OBJECTIVES: Neuropathic pain (NP) is one of the most common forms of chronic pain, yet current treatment options are limited in effectiveness. Peripheral nerve injury activates spinal microglia, altering their inflammatory response and phagocytic functions, which contributes to the progression of NP. Most current research on NP focuses on microglial inflammation, with relatively little attention to their phagocytic function. Early growth response factor 2 (EGR2) has been shown to regulate microglial phagocytosis, but its specific role in NP remains unclear. This study aims to investigate how EGR2 modulates microglial phagocytosis and its involvement in NP, with the goal of identifying potential therapeutic targets. METHODS: Adult male Sprague-Dawley (SD) rats were used to establish a chronic constriction injury (CCI) model of the sciatic nerve. Pain behaviors were assessed on days 1, 3, 7, 10, and 14 post-surgery to confirm successful model induction. The temporal and spatial expression of EGR2 in the spinal cord was examined using real-time quantitative PCR (RT-qPCR), Western blotting, and immunofluorescence staining. Adeno-associated virus (AAV) was used to overexpress EGR2 in the spinal cord, and behavioral assessments were performed to evaluate the effects of EGR2 modulation of NP. CCI and lipopolysaccharide (LPS) models were established in animals and microglial cell lines, respectively, and changes in phagocytic activity were measured using RT-qPCR and fluorescent latex bead uptake assays. After confirming the involvement of microglial phagocytosis in NP, AAV was used to overexpress EGR2 in both in vivo and in vitro models, and phagocytic activity was further evaluated. Finally, eukaryotic transcriptome sequencing was conducted to screen differentially expressed mRNAs, followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses to identify potential downstream effectors of EGR2. RESULTS: The CCI model successfully induced NP. Following CCI, EGR2 expression in the spinal cord was upregulated in parallel with NP development. Overexpression of EGR2 via spinal AAV injection enhanced microglial phagocytic activity and increased pain hypersensitivity in rats. Both animal and cellular models showed that CCI or LPS stimulation enhanced microglial phagocytosis, which was further amplified by EGR2 overexpression. Transcriptomic analysis of spinal cord tissues from CCI rats overexpressing EGR2 revealed upregulation of numerous genes associated with microglial phagocytosis and pain regulation. Among them, Lag3 emerged as a potential downstream target of EGR2. CONCLUSIONS EGR2 contributes to the maintenance of NP by enhancing microglial phagocytosis in the spinal dorsal horn.
Animals ; Microglia/metabolism* ; Phagocytosis/physiology* ; Rats, Sprague-Dawley ; Neuralgia/physiopathology* ; Early Growth Response Protein 2/metabolism* ; Male ; Rats ; Spinal Cord/metabolism* ; Sciatic Nerve/injuries*

Gastric cancer,which has high incidence and mortality rates worldwide,faces numerous challenges in its diagnosis and treatment.In recent years,the combination of multi-omics technology and artificial intelligence(AI)algorithms has brought new hope for the diagnosis and treatment of this malignant disease.Multi-omics technology encompasses the fields of genomics,transcriptomics,proteomics,meta-bolomics,and radiomics,and can comprehensively reveal the biological characteristics of gastric cancer.AI algorithms,particularly machine-and deep-learning methods,possess powerful data integration,feature extraction,and pattern recognition capabilities,enabling the extrac-tion of the most valuable information from vast and complex multi-omics data.Such technology can aid in the early screening,precise dia-gnosis,personalized treatment,and prognostic assessment of gastric cancer.In this article,research progress on AI-based multi-omics tech-nology for the diagnosis and treatment of gastric canceris reviewed,and current applications of such technology at different diagnostic and therapeutic stages,the challenges faced,and future development directions are discussed,with the aim of providing new ideas and meth-ods for the diagnosis and treatment of this malignant disease.

Objective To explore the surgical treatment strategy for patients with thyroid cancer complicated with primary hyperparathyroidism(PHPT).Methods A retrospective analysis was conducted on the case data of thyroid cancer patients who underwent surgical treatment at Beijing Friendship Hospital,Capital Medical University from January 2016 to January 2022.Among them,22 patients with PHPT were included in study group,and 44 patients were randomly selected from thyroid cancer patients during the same period at a ratio of 1∶2 and included in control group.The operation time,intraoperative blood loss,hospital stay and occurrence of complications of two groups of patients were compared.Results The operation time of patients in study group was significantly longer than that in control group(P＜0.01).There was no statistically significant difference in intraoperative blood loss and hospital stay between two groups of patients(P＞0.05).There were 5 cases of temporary hypocalcemia in study group,12 cases of temporary hypocalcemia and 1 case of incision infection in control group.There was no statistically significant difference in incidence of postoperative complications between two groups of patients(P＞0.05).Conclusion Thyroid cancer complicated with PHPT increases the complexity of treatment.Through adequate preoperative diagnosis and reasonable surgical treatment strategies,the risks of secondary surgery and postoperative complications can be effectively reduced,and the prognosis of patients can be improved.

