BACKGROUND:Magnetic nanomaterials,as a hot topic in the biomedical field in recent years,are often used to enhance the targeted delivery of drugs to the affected area.OBJECTIVE:To investigate the effects of magnetic nano drug carriers on skeletal muscle injury markers and inflammatory responses in rats with sports injuries.METHODS:Magnetic nanoparticles were prepared.A total of 88 male SD rats were randomly divided into a blank group(n=8),an injury control group(n=32),a Yunnan Baiyao group(n=24),and a magnetic nano-drug carrier group(n=24)by using a random number table method.The latter three groups were modeled with exercise-induced muscle injury(treadmill slope of-16°,running speed of 16 m/min,and training time of 120 min).Immediately after exercise,after verifying the success of the model,Yunnan Baiyao patch was applied to the gastrocnemius muscle of the rats in the Yunnan Baiyao group.Yunnan Baiyao patch loaded with magnetic nanoparticles was applied to the gastrocnemius muscle of the rats in the magnetic nano-drug carrier group.At 24,48,and 120 hours after exercise,blood was drawn from the abdominal aorta of rats to detect the activities of creatine kinase and lactate dehydrogenase,as well as the levels of myoglobin,interleukin-6,and tumor necrosis factor-α.Hematoxylin-eosin staining was used to observe the infiltration of inflammatory cells in the gastrocnemius muscle.RESULTS AND CONCLUSION:(1)Compared with the blank group,the levels of myoglobin,creatine kinase,lactate dehydrogenase and tumor necrosis factorα in the injury control group at 24,48 and 120 hours after exercise were increased(P＜0.05),and the level of interleukin 6 at 24 and 120 hours after exercise was increased(P＜0.05).Compared with the injury control group,the level of myoglobin in the Yunnan Baiyao group at 24 and 48 hours after exercise was decreased(P＜0.05),the activities of creatine kinase and lactate dehydrogenase at 24,48 and 120 hours were decreased(P＜0.05),and the levels of interleukin 6 and tumor necrosis factor α at 120 hours after exercise were decreased(P＜0.05).Compared with the Yunnan Baiyao group,the level of myoglobin in the magnetic nano-drug carrier group at 24 and 48 hours after exercise was decreased(P＜0.05),the activities of creatine kinase and tumor necrosis factor α at 48 and 120 hours after exercise were decreased(P＜0.05),and the lactate dehydrogenase activity was reduced(P＜0.05).(2)Hematoxylin-eosin staining showed that a large number of inflammatory cells infiltrated in the muscle fibers of the injury control group 24 hours after exercise,and then the inflammatory cell infiltration gradually decreased,and the local damaged muscle fibers began to regenerate 120 hours after exercise.A large number of inflammatory cells infiltrated in the muscle fibers of the Yunnan Baiyao group and the magnetic nano-drug carrier group 24 hours after exercise,and then the inflammatory cell infiltration gradually decreased,and the damaged muscle fibers were regenerating 120 hours after exercise,and there was no significant difference from the blank group.(3)The results show that Yunnan Baiyao patch combined with magnetic nanoparticles can accelerate the recovery of exercise-induced muscle injury in rats,and the effect is better than that of Yunnan Baiyao alone.

BACKGROUND:Spondylolisthesis is a common disease,and there is a lack of effective drugs to treat it.There is still a need to further define the pathogenesis and screen out more suitable therapeutic targets for spondylolisthesis.Mendelian randomization analysis can be used to explore the drugable genes associated with spondylolisthesis and provide valuable guidance for the development of more effective and targeted therapeutic drugs.OBJECTIVE:To explore potential therapeutic targets and effective drugs for spondylolisthesis by means of pharmaceutically available genome-wide Mendelian randomization analysis.METHODS:Using the Finnish database,eQTLGen consortium,drug signature database,drug-gene interaction database,protein-protein interaction database,organic small molecule biological activity database and protein structure database,which contains genome and health information of half a million Finns,data on druggable genes were subjected to two-sample Mendelian randomization analysis and co-localization analysis with data from genome-wide association studies of spondylolisthesis to identify genes highly associated with spondylolisthesis.In addition,GO and KEGG enrichment analysis,protein network construction,drug prediction and molecular docking were performed to provide valuable guidance for the development of more effective and targeted therapeutic agents.RESULTS AND CONCLUSION:In this study,we identified 34 potential drug target genes that were significantly associated with spondylolisthesis,particularly the gene APOBEC3G.This gene showed a significant association with spondylolisthesis outcomes through Mendelian analysis and co-localization analysis,suggesting that APOBEC3G may be a priority therapeutic target.As for other potential mechanisms and drugs,we still need to conduct more in-depth research to determine their roles.This study used a database from a European population,which can be used as a reference for the study of population genetics in China.

