[摘 要] 目的：探究银杏内酯B（GKB）调控蛋白激酶R样内质网激酶（PERK）/转录激活子4（ATF4）/C/EBP同源蛋白（CHOP）信号通路对肝癌细胞增殖、迁移、凋亡和上皮间质转化（EMT）的影响。方法：将人肝癌细胞MHCC-97H随机分为对照组、GKB组、GSK2656157（PERK抑制剂）组和GKB + GSK2656157组，以GKB和GSK2656157分别干预后，采用MTT法和EdU染色检测各组细胞的增殖活性及增殖率，划痕愈合实验、流式细胞术分别检测各组细胞的迁移及凋亡水平，WB法检测各组细胞中EMT和PERK/ATF4/CHOP信号通路相关蛋白的表达水平。构建MHCC-97H细胞裸鼠移植瘤模型，以同法分组及药物干预后测定各组移植瘤体积，采用免疫组化、TUNEL染色分别检测各组肿瘤细胞增殖、凋亡水平，WB法检测各组移植瘤组织中EMT和PERK/ATF4/CHOP信号通路相关蛋白的表达水平。结果：与对照组比较，GKB组细胞活性、增殖率、迁移率、移植瘤体积、Ki-67阳性细胞率、MMP2、N-cadherin与MMP9蛋白表达均显著降低（均P < 0.05），细胞凋亡率、TUNEL阳性细胞率、p-PERK/PERK与E-cadherin、ATF4、CHOP蛋白表达均显著升高（均P < 0.05）；GSK2656157组各指标变化与GKB组相反（均P < 0.05）。与GKB组比较，GKB + GSK2656157组细胞活性、增殖率、迁移率、移植瘤体积、Ki-67阳性细胞率、MMP2、N-cadherin与MMP9蛋白表达均显著升高（均P < 0.05），细胞凋亡率、TUNEL阳性细胞率、p-PERK/PERK与E-cadherin、ATF4、CHOP蛋白表达均显著降低（均P < 0.05）。结论：GKB可通过激活PERK/ATF4/CHOP信号通路抑制肝癌MHCC-97H细胞增殖、迁移和EMT并促进其凋亡。

Objective To explore the feasibility and reference value of allogeneic lung transplantation and postoperative monitoring in miniature pigs for lung transplantation research. Methods Two miniature pigs (R1 and R2) underwent left lung allogeneic transplantation. Complement-dependent cytotoxicity tests and blood cross-matching were performed before surgery. The main operative times and partial pressure of arterial oxygen (PaO₂) after opening the pulmonary artery were recorded during surgery. Postoperatively, routine blood tests, biochemical blood indicators and inflammatory factors were detected, and pathological examinations of multiple organs were conducted. Results The complement-dependent cytotoxicity test showed that the survival rate of lymphocytes between donors and recipients was 42.5%-47.3%, and no agglutination reaction occurred in the cross-matching. The first warm ischemia times of D1 and D2 were 17 min and 10 min, respectively, and the cold ischemia times were 246 min and 216 min, respectively. Ultimately, R1 and R2 survived for 1.5 h and 104 h, respectively. Postoperatively, in R1, albumin (ALB) and globulin (GLB) decreased, and alanine aminotransferase increased; in R2, ALB, GLB and aspartate aminotransferase all increased. Urea nitrogen and serum creatinine increased in both recipients. Pathological results showed that in R1, the transplanted lung had partial consolidation with inflammatory cell infiltration, and multiple organs were congested and damaged. In R2, the transplanted lung had severe necrosis with fibrosis, and multiple organs had mild to moderate damage. The expression levels of interleukin-1β and interleukin-6 increased in the transplanted lungs. Conclusions The allogeneic lung transplantation model in miniature pigs may systematically evaluate immunological compatibility, intraoperative function and postoperative organ damage. The data obtained may provide technical references for subsequent lung transplantation research.