Aiming at the problem that the amount of Oxygen remaining and available time can not be accurately predicted while an astronaut conducting extravehicular activities(EVAs)in EVA spacesuit.Research the oxygen consumption process of EVA spacesuit.The model and algorithm of oxygen consumption are established by the gas state equation including compressibility and temperature coefficient,combined with human metabolism and micro leakage characteristics of spacesuit.Experimental data show that the orecast model and algorithm hasing high accuracy and practicability.

As an airway management tool,the seal performance of the laryngeal mask is crucial.The seal pressure of the laryngeal mask is a key indicator for evaluating the performance of the laryngeal mask.Appropriate seal pres-sure is of great clinical significance to ensure effective ventilation and avoid complications.This article reviews the factors that affect the seal pressure of the laryngeal mask,including structural design,material characteristics,in-flation volume,insertion skill,airway pressure,and patients'individual characteristics.Understanding and optimi-zing the above factors can help anesthesiologists to better apply the laryngeal mask in clinical anesthesia,to reduce patient complications,and improve patient safety as well as comfort.

Objective To summarize and analyze the clinical features,imaging manifestations,pathological characteristics,treatment approaches,and prognosis of adrenal anastomotic hemangioma(AH),so as to enhance the clinical understanding of this disease.Methods A retrospective analysis was conducted on 3 adrenal AH patients treated in Tongji Hospital during Jan.2012 and Dec.2024.Relevant literature was reviewed.Results All patients were male,aged 34-56 years,with a maximum tumor diameter of 2.0-5.0 cm.All tumors were solitary.No patients presented with special clinical manifestations.Biochemical tests indicated tumors with no endocrine function.Contrast-enhanced computed tomography showed circular mixed density shadows with uneven edge enhancement.Two patients underwent laparoscopic partial adrenal resection,and one patient received robot-assisted laparoscopic partial adrenal resection.Postoperative pathological results of all three cases indicated AH.Immunohistochemistry showed CD31(+),CD34(+),and ERG(+).No recurrence was found in a postoperative follow-up of 1-45 months.A total of 22 cases of adrenal AH were reported in the literature and our center,with onset age ranging from 34 to 83 years.The patients included 17 males and 5 females,with a maximum tumor diameter of 0.6-8.8 cm.Among them,2 cases were multifocal and the tumors were located in the kidneys,beside kidneys,or in the inferior vena cava.Two cases showed clinical manifestations of lower back pain.During the follow-up of 156 months,no recurrence or metastasis was observed.Conclusion Adrenal AH is a rare benign tumor,which mainly occurs in middle-aged and elderly people with no clinical symptoms and endocrine function.Imaging can easily mistake it for pheochromocytoma or well differentiated vascular sarcoma,and the diagnosis mainly relies on pathological examination.It should be distinguished from pheochromocytoma and well differentiated vascular sarcoma.Surgery is the main treatment method and the prognosis is good.