BACKGROUND:Magnetic nanomaterials,as a hot topic in the biomedical field in recent years,are often used to enhance the targeted delivery of drugs to the affected area.OBJECTIVE:To investigate the effects of magnetic nano drug carriers on skeletal muscle injury markers and inflammatory responses in rats with sports injuries.METHODS:Magnetic nanoparticles were prepared.A total of 88 male SD rats were randomly divided into a blank group(n=8),an injury control group(n=32),a Yunnan Baiyao group(n=24),and a magnetic nano-drug carrier group(n=24)by using a random number table method.The latter three groups were modeled with exercise-induced muscle injury(treadmill slope of-16°,running speed of 16 m/min,and training time of 120 min).Immediately after exercise,after verifying the success of the model,Yunnan Baiyao patch was applied to the gastrocnemius muscle of the rats in the Yunnan Baiyao group.Yunnan Baiyao patch loaded with magnetic nanoparticles was applied to the gastrocnemius muscle of the rats in the magnetic nano-drug carrier group.At 24,48,and 120 hours after exercise,blood was drawn from the abdominal aorta of rats to detect the activities of creatine kinase and lactate dehydrogenase,as well as the levels of myoglobin,interleukin-6,and tumor necrosis factor-α.Hematoxylin-eosin staining was used to observe the infiltration of inflammatory cells in the gastrocnemius muscle.RESULTS AND CONCLUSION:(1)Compared with the blank group,the levels of myoglobin,creatine kinase,lactate dehydrogenase and tumor necrosis factorα in the injury control group at 24,48 and 120 hours after exercise were increased(P＜0.05),and the level of interleukin 6 at 24 and 120 hours after exercise was increased(P＜0.05).Compared with the injury control group,the level of myoglobin in the Yunnan Baiyao group at 24 and 48 hours after exercise was decreased(P＜0.05),the activities of creatine kinase and lactate dehydrogenase at 24,48 and 120 hours were decreased(P＜0.05),and the levels of interleukin 6 and tumor necrosis factor α at 120 hours after exercise were decreased(P＜0.05).Compared with the Yunnan Baiyao group,the level of myoglobin in the magnetic nano-drug carrier group at 24 and 48 hours after exercise was decreased(P＜0.05),the activities of creatine kinase and tumor necrosis factor α at 48 and 120 hours after exercise were decreased(P＜0.05),and the lactate dehydrogenase activity was reduced(P＜0.05).(2)Hematoxylin-eosin staining showed that a large number of inflammatory cells infiltrated in the muscle fibers of the injury control group 24 hours after exercise,and then the inflammatory cell infiltration gradually decreased,and the local damaged muscle fibers began to regenerate 120 hours after exercise.A large number of inflammatory cells infiltrated in the muscle fibers of the Yunnan Baiyao group and the magnetic nano-drug carrier group 24 hours after exercise,and then the inflammatory cell infiltration gradually decreased,and the damaged muscle fibers were regenerating 120 hours after exercise,and there was no significant difference from the blank group.(3)The results show that Yunnan Baiyao patch combined with magnetic nanoparticles can accelerate the recovery of exercise-induced muscle injury in rats,and the effect is better than that of Yunnan Baiyao alone.

BACKGROUND:Spondylolisthesis is a common disease,and there is a lack of effective drugs to treat it.There is still a need to further define the pathogenesis and screen out more suitable therapeutic targets for spondylolisthesis.Mendelian randomization analysis can be used to explore the drugable genes associated with spondylolisthesis and provide valuable guidance for the development of more effective and targeted therapeutic drugs.OBJECTIVE:To explore potential therapeutic targets and effective drugs for spondylolisthesis by means of pharmaceutically available genome-wide Mendelian randomization analysis.METHODS:Using the Finnish database,eQTLGen consortium,drug signature database,drug-gene interaction database,protein-protein interaction database,organic small molecule biological activity database and protein structure database,which contains genome and health information of half a million Finns,data on druggable genes were subjected to two-sample Mendelian randomization analysis and co-localization analysis with data from genome-wide association studies of spondylolisthesis to identify genes highly associated with spondylolisthesis.In addition,GO and KEGG enrichment analysis,protein network construction,drug prediction and molecular docking were performed to provide valuable guidance for the development of more effective and targeted therapeutic agents.RESULTS AND CONCLUSION:In this study,we identified 34 potential drug target genes that were significantly associated with spondylolisthesis,particularly the gene APOBEC3G.This gene showed a significant association with spondylolisthesis outcomes through Mendelian analysis and co-localization analysis,suggesting that APOBEC3G may be a priority therapeutic target.As for other potential mechanisms and drugs,we still need to conduct more in-depth research to determine their roles.This study used a database from a European population,which can be used as a reference for the study of population genetics in China.