Objective To explore the association between the ratio of red blood cell distribution width to albumin level(RAR)and the risk of non-valvular atrial fibrillation(NVAF)in patients with hyperuricemia.Methods A total of 8 277 patients with hyperuricemia who underwent physi-cal examinations at the Physical Examination Center of Northern Jiangsu People's Hospital from January 2021 to June 2024 were enrolled.From them,185 patients with AF were assigned into a case group,and 740 patients without AF were into a control group in a ratio of 1∶4 with propen-sity score matching(PSM).Logistic regression analysis,restricted cubic spline analysis,and sub-group analysis were employed to investigate the association between RAR and the risk of NVAF in hyperuricemic patients.Results The case group had significantly larger ratio of smoking,high-er levels of red blood cell distribution width,total bilirubin,hematocrit,and RAR index,but lower albumin,low-density lipoprotein cholesterol(LDL-C)and triglyceride(TG)levels,and smaller ra-tio of fatty liver than the control group(P＜0.01).Multivariate logistic regression analysis showed that the patients at Q2,Q3,and Q4 quartiles of RAR index have higher risk for AF than those at Q1 quartile(OR=2.843,OR=4.263,OR=7.801,P＜0.01).The effect of RAR index was significant when below the breakpoint of 2.85(OR=1.492,95％CI:1.151-1.993,P=0.004).Subgroup analysis indicated significant interactions between RAR index and age as well as smok-ing(P interaction＜0.05).The area under curve value of RAR index in predicting NVAF occurrence in male hyperuricemic patients was 0.679(95％CI:0.632-0.725).Conclusion In patients with hyperuricemia,a higher RAR index is associated with an increased risk of NVAF.RAR index has guiding significance for diagnosing male hyperuricemic patients complicated with AF.

Objective To explore the mechanism of Quhan Zhufeng Mixture on proliferation and apoptosis of rheumatoid arthritis fibroblast-like synoviocyte(RA-FLS)based on NDRG2/JAK2/STAT3 signaling pathway.Methods RA-FLS cells were cultured in vitro,and were divided into ① blank serum group,methotrexate group,Quhan Zhufeng Mixture low-,medium-and high-dosage groups;② blank serum group,AG490 group,Quhan Zhufeng Mixture low-,medium-and high-dosage groups.Different concentrations of drug-containing serum were used to intervene cells.Cell proliferation was detected by CCK-8 method,apoptosis was detected by flow cytometry,and mRNA expressions of Bax,Bcl-2,Caspace-3,Caspace-9,N-myc downstream regulatory gene 2(NDRG2),Janus kinase 2(JAK2)and signal transduction and transcription activator 3(STAT3)were detected by RT-qPCR,Western blot was used to detect the protein expressions of Bax,Bcl-2,Caspace-3,Caspace-9,NDRG2,JAK2,STAT3,p-JAK2 and p-STAT3 in cells.Results Compared with the blank serum group,cell survival rate in methotrexate group,Quhan Zhufeng Mixture all dosage groups significantly decreased(P<0.01),the apoptosis rate significantly increased(P<0.01),the mRNA and protein expressions of Bax and Caspase-9 significantly increased(P<0.05,P<0.01),while the mRNA and protein expression of Bcl-2 significantly decreased(P<0.01),and Caspase-3 mRNA and protein expression in methotrexate group and Quhan Zhufeng Mixture medium-and high-dosage groups significantly increased(P<0.01).Compared with the blank serum group,the mRNA and protein expression of NDRG2 significantly increased in Quhan Zhufeng Mixture all dosage groups(P<0.05,P<0.01),the mRNA and protein expressions of JAK2 and STAT3 were significantly reduced in AG490 group and Quhan Zhufeng Mixture medium-and high-dosage groups(P<0.05,P<0.01),and the expressions of p-JAK2 and p-STAT3 proteins were significantly reduced(P<0.01).Conclusion Quhan Zhufeng Mixture can regulate the proliferation and apoptosis of RA-FLS by regulating the activity of NDRG2/JAK2/STAT3 signaling pathway,playing a role in treating rheumatoid arthritis.

