ObjectiveTo evaluate the efficacy and safety of Janus kinase （JAK） inhibitors combined with Chinese herbal medicine （CHM） in treating rheumatoid arthritis （RA）. MethodsClinical data from 169 RA patients were retrospectively collected. Among them， 71 cases received JAK inhibitors as the control group， while 98 cases received JAK inhibitors plus CHM as the observation group， both treated for 24 weeks. The rheumatoid factor （RF）， cyclic citic peptide antibody （anti-CCP）， erythrocyte sedimentation rate （ESR）， C-reactive protein （CRP）， and white blood cell count （WBC） were recorded before and after treatment. Databases including CNKI， Wanfang， VIP， PubMed and Web of Science were searched from inception till August 31st， 2025 for randomized controlled trials （RCTs） on the combined use of JAK inhibitors and CHM for RA. The methodological quality of the included studies was evaluated using the risk of bias assessment tool. Meta-analyses were performed for RF， anti-CCP， ESR， CRP， 28-joint disease activity score （DAS28）， overall clinical effective rate， and incidence of adverse events. Sensitivity analysis were also performed. ResultsThe retrospective study demonstrated that after treatment， ESR， CRP， and anti-CCP levels decreased in the observation group， while ESR and CRP levels decreased in the control group （P＜0.05）. Moreover， ESR and RF levels in the observation group were lower than those in the control group （P＜0.05）. A total of 9 RCTs involving 770 patients were included in the meta-analysis. The results indicated that the JAK inhibitors plus CHM group was superior to the JAK inhibitors group in reducing RF （MD=-8.97， 95%CI -15.01 to -2.94， P=0.004）， CRP （MD=-3.34， 95%CI -3.82 to -2.86， P＜0.001）， ESR （MD=-5.33， 95%CI -7.98 to -2.69， P＜0.001）， and DAS28 score （MD=-0.54， 95%CI -0.74 to -0.34， P＜0.001）， as well as in improving the overall clinical effective rate （OR=4.53， 95%CI 2.55 to 8.03， P＜0.001）. No statistically significant differences were observed between groups in anti-CCP levels （SMD=-2.08， 95%CI -4.41 to 0.24， P=0.080） or incidence of adverse events （OR=0.93， 95%CI 0.55 to 1.57， P=0.790）. ConclusionThe combination of JAK inhibitors and CHM demonstrates remarkable efficacy in treating RA， contributing to improved disease activity and reduced inflammatory markers with a favorable safety profile.

Objective:To investigate the role and molecular mechanisms of signal transducer and activator of tran-scription 3(STAT3)in the paraventricular nucleus(PVN)of the hypothalamus in regulating body weight and energy metabolism in mice.Methods:AAV2/9-hSyn-Cre-EGFP virus was stereotactically injected into the PVN of STAT3Flox/Flox mice to conditionally knock out(CKO)STAT3 in the PVN.STAT3 expression was verified via immunoflu-orescence staining and Western blot.Body weight and temperature were monitored,glucose tolerance was assessed using glucose tolerance tests in mice,and morphological changes in the liver,interscapular brown adipose tissue(IBAT),in-guinal white adipose tissue(IWAT),and quadriceps muscle were evaluated via hematoxylin-eosin(HE)staining.RT-qPCR was used to measure mRNA levels of platelet-derived growth factor receptor α(PDGFRα),peroxisome prolifera-tor-activated receptor γ(PPARγ),hormone-sensitive lipase(HSL),and adipose triglyceride lipase(ATGL)in these tissues.Results:STAT3 protein expression in the PVN of CKO mice was significantly reduced,and the number of STAT3-positive neurons was also decreased.Compared to wild-type(WT)mice,CKO mice exhibited increased body weight,impaired thermogenesis in IBAT,and reduced glucose tolerance.HE staining revealed lipid droplet accumula-tion in hepatocytes of the liver,enlarged adipocytes with hypertrophic lipid droplets and leukocyte infiltration in adipose tissues,and intermuscular fat deposition in the quadriceps muscle.RT-qPCR analysis showed decreased mRNA levels of PDGFRα,HSL,and ATGL in the liver;upregulated PPARγ mRNA but downregulated HSL and ATGL mRNA in IBAT and IWAT;and reduced PPARγ and HSL mRNA levels in the quadriceps muscle of CKO mice.Conclusion:The STAT3 signaling pathway in the PVN is critical for maintaining systemic energy balance and serves as a key node in met-abolic regulation.