This paper introduces professor WU Rongzu's clinical experience in using Fuyang Tongmi Decoction （扶阳通秘汤， FTD） to treat irritable bowel syndrome with constipation （IBS-C）. It is believed that yang qi depletion， water cold， earth dampness， and wood constraint are the key pathogenesis.The treatment principle is warming water， drying the earth and venting wood， with the basic formula FTD adjusted according to the symptoms. This approach aims to transport the qi movement of the middle jiao （焦） and support the recovery of intestinal function of directing turbidity downward， providing a treatment strategy for IBS-C caused by yang deficiency.

Background: and Purpose: To assess the long-term effectiveness, safety, and economic viability of recently approved Alzheimer’s disease (AD) therapies, as well as to evaluate the real-world application of novel diagnostics among AD patients with diverse comorbidities, comprehensive real-world data (RWD) analysis is essential. The Korean JOint RegistrY for ALZheimer’s Treatment and Diagnostics (JOY-ALZ) endeavors to create a registry of RWD derived from clinical practice on new diagnostic methods and therapeutic agents for AD introduced in Korea since 2021. Methods: Participants must fulfill all the following: 1) be at least 19 years old; 2) be actively receiving, scheduled to initiate, or undergoing evaluation for any AD disease-modifying treatment; 3) have completed amyloid positron emission tomography or cerebrospinal fluid AD immunoassay (a positive result is not essential for participation); 4) have a clinical classification of cognitively unimpaired, mild cognitive impairment, or probable AD dementia. Data generated during routine care is segmented into a minimum dataset, extended dataset, and research-only dataset requiring extra consent. Assessments encompass clinical, cognitive, functional, neurobehavioral, neuroimaging, and biomarker evaluations, in addition to systematic monitoring of new AD treatments and their safety.Data are collected and monitored at baseline, at semiannual intervals during the initial 2 years, and then annually up to 2034. To date, 46 medical centers will participate in JOY-ALZ. Conclusions JOY-ALZ is expected to promote understanding of the long-term clinical outcomes, safety, and cost-effectiveness of recently introduced diagnostics and treatments for AD, thereby supporting the progress of precision medicine in AD care and diagnosis.

Background/Aims: Recent advances in computer-aided diagnosis (CADx) systems have demonstrated expert-level accuracy in the optical diagnosis of colorectal polyps. High-confidence (HC) diagnoses have been defined as those made within 3 seconds without hesitation, and these systems have been shown to improve diagnostic accuracy. We aimed to evaluate the performance of endoscopists with varying levels of experience in diagnosing colorectal polyps with the assistance of a new CADx system applying the 3-second rule and without artificial intelligence assistance. Methods: In this multicenter ex vivo study, 35 endoscopists assessed 100 polyps (51 adenomas, 39 hyperplastic polyps, 10 sessile serrated lesions) using narrow-band imaging video clips on an online platform. Assessments consisted of individual endoscopist diagnosis and CADx-assisted diagnosis. HC assignments followed the 3-second rule in both phases. Performance metrics included HC accuracy, HC rate, and adherence to the Preservation and Incorporation of Valuable Endoscopic Innovations (PIVI) and Simple Optical Diagnosis Accuracy (SODA) thresholds. Results: HC diagnostic accuracy improved from 78.3% (95% confidence interval [CI], 76.6% to 80.0%) to 89.8% (95% CI, 88.6% to 90.9%) with CADx assistance (p<0.001). The proportion of HC predictions increased from 64.2% to 75.4% (p<0.001). Novice endoscopists showed marked improvement with CADx (74.1% vs 88.8%; p<0.001). CADx-assisted diagnoses nearly met SODA and PIVI thresholds under the 3-second rule. Additional analysis demonstrated that CADx assistance significantly improved interobserver agreement and ground truth, particularly for novices (κ=0.37 to κ=0.65; p<0.001). Conclusions Integrating CADx with the 3-second rule significantly enhances the performance of endoscopists in the optical diagnosis of colorectal polyps, with the greatest benefit observed among novice endoscopists.