Objective To investigate the therapeutic effects of upper limb rehabilitation robot training combined with intermittent theta burst stimulation(iTBS)on upper limb motor and neurological function in stroke patients with hemiplegia.Methods This study retrospectively consecutive enrolled 46 stroke hemiparetic patients from the Department of Rehabilitation Medicine,Nanjing Pukou People's Hospital.The patients were randomly assigned to a control group and an experimental group(23patients in each)using a random number table.Baseline data,including sex,age,disease duration,side of hemiplegia,and stroke type,were collected from patients enrolled.All patients received conventional treatment.The control group received upper limb rehabilitation robot training combined with iTBS sham stimulation(coil placed perpendicular to the skull),while the experimental group received upper limb rehabilitation robot training combined with iTBS real stimulation(coil placed parallel to the skull).Both groups underwent treatment for 3 weeks.Upper limb motor function was assessed using the Fugl-Meyer upper extremity(FMA-UE)scale and Wolf motor function test(WMFT);while neurological function was evaluated using the motor-evoked potentials(MEP)latency,amplitude,and central motor conduction time(CMCT)of the affected thumb abductor muscle.Activities of daily living were assessed using the modified Barthel index(MBI).Results(1)No significant differences in baseline data were found between the two groups(all P＞0.05).(2)Before treatment,the FMA-UE and WMFT scores in the experimental group were 27.48±7.87 and 28.22±3.87,respectively;and in the control group were 26.35±4.78 and 28.35±3.33,respectively;there were no significant differences in both FMA-UE and WMFT scores between the two groups(all P＞0.05).After 3weeks of treatment,the FMA-UE and WMFT scores in the experimental group were 40.35±8.96 and 37.74±4.11,respectively;and in the control group were 32.78±4.50 and 32.57±4.11,respectively;there were significant interaction effects of time and group(Ftime×group values of 19.613 and 31.522,both P＜0.01),main effects of group(Fgroup values of 5.401 and 5.897,both P＜0.05),and main effects of time(Ftime values of 176.516 and 211.478,both P＜0.01).(3)Before treatment,the MEP latency,amplitude,and CMCT in the experimental group were(24.39±3.56)ms,(137.77±42.67)μV,and(10.62±2.76)ms,respectively;and in the control group were(24.64±2.77)ms,(136.74±48.77)μV,and(10.73±1.84)ms,respectively,there were no significant differences between the two groups(all P＞0.05).After 3weeks of treatment,the MEP latency,amplitude,and CMCT in the experimental group were(20.39±1.83)ms,(239.91±43.70)μV,and(6.58±1.23)ms,respectively,and in the control group were(22.53±3.53)ms,(198.54±50.37)μV,and(9.19±1.60)ms,respectively,there were significant interaction effects of time and group(Ftime×group values of 7.270,15.554,and 20.110,all P＜0.05)and main effects of time(Ftime values of 76.540,256.706,and 100.629,all P＜0.01),the main effect of group for CMCT was significant(Fgroup=7.406,P＜0.01),but there were no significant difference in the main effect of group on MEP latency,amplitude between two groups(Fgroup values of 2.145,2.778,both P＞0.05).(4)Before treatment,the MBI score in the experimental group was 42.83±7.36,and in the control group was 43.91±6.56,with no significant difference between two groups(P＞0.05).After 3 weeks of treatments,the MBI score in the experimental group was 67.83±12.69,and in the control group was 54.13±5.57,there were significant interaction effects of time and group(Ftime×group=39.862,P＜0.01),main effects of group(Fgroup=8.083,P=0.007),and main effects of time(Ftime=226.241,P＜0.01).Conclusions Upper limb rehabilitation robot training combined with iTBS can improve upper limb motor function and neurological function and enhance the daily living activity ability of stroke patients.Real iTBS combined with robot training has a more significant effect than sham iTBS.

Objective To summarize and analyze the clinical features,imaging manifestations,pathological characteristics,treatment approaches,and prognosis of adrenal anastomotic hemangioma(AH),so as to enhance the clinical understanding of this disease.Methods A retrospective analysis was conducted on 3 adrenal AH patients treated in Tongji Hospital during Jan.2012 and Dec.2024.Relevant literature was reviewed.Results All patients were male,aged 34-56 years,with a maximum tumor diameter of 2.0-5.0 cm.All tumors were solitary.No patients presented with special clinical manifestations.Biochemical tests indicated tumors with no endocrine function.Contrast-enhanced computed tomography showed circular mixed density shadows with uneven edge enhancement.Two patients underwent laparoscopic partial adrenal resection,and one patient received robot-assisted laparoscopic partial adrenal resection.Postoperative pathological results of all three cases indicated AH.Immunohistochemistry showed CD31(+),CD34(+),and ERG(+).No recurrence was found in a postoperative follow-up of 1-45 months.A total of 22 cases of adrenal AH were reported in the literature and our center,with onset age ranging from 34 to 83 years.The patients included 17 males and 5 females,with a maximum tumor diameter of 0.6-8.8 cm.Among them,2 cases were multifocal and the tumors were located in the kidneys,beside kidneys,or in the inferior vena cava.Two cases showed clinical manifestations of lower back pain.During the follow-up of 156 months,no recurrence or metastasis was observed.Conclusion Adrenal AH is a rare benign tumor,which mainly occurs in middle-aged and elderly people with no clinical symptoms and endocrine function.Imaging can easily mistake it for pheochromocytoma or well differentiated vascular sarcoma,and the diagnosis mainly relies on pathological examination.It should be distinguished from pheochromocytoma and well differentiated vascular sarcoma.Surgery is the main treatment method and the prognosis is good.