Objective To construct a nomogram model for predicting pulmonary hemorrhage associated with the positioning of pulmonary nodules with the new four-hook positioning needle based on clinical-CT imaging features and evaluate its predictive efficacy.Methods We made a retrospective analysis of the clinical,imaging and pathological data of 449 patients with pulmonary nodules positioned by the new four-hook positioning needle.According to the random number table method(7∶3),they were divided into a training set of 314 cases and a validation set of 135 cases.Each data set was further divided into positive group and negative group for pulmonary hemorrhage according to the presence or absence of pulmonary hemorrhage.We evaluated the CT imaging features of pulmonary nodules,including nodule nature(pure ground-glass density,mixed ground-glass density,solid nodule),nodule diameter,distance from the nodule to the pleural surface(hereinafter referred to as length),nodule positioning time,and association with pulmonary hemorrhage.Independent sample t-test,Mann-Whitney U test and x2 test were used to compare the correlations of clinical and CT features of pulmonary nodules with pulmonary hemorrhage.LASSO regression and multivariate Logistic regression were employed to screen the independent risk factors related to pulmonary hemorrhage and construct a nomogram model.The receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of the model,and the calibration curve and decision curve were respectively used for the verification of the nomogram model and evaluation of the clinical net benefit.Results The results of LASSO regression showed that the nature of pulmonary nodules,underlying diseases,smoking and length were the characteristic variables related to pulmonary hemorrhage.Based on the minimum akaike information criterion(AIC),the screened characteristic variables were included in the multivariate Logistic backward stepwise regression analysis.The results showed that the nature of pulmonary nodules,underlying diseases,smoking and length were all independent risk factors related to pulmonary hemorrhage.A nomogram was established according to the above independent risk factors and the ROC curve was drawn.The AUC of the training set was 0.86(95％CI:0.80-0.91),and the AUC of the validation set was 0.88(95％CI:0.80-0.96),with no statistically significant difference(P＞0.05).The calibration curve suggested that the predicted values of the nomogram were close to the actual values,and the decision curve analysis showed that the net benefit of the model was good.Conclusion The nomogram model established by combining clinical-CT features such as the nature of pulmonary nodules,underlying diseases,smoking and length can effectively predict pulmonary hemorrhage associated with the positioning of pulmonary nodules with the new four-hook positioning needle.

Objective To construct a nomogram model for predicting pulmonary hemorrhage associated with the positioning of pulmonary nodules with the new four-hook positioning needle based on clinical-CT imaging features and evaluate its predictive efficacy.Methods We made a retrospective analysis of the clinical,imaging and pathological data of 449 patients with pulmonary nodules positioned by the new four-hook positioning needle.According to the random number table method(7∶3),they were divided into a training set of 314 cases and a validation set of 135 cases.Each data set was further divided into positive group and negative group for pulmonary hemorrhage according to the presence or absence of pulmonary hemorrhage.We evaluated the CT imaging features of pulmonary nodules,including nodule nature(pure ground-glass density,mixed ground-glass density,solid nodule),nodule diameter,distance from the nodule to the pleural surface(hereinafter referred to as length),nodule positioning time,and association with pulmonary hemorrhage.Independent sample t-test,Mann-Whitney U test and x2 test were used to compare the correlations of clinical and CT features of pulmonary nodules with pulmonary hemorrhage.LASSO regression and multivariate Logistic regression were employed to screen the independent risk factors related to pulmonary hemorrhage and construct a nomogram model.The receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of the model,and the calibration curve and decision curve were respectively used for the verification of the nomogram model and evaluation of the clinical net benefit.Results The results of LASSO regression showed that the nature of pulmonary nodules,underlying diseases,smoking and length were the characteristic variables related to pulmonary hemorrhage.Based on the minimum akaike information criterion(AIC),the screened characteristic variables were included in the multivariate Logistic backward stepwise regression analysis.The results showed that the nature of pulmonary nodules,underlying diseases,smoking and length were all independent risk factors related to pulmonary hemorrhage.A nomogram was established according to the above independent risk factors and the ROC curve was drawn.The AUC of the training set was 0.86(95％CI:0.80-0.91),and the AUC of the validation set was 0.88(95％CI:0.80-0.96),with no statistically significant difference(P＞0.05).The calibration curve suggested that the predicted values of the nomogram were close to the actual values,and the decision curve analysis showed that the net benefit of the model was good.Conclusion The nomogram model established by combining clinical-CT features such as the nature of pulmonary nodules,underlying diseases,smoking and length can effectively predict pulmonary hemorrhage associated with the positioning of pulmonary nodules with the new four-hook positioning needle.