Objective:To develop the Symptom Assessment Scale for Patients Undergoing Bladder Irrigation Chemotherapy and evaluate its reliability and validity.Methods:Based on the theory of unpleasant symptoms, a preliminary version of the Symptom Assessment Scale for Patients Undergoing Bladder Irrigation Chemotherapy was developed through literature analysis, semi-structured interviews, and the Delphi method. After revising certain items in the pre-survey, convenience sampling was used to select patients who underwent bladder instillation chemotherapy in the Department of Urology Surgery of three ClassⅢ Grade A hospitals in Yunnan Province from January to July 2024 as research subjects to test the reliability and validity of the scale.Results:A total of 168 questionnaires were distributed, and 162 valid questionnaires were collected, with a valid response rate of 96.429% (162/168). The Symptom Assessment Scale for Patients Undergoing Bladder Irrigation Chemotherapy covered two areas of symptom severity and symptom distress, comprising five dimensions and 27 items. The Cronbach's α coefficient for the total scale was 0.953, and the split-half reliability coefficient was 0.806. Exploratory factor analysis revealed that the four common factors for symptom severity contributed to 73.196% of the cumulative variance, while the single common factor for symptom distress accounted for 68.285% of the cumulative variance. Confirmatory factor analysis revealed that all indicators met the fit criteria, indicating that the model possessed good goodness-of-fit. The content validity index at the scale level was 0.940, while the content validity index at the item level ranged from 0.833 to 1.000.Conclusions:The Symptom Assessment Scale for Patients Undergoing Bladder Irrigation Chemotherapy developed in this study demonstrates good reliability and validity, and is suitable for evaluating symptoms in patients undergoing bladder infusion chemotherapy.

Objective To compare the efficacy of anticoagulation treatment(AT)alone and combining mechanical thrombectomy(MT)for cerebral venous sinus thrombosis(CVST).Methods Totally 150 patients with CVST were collected,including 90 underwent only AT(AT group)and 60 underwent MT+AT(combined group).The rate of venous sinus recanalization at discharge,the prognosis at discharge and 6,12 months after discharge(modified Rankin scale[mRS]score of 0 to 2 was considered as good prognosis)were compared between groups,and relative complications were recorded.Results At discharge,the rate of complete and partial recanalization of venous sinuses in combined group were both higher than that in AT group(both P＜0.001).No significant difference of the rate of good prognosis at discharge was found between groups(P=0.191),while 6 and 12 months after discharge,the rate of good prognosis in combined group were both higher than that in AT group(P=0.046,0.028).During the treatment and follow-up period,no significant difference of the incidence of complications was found between groups(5.00%[3/60]vs.11.11%[10/90],P=0.245).Conclusion Compared with AT alone,AT combining with MT could improve revascularization rate and prognosis of CVST without increasing the risk of complications.

Objective To explore clinical effect of accessory scaphoid bone fusion in treating type Ⅱ painful accessory scaphoid bone.Methods A retrospective analysis was performed on 26 patients with type Ⅱ painful accessory navicular bone treated by accessory navicular bone fusion from January 2012 to June 2022,including 1 male and 25 females,aged from 18 to 70 years old with an average of(44.61±16.32)years old;10 patients with type Ⅱ A and 16 patients with type Ⅱ B;20 patients with simple fusion and 6 patients with fusion plus calcaneal translocation osteotomy.Changes of Meary angle,Pitch angle,an-teroposterior talar-first metatarsal angle(T1MA),talonavicular coverage angle(TCA),lateral talocalcaneal angle(LTCA)be-fore operation and 6 months after operation were observed and compared,and American Orthopedic Foot and Ankle Society(AOFAS)foot and ankle score and visual analogue scale(VAS)were used to explore clinical effect.Results All 26 patients were followed up for 7 to 24 months with an average of(10.72±3.94)months.Meary angle,Pitch angle,T1MA,TCA and LTCA were improved from(9.20±2.57)°,(16.45±3.57)°,(33.34±5.02)°,(22.42±5.86)°,(48.89±4.43)° before opertaion to(3.33±1.06)°,(22.33±4.56)°,(23.89±3.48)°,(11.83±2.67)°,(36.50±3.50)° at 6 months after operation,the difference were statistically significant(P＜0.01).Postoperative AOFAS foot and ankle score were(86.24±4.33)and(93.18±6.02)for type Ⅱ A and type Ⅱ B at 6 months,which were significantly improved compared with those for type Ⅱ A and type Ⅱ B before op-eration(67.34±6.55)and(65.12±9.51),and the difference was statistically significant(P＜0.01);20 patients got excellent re-sult,5 good and 1 poor.Preoperative VAS of type ⅡA(5.67±1.58)and type Ⅱ B(5.77±1.49)were improved to(2.13±1.01)and(1.43±0.68)at 6 months after operation,with statistical significance(P＜0.01).Conclusion Fusion of accessory navicular bone in patients with type Ⅱ painful accessory navicular bone combined with internal calcaneal osteotomy in patients with par-tial calcaneal valvaration could effectively correct flat foot deformity and relieve pain,and could be used as a clinical treatment for painful accessory navicular bone.