Objective To investigate the therapeutic effects of upper limb rehabilitation robot training combined with intermittent theta burst stimulation(iTBS)on upper limb motor and neurological function in stroke patients with hemiplegia.Methods This study retrospectively consecutive enrolled 46 stroke hemiparetic patients from the Department of Rehabilitation Medicine,Nanjing Pukou People's Hospital.The patients were randomly assigned to a control group and an experimental group(23patients in each)using a random number table.Baseline data,including sex,age,disease duration,side of hemiplegia,and stroke type,were collected from patients enrolled.All patients received conventional treatment.The control group received upper limb rehabilitation robot training combined with iTBS sham stimulation(coil placed perpendicular to the skull),while the experimental group received upper limb rehabilitation robot training combined with iTBS real stimulation(coil placed parallel to the skull).Both groups underwent treatment for 3 weeks.Upper limb motor function was assessed using the Fugl-Meyer upper extremity(FMA-UE)scale and Wolf motor function test(WMFT);while neurological function was evaluated using the motor-evoked potentials(MEP)latency,amplitude,and central motor conduction time(CMCT)of the affected thumb abductor muscle.Activities of daily living were assessed using the modified Barthel index(MBI).Results(1)No significant differences in baseline data were found between the two groups(all P＞0.05).(2)Before treatment,the FMA-UE and WMFT scores in the experimental group were 27.48±7.87 and 28.22±3.87,respectively;and in the control group were 26.35±4.78 and 28.35±3.33,respectively;there were no significant differences in both FMA-UE and WMFT scores between the two groups(all P＞0.05).After 3weeks of treatment,the FMA-UE and WMFT scores in the experimental group were 40.35±8.96 and 37.74±4.11,respectively;and in the control group were 32.78±4.50 and 32.57±4.11,respectively;there were significant interaction effects of time and group(Ftime×group values of 19.613 and 31.522,both P＜0.01),main effects of group(Fgroup values of 5.401 and 5.897,both P＜0.05),and main effects of time(Ftime values of 176.516 and 211.478,both P＜0.01).(3)Before treatment,the MEP latency,amplitude,and CMCT in the experimental group were(24.39±3.56)ms,(137.77±42.67)μV,and(10.62±2.76)ms,respectively;and in the control group were(24.64±2.77)ms,(136.74±48.77)μV,and(10.73±1.84)ms,respectively,there were no significant differences between the two groups(all P＞0.05).After 3weeks of treatment,the MEP latency,amplitude,and CMCT in the experimental group were(20.39±1.83)ms,(239.91±43.70)μV,and(6.58±1.23)ms,respectively,and in the control group were(22.53±3.53)ms,(198.54±50.37)μV,and(9.19±1.60)ms,respectively,there were significant interaction effects of time and group(Ftime×group values of 7.270,15.554,and 20.110,all P＜0.05)and main effects of time(Ftime values of 76.540,256.706,and 100.629,all P＜0.01),the main effect of group for CMCT was significant(Fgroup=7.406,P＜0.01),but there were no significant difference in the main effect of group on MEP latency,amplitude between two groups(Fgroup values of 2.145,2.778,both P＞0.05).(4)Before treatment,the MBI score in the experimental group was 42.83±7.36,and in the control group was 43.91±6.56,with no significant difference between two groups(P＞0.05).After 3 weeks of treatments,the MBI score in the experimental group was 67.83±12.69,and in the control group was 54.13±5.57,there were significant interaction effects of time and group(Ftime×group=39.862,P＜0.01),main effects of group(Fgroup=8.083,P=0.007),and main effects of time(Ftime=226.241,P＜0.01).Conclusions Upper limb rehabilitation robot training combined with iTBS can improve upper limb motor function and neurological function and enhance the daily living activity ability of stroke patients.Real iTBS combined with robot training has a more significant effect than sham iTBS.

Gastric cancer,which has high incidence and mortality rates worldwide,faces numerous challenges in its diagnosis and treatment.In recent years,the combination of multi-omics technology and artificial intelligence(AI)algorithms has brought new hope for the diagnosis and treatment of this malignant disease.Multi-omics technology encompasses the fields of genomics,transcriptomics,proteomics,meta-bolomics,and radiomics,and can comprehensively reveal the biological characteristics of gastric cancer.AI algorithms,particularly machine-and deep-learning methods,possess powerful data integration,feature extraction,and pattern recognition capabilities,enabling the extrac-tion of the most valuable information from vast and complex multi-omics data.Such technology can aid in the early screening,precise dia-gnosis,personalized treatment,and prognostic assessment of gastric cancer.In this article,research progress on AI-based multi-omics tech-nology for the diagnosis and treatment of gastric canceris reviewed,and current applications of such technology at different diagnostic and therapeutic stages,the challenges faced,and future development directions are discussed,with the aim of providing new ideas and meth-ods for the diagnosis and treatment of this malignant disease.