Objective To explore the impact of an intelligent puncture navigation used by different physicians with varying years of experience to perform the lung puncture biopsy surgery.Methods A retrospective selection was conducted of 182 patients who completed lung puncture biopsy surgery.The primary parameters were recorded included puncture time,the number of needle adjust-ments,dose length product(DLP),and complications.The physicians were categorized into high-experience and low-experience groups based on their years of clinical practice.The differences of navigation guidance and manual puncture were compared between the two groups.Results The use of navigation guidance significantly reduced the procedure time for both groups of physicians(P<0.05).Additionally,for the low-experience group,navigation guidance notably decreased the number of needle adjustments(P<0.05)and reduced the radiation dose received by patients(P<0.05).Conclusion The application of intelligent puncture navigation can shorten the procedure time,reduce the number of needle adjustments,and lower the radiation dose received by patients in lung puncture biopsy procedures.It also bridges the operational performance gap between low-experience and high-experience physicians,making it a val-uable imaging-guided tool for widespread adoption.

Objective To explore the impact of an intelligent puncture navigation used by different physicians with varying years of experience to perform the lung puncture biopsy surgery.Methods A retrospective selection was conducted of 182 patients who completed lung puncture biopsy surgery.The primary parameters were recorded included puncture time,the number of needle adjust-ments,dose length product(DLP),and complications.The physicians were categorized into high-experience and low-experience groups based on their years of clinical practice.The differences of navigation guidance and manual puncture were compared between the two groups.Results The use of navigation guidance significantly reduced the procedure time for both groups of physicians(P<0.05).Additionally,for the low-experience group,navigation guidance notably decreased the number of needle adjustments(P<0.05)and reduced the radiation dose received by patients(P<0.05).Conclusion The application of intelligent puncture navigation can shorten the procedure time,reduce the number of needle adjustments,and lower the radiation dose received by patients in lung puncture biopsy procedures.It also bridges the operational performance gap between low-experience and high-experience physicians,making it a val-uable imaging-guided tool for widespread adoption.

Objective:To investigate the role and molecular mechanisms of signal transducer and activator of tran-scription 3(STAT3)in the paraventricular nucleus(PVN)of the hypothalamus in regulating body weight and energy metabolism in mice.Methods:AAV2/9-hSyn-Cre-EGFP virus was stereotactically injected into the PVN of STAT3Flox/Flox mice to conditionally knock out(CKO)STAT3 in the PVN.STAT3 expression was verified via immunoflu-orescence staining and Western blot.Body weight and temperature were monitored,glucose tolerance was assessed using glucose tolerance tests in mice,and morphological changes in the liver,interscapular brown adipose tissue(IBAT),in-guinal white adipose tissue(IWAT),and quadriceps muscle were evaluated via hematoxylin-eosin(HE)staining.RT-qPCR was used to measure mRNA levels of platelet-derived growth factor receptor α(PDGFRα),peroxisome prolifera-tor-activated receptor γ(PPARγ),hormone-sensitive lipase(HSL),and adipose triglyceride lipase(ATGL)in these tissues.Results:STAT3 protein expression in the PVN of CKO mice was significantly reduced,and the number of STAT3-positive neurons was also decreased.Compared to wild-type(WT)mice,CKO mice exhibited increased body weight,impaired thermogenesis in IBAT,and reduced glucose tolerance.HE staining revealed lipid droplet accumula-tion in hepatocytes of the liver,enlarged adipocytes with hypertrophic lipid droplets and leukocyte infiltration in adipose tissues,and intermuscular fat deposition in the quadriceps muscle.RT-qPCR analysis showed decreased mRNA levels of PDGFRα,HSL,and ATGL in the liver;upregulated PPARγ mRNA but downregulated HSL and ATGL mRNA in IBAT and IWAT;and reduced PPARγ and HSL mRNA levels in the quadriceps muscle of CKO mice.Conclusion:The STAT3 signaling pathway in the PVN is critical for maintaining systemic energy balance and serves as a key node in met-abolic regulation.

