,and endoplasmic reticulum stress.Key targets included CASP3(caspase-3),PTGS2,BCL2,CCL2,and CYP219.(2)PA treatment improved renal function and reduced tubular epithelial injury.It significantly de-creased NGAL,KIM-1,and cleaved caspase-3 protein levels,as well as inflammatory factors TNF-α,IL-1β,and MCP-1 mRNA and protein expression.PA also reduced apoptosis of renal tubular epithelial cells.Enzyme activity assays and mo-lecular docking revealed that PA exerted its anti-apoptotic effect by directly binding to caspase-3,thereby inhibiting its ac-tivation by caspase-8.CONCLUSION:PA demonstrated a therapeutic effect in LPS-AKI,potentially through the inhibi-tion of inflammatory factor synthesis and release,as well as the inhibition of caspase-3 activation by caspase-8,reducing apoptosis in renal tubular epithelial cells.

Objective To explore the clinical effect of cold treatment of replacement fluid in continuous blood purification(CBP)of patients with heat stroke.Methods Clinical data of 46 patients with heat stroke who were treated with CBP in Hainan Hospital of PLA General Hospital from July 2018 to September 2022 were retrospectively analyzed.The patients were assigned to control group(23 cases,conventional treatment for heat stroke and CBP with room temperature replacement fluid)and observation group(23 cases,conventional treatment for heat stroke and CBP with cooling replacement fluid).The body temperatures were compared between the two groups before treatment and 30 min,2 h,6 h,12 h and 24 h after treatment.The prothrombin activity(PTA),activated partial thromboplastin time(APTT),D-dimer(D-D),fibrinogen(FIB)and platelet count(PLT)before treatment and at 24 h(T1),3 d(T2)and 7 d(T3)after treatment,as well as the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHEⅡ)score at 7 d after treatment were also compared between the two groups.Results There was no significant difference in temperature or coagulation function between the two groups before treatment(P>0.05).The temperature of the observation group was significantly different from that of the control group at 2 h,6h and 12h after treatment(P<0.05).After treatment,the levels of PTA,FIB and PLT in the observation group at T1,T2 and T3 were higher than those in the control group,while the level of D-D in the observation group was lower than that in the control group,and the APPT at T1 and T2 was significantly shorter than that in the control group(P<0.05).PTA,APPT,D-D,FIB and PLT of the two groups were improved after treatment(P<0.05).Conclusion The cold treatment of replacement fluid can quickly shorten the cooling time of patients with heat stroke during CBP,and significantly improve coagulation function.It is worthy of clinical promotion so as to improve the progrosis of patients with heat strok.

Objective : To explore the relationship between single nucleotide polymorphisms ( SNPs) in D-loop region of mitochondrial DNA ( mtDNA) and mtDNA copy number and the risk of dermatomyositis ( DM) ，and its in- fluencing factors． Methods : 74 patients with DM and 92 healthy controls were included in the study． Genomic DNA was extracted from peripheral blood and the target fragment of mtDNA D-loop region was amplified by PCR technique，and the products were subsequently sequenced．Serum levels of ROS were assessed using a high-sensi- tivity reactive oxygen species detection kit．The expression levels of cytokines，interleukin ( IL) -5，IL-13，inter- feron-γ ( IFN-γ) ，IL-2，IL-6，IL-10，tumor necrosis factor-α ( TNF-α) and IL-4 were measured using Flow Fluo- rescence Immunmicrobeads Assay．Wilcoxon rank-sum test was used to assess the potential correlation between cy- tokines and SNPs associated with DM risk．The relative copy number of mtDNA was measured using quantitative re- al-time polymerase chain reaction ( qPCR) analysis． Results : Two SNPs ( 16304T / C，16519T / C) were found to be associated with the risk of developing DM，and alleles 16304C ( χ2 = 4. 937，P = 0. 026) and 16519C ( χ2 = 4. 405，P = 0. 036) in the mitochondrial D-loop region were confirmed to be associated with DM development risk． The DM risk-associated allele 16304C was significantly associated with lower IL-4 expression ( P = 0. 016) ．The mtDNA copy number was significantly higher in DM patients than in controls ( P ＜0. 001) ． Conclusion Mitochondrial D-loop SNPs can be potential biomarkers for DM risk，and SNPs may be involved in DM by influencing cytokines．DM shows high expression of mtDNA copy number，and the increase in mtDNA copy number may lead to mitochondrial dysfunction，which triggers the pathogenesis of DM．