Janus kinase (JAK) inhibitors are an important treatment option for ulcerative colitis, providing rapid onset of action, oral administration, and efficacy even after biologic failure. The 3 approved agents—tofacitinib, filgotinib, and upadacitinib—differ in JAK isoform selectivity, leading to clinically meaningful differences in efficacy and safety. Evidence from network meta-analyses, clinical trials, and real-world studies consistently shows that upadacitinib provides the highest efficacy for induction and maintenance of remission, whereas filgotinib demonstrates the most favorable safety profile. The strong efficacy of upadacitinib and tofacitinib is particularly relevant in patients with severe disease, including acute severe ulcerative colitis, and upadacitinib maintains high efficacy regardless of prior advanced therapy exposure. JAK inhibitors also benefit extraintestinal manifestations. Although risks such as herpes zoster, serious infection, thromboembolism, and major cardiovascular events differ among agents, long-term data suggest generally acceptable safety when used appropriately. Intraclass JAK-to-JAK cycling is feasible, with about half of patients achieving steroid-free clinical remission in retrospective cohorts. Based on mechanistic, clinical, and real-world evidence, filgotinib may be a first-line option for patients with lower disease activity or when safety is a priority, whereas upadacitinib or tofacitinib may be preferred in higher disease activity. Strategically selecting agents may improve durability and outcomes.

Objective:To investigate the survival outcomes and prognostic factors in patients undergoing radical resection for pancreatic body and tail cancer.Methods:A retrospective case series study was conducted on 992 patients who underwent radical resection for pancreatic body and tail cancer at the Pancreatic Center of the First Affiliated Hospital of Nanjing Medical University from January 2016 to June 2024. In this study, 577 (58.2%) were male and 415 (41.8%) were female,with an age of (65±9) years (range: 26 to 86 years). Follow-up continued until June 2024. Survival rates were estimated using the Kaplan-Meier method,and prognostic factors were identified using univariate and multivariate Cox proportional hazards models.Results:Among 992 patients,open surgery was the predominant approach (89.1%, 884/992), and radical antegrade modular pancreatosplenectomy (RAMPS) was performed in 317 patients (32.0%). Combined organ resection,venous resection,and arterial resection were performed in 23.5%, 9.3%,and 11.2% of patients,respectively. The rates of R0, R1-1 mm, and R1-direct resections were 49.8% (494/992),41.5% (412/992), and 8.7% (86/992),respectively. Stage ⅡB was the most common TNM stage (32.2%,319/992). A total of 801 patients (80.8%) received adjuvant chemotherapy. The median follow-up period was 32.0(8.8) months(range:3.2 to 105.3 months),during which 508 patients (51.2%) died. The overall median survival (OS) was 26.4 months,with 1-,3-, and 5-year survival rates of 79.0%,40.0%, and 29.0%, respectively. In the recent five years (from 2020 to 2024), the median OS improved significantly to 34.1 months compared to 20.0 months from 2016 to 2019 ( P<0.01). Histological subtype analysis showed that the median OS time was 26.7 months for pancreatic ductal adenocarcinoma (PDAC, n=855),58.9 months for invasive intraductal papillary mucinous carcinoma (IPMC, n=32),and 15.7 months for adenosquamous carcinoma of pancreas (ASCP, n=73) ( P=0.001). Among PDAC patients, adjuvant chemotherapy significantly improved survival (29.1 months vs. 14.4 months, P<0.01);in IPMC patients, adjuvant chemotherapy also extended survival (65.7 months vs. 58.9 months, P=0.047). Although ASCP patients receiving chemotherapy had a longer median OS time than those without (18.8 months vs. 8.9 months),the difference was not statistically significant ( P=0.151). Multivariate Cox regression analysis in PDAC patients indicated that adjuvant chemotherapy, R0 resection, T stage,N stage,and tumor differentiation were independent prognostic factors ( P<0.01). The median OS time by TNM stage was:not reached for stage ⅠA, 51.6 months for ⅠB, 25.5 months for ⅡA, 23.7 months for ⅡB, 23.0 months for Ⅲ, and 14.4 months for Ⅳ. The median OS time for R0,R1-1 mm,and R1-direct resections was 34.1,24.7,and 15.7 months,respectively ( P<0.01). Conclusion:Adjuvant chemotherapy,R0 resection,tumor stage,and differentiation are independent prognostic factors for pancreatic body and tail cancer.