With the increasing global recognition of Traditional Chinese Medicine (TCM), acupuncture, as a non-pharmacological treatment, has demonstrated promising potential in alleviating symptoms, improving quality of life, and modulating immune and neurological system functions in patients with Crohn's disease (CD). This review summarizes the theoretical foundations and recent research progress on acupuncture for CD, and introduces a personalized "Three Discriminations" diagnostic and therapeutic strategy based on syndrome differentiation, meridian differentiation, and acupoint selection. It also identifies the target patient populations and clinical application value of acupuncture in CD treatment. Despite preliminary progress, acupuncture treatment for CD still faces multiple challenges, including limited high-quality clinical research evidence, uneven resource distribution, non-standardized efficacy evaluation systems, insufficiently standardized treatment strategies, and an incomplete understanding of its underlying mechanisms. Future efforts should focus on establishing high-quality evidence systems, optimizing integrative treatment strategies combining acupuncture with conventional medicine, and conducting deep exploration of multi-dimensional mechanisms, with the goal of promoting the standardized integration of acupuncture into the management of CD and providing patients with safer, more precise, and sustainable therapeutic options.

Objective To investigate the relationship between the serum levels of lncRNA mathematically expressed gene 3(lncRNA MEG3),lncRNA SRY-box transcription factor 2 overlapping transcript(lncRNA SOX2OT)and renal function and prognosis in patients with type 2 diabetic nephropathy(T2DN).Methods 205 patients with T2DN admitted to Shaanxi Provincial People's Hospital from January 2019 to January 2021(T2DN group)were selected,as well as 150 simple T2DM patients(T2DM group)and 150 healthy individuals(control group)during the same period.And the patients with T2DN were classified into the poor prognosis group(n=73)and the good prognosis group(n=132)according to the 3-year prognosis.Serum levels of lncRNA MEG3 and lncRNA SOX2OT were detected.Pearson analysis was used for correlation analysis;The influencing factors were analyzed using logistic regression,and the predictive value was evaluated using the subject's work characteristic curve.Results The serum lncRNA MEG3(2.20±0.32)in the T2DN group was higher than that in the T2DM group(1.49±0.20)and control group(1.00±0.06),and the lncRNA SOX2OT(0.50±0.11)was lower than that in the T2DM group(0.73±0.15)and control group(1.05±0.16),the differences were statistically significant(t=23.960,45.322;28.745,16.670,all P<0.01).The serum lncRNA MEG3 levels in T2DN patients were negatively correlated with estimated glomerular filtration rate(eGFR)and positively correlated with urinary albumin/creatinine ratio(UACR)levels(r=-0.532,0.485,all P<0.01)and the serum lncRNA SOX2OT level was positively correlated with eGFR and negatively correlated with UACR(r=0.421,-0.517,all P<0.01).The risk factors for poor prognosis in T2DN patients were chronic kidney disease stage 4,UACR and lncRNA MEG3(Wald χ2=6.360,6.678,16.652,all P＜0.05)while the protective factors were eGFR,lncRNA SOX2OT(Wald χ2=5.463,11.797,all P＜0.05).The AUC predicted by the combination of serum lncRNA MEG3 and lncRNA SOX2OT was larger than that predicted by lncRNA MEG3 and lncRNA SOX2OT predicts separately,and the differences were statistically significant(Z=3.841,3.337,all P<0.05).Conclusion Elevated serum lncRNA MEG3 levels and reduced lncRNA SOX2OT levels are associated with reduced renal function and poor prognosis in patients with T2DN,and the combination of the two tests has a high predictive value for poor prognosis in patients with T2DN.

Organic ultraviolet absorbers (OUVs) have been widely used in personal care products and industrial products due to their unique physicochemical properties. However, with the advancement of science and technology and the deepening of research, the potential risks of OUVs have gradually emerged. They have been proven to be persistent, bioconcentrated and potential endocrine disruptors that may pose a threat to human health. In recent years, some OUVs have been widely detected in environmental and human samples worldwide, and the concentration of detection has been increasing year by year, which has attracted extensive attention both domestically and internationally. This article summarizes the research results of OUVs exposure in recent years from two aspects: external environmental exposure and internal human exposure, aiming to provide a valuable reference for the subsequent research on human exposure and health risk assessment of OUVs.