Laparoscopic right hemicolectomy is the standard surgical procedure for treating right-sided colon cancer,yet its complex anatomical layers and technically demanding operations pose significant challenges to surgeons'expertise.Currently,surgical skill assessment in clinical practice still predominantly relies on subjective expert evaluation,an approach inherently limited by low efficiency and inconsistent standards.With the rapid advancement of artificial intelligence(AI)technologies(particularly breakthroughs in computer vision and deep learning algorithms),a revolutionary technical foundation has been established for developing objective and precise automated surgical evaluation systems.This article comprehensively reviewed the current clinical application status of right hemicolectomy in China,thoroughly examined the clinical necessity and technical feasibility of constructing an intelligent surgical assessment system,and systematically presented our center's cutting-edge research achievements in this field.Looking ahead,AI-driven intelligent evaluation systems are expected to standardize and quantify surgical skill assessment.Such innovation will not only transform surgical training programs and enhance the quality of multicenter clinical research,but also promote the standardization of precision surgical protocols.This advancement holds significant clinical value and societal importance by improving long-term patient outcomes and fostering more equitable distribution of medical resources.

Objective To compare the clinical pregnancy outcomes of tamoxifen(TAM),TAM combined with intrauterine perfusion of platelet-rich plasma(PRP),and hormone replacement therapy(HRT)combined with intrauterine perfusion of PRP for frozen-thawed embryo transfer(FET)in patients with thin endometrium.Methods A retrospective analysis was performed on clinical data of 321 patients with thin endometrium(endome-trial thickness≤7 mm in previous cycles)who underwent FET at the Reproductive Medicine Center of Guangdong Provincial Reproductive Hospital from January 2023 to April 2025.According to the treatment protocols,the patients were divided into three groups:TAM group(Group A,n=98),TAM+PRP group(Group B,n=91),and HRT+PRP group(Group C,n=132).General information,endometrial thickness on the conversion day before and after treatment,clinical pregnancy outcomes,andcosts of endometrial preparation treatment were com-pared among the three groups.Results There were no significant differences in age,duration of infertility,type of infertility,anti-Müllerian hormone(AMH)level,basal follicle-stimulating hormone(FSH)among the three groups(P>0.05).After treatment,there were no significant differences in endometrial thickness on the conversion day or the extent of increase among the three groups(P>0.05).The clinical pregnancy rates in Group A,Group B,and Group C were 56.1%,51.6%,and 43.2%respectively,with a significant difference(P=0.011);the embryo implantation rates were 43.6%,45.5%,and 34.6%respectively,showing a significant difference(P=0.019).The early abortion rate in Group A(3.64%)was significantly lower than that in Group C(15.79%)(P<0.01).In terms of treatment cost of endometrial preparation treatment,the cost in Group A(676.5±494.5 Yuan)was significantly lower than that in Group B(2 401.2±764.2 Yuan)and Group C(3 093.8±758.3 Yuan)(P<0.01).Conclusion In FET cycles for patients with thin endometrium,the clinical outcomes of TAM,TAM+PRP and HRT+PRP are comparable,and TAM demonstrates advantages in terms of a lower early miscarrage rate and better cost-effectiveness,thus serving as an option for endometrial preparation in patients with thin endometrium.

This study investigated the influence of Leptospira interrogans infection on the expression of the autophagy-related proteinsmyosin-like BCL2 interacting protein(Beclin-1),microtubule-associated proteinlight chain 3B(LC3B),and sequestosome 1(P62).C3H/HeJ mice were infected with L.interrogansserovar stain Lai for construction of an animal model of leptospirosis.Silver strain-ing was used to detect leptospires in lung,liver,and kidney tissues of L.interrogans-infected mice.Histological changes in these tis-sues were detected with hematoxylin and eosin(HE)staining.The morphology of autophagosomes and leptospires in the lung,liver,and kidney tissues of L.interrogans-infected micewere determined through transmission electron microscopy.Expression of the autophagy-related proteins Beclin-1,LC3B,and P62 in the lung,liver,and kidney tissues of L.interrogans-infected C3H/HeJ mice was measured with immunohistochemistry.In these tissues,silver straining examination revealed leptospires.These tissues also showed histopathological changes typical of leptospirosis,such as pulmonary hemorrhage,extensive hepatocyte necrosis,both glomerular and tubular necrosis,and inflammatory cell infiltration;moreover,the leptospires were surrounded by autophagosomes.Immunohistochemi-cal examination indicated elevated expression of both Beclin-1 and LC3B in the lung,liver and kidney tissues of L.interrogans-infected mice(P<0.05),whereas the P62 level was significantly diminished in every tissue sample during L.interrogans infection(P<0.05).These results indicated that autophagy is activated during L.interrogans infection in the lung,liver,and kidney tissues of C3H/HeJ mice.

AIM:This study investigates the antidepressant mechanism of Jieyu-Anshen formula combined with selenium in chronic unpredictable mild stress(CUMS)mice through network pharmacology and animal experiments.METHODS:Potential drug targets were identified using the TCMSP,Genecards,and STRING databases.A protein-pro-tein interaction network was then constructed,followed by Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Ge-nomes(KEGG)enrichment analyses and molecular docking validation.Sixty male KM mice were divided into six groups:control,model,selenium,Jieyu Anshen formula,selenium+Jieyu Anshen formula,and fluoxetine.Depression-like behav-iors were assessed using the tail suspension test,forced swimming test,and elevated plus-maze test.Enzyme-linked immu-nosorbent assay(ELISA)was used to measure hippocampal levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),IL-1β,5-hydroxytryptamine(5-HT),and dopamine(DA).Histopathological changes in the hippocampus were ex-amined using hematoxylin and eosin(HE)staining.Additionally,protein expression levels of nuclear factor-κB p65(NF-κB p65),phospho-NF-κB-p65(p-NF-κB p65),prostaglandin-endoperoxide synthase 2(PTGS2),glutathione peroxidase 4(GPX4),and selenoprotein S(SelS)were detected through immunohistochemistry and Western blot.RESULTS:Jieyu-Anshen formula combined with selenium significantly improved depression-like behaviors in CUMS mice,reduced inflammatory cytokine(IL-6,TNF-α and IL-1β)levels,restored the levels of 5-HT and DA,and inhibited NF-κB signal-ing pathway activation.CONCLUSION:Jieyu Anshen formula combined with selenium significantly improved depres-sion-like behaviors in CUMS mice,potentially by improving hippocampal morphology,modulating the NF-κB signaling pathway,suppressing inflammatory factor expression,and enhancing hippocampal 5-TH and DA levels.

Laparoscopic right hemicolectomy is the standard surgical procedure for treating right-sided colon cancer,yet its complex anatomical layers and technically demanding operations pose significant challenges to surgeons'expertise.Currently,surgical skill assessment in clinical practice still predominantly relies on subjective expert evaluation,an approach inherently limited by low efficiency and inconsistent standards.With the rapid advancement of artificial intelligence(AI)technologies(particularly breakthroughs in computer vision and deep learning algorithms),a revolutionary technical foundation has been established for developing objective and precise automated surgical evaluation systems.This article comprehensively reviewed the current clinical application status of right hemicolectomy in China,thoroughly examined the clinical necessity and technical feasibility of constructing an intelligent surgical assessment system,and systematically presented our center's cutting-edge research achievements in this field.Looking ahead,AI-driven intelligent evaluation systems are expected to standardize and quantify surgical skill assessment.Such innovation will not only transform surgical training programs and enhance the quality of multicenter clinical research,but also promote the standardization of precision surgical protocols.This advancement holds significant clinical value and societal importance by improving long-term patient outcomes and fostering more equitable distribution of medical resources.