Ghrelin is a hormone produced by the stomach that regulates energy metabolism after acting on the central nervous system.Cocaine amphetamine-regulated transcriptional peptide(CART)neurons participate in the regulation of feeding behavior and energy balance.It is known that CART neurons are influenced by hormones to regulate energy homeostasis,but whether ghre-lin exerts its pro-appetite function by influencing CART neurons is unknown.Therefore,this study focuses on the role of VMHCART neurons in the regulation of feeding and relative body weight by ghrelin.Firstly,the whole brain expression of CART was determined by immunofluorescence.Then the effect of intraperitoneal injection of ghrelin on the expression of DMHCART neurons was evalua-ted.Finally,the ghrelin was delivered to DMH and the changes of food intake and relative body weight of mice were measured.CART immunoreactive neurons were detected in medial preoptic nucleus(MPA),arcuate nucleus(ARC),dorsomedial hypothalamic nucleus(DMH),thalamic pa-raventricular nucleus(PVT)and raphe nucleus(ROb).Compared with the control group,periph-eral injection of ghrelin significantly increased the expression of DMHC ART immunoreactive neurons(P=0.037 3).DMH long-term injection of ghrelin resulted in an increase in body weight(P=0.004 0)and feed intake(P=0.023 1).The results provide anatomical evidence for the whole brain distribution of CART,which proves that ghrelin affects feed intake and body weight of mice through CART neurons in DMH,suggesting that specific neuron types and regional specificity are involved in ghrelin regulation of feed intake and energy homeostasis.

Vesicular glutamate transporter 2(VGlut2)is expressed in the PVN of the hypothalamic paraventricular nucleus(PVNVG1ut2)as an excitatory neurotransmitter,which regulates food intake and energy metabolism and plays an important role in maintaining homeostasis.However,it is not clear that the upstream and downstream projection network of PVNVGut2 neurons hinders the anal-ysis of glutamatergic neuron circuit function.Anterograde and retrograde tracer viruses were injec-ted into the PVN of VGlut2 mice by stereotactic brain injection technique to find the input and output nuclei of PVNVGlut2 neurons.Anterograde tracing results showed that PVNVGlut2 neurons pro-jected to the downstream medial amygdala(MeAD)and arcuate nucleus(ARC).Retrograde trac-ing results showed that PVNVGlut2 received input from the prefrontal nucleus(Pr),the reticular tegmental nucleus(RtTg),and the hypoglossal nucleus(12N).In addition,VGlut2 was found to be co-expressed with neuronal nitric oxide synthase(nNOS)neurons in the PVN.The anatomical net-work of PVNVG1ut2 neurons was analyzed by virus tracking tool,which laid the anatomical founda-tion for further study on the functional regulation of PVNVGlut2.

Amylin exerts a satiety-limiting effect on food intake by influencing the regulation of en-ergy metabolism in the central nucleus.However,the binding sites of amylin are widely distributed throughout the central nervous system,and it remains unclear whether the locus coeruleus(LC)responds to amylin stimulation.Therefore,this experiment aims to confirm whether amylin exerts its inhibitory effect on food intake through the LC following localized damage to the LC nucleus.The results indicate that amylin,while suppressing appetite,activates c-Fos neurons and tyrosine hydroxylase(TH)within the LC,leading to increased heat production in the interscapular brown adipose tissue(IBAT)of mice.However,after LC damage,the central feeding inhibition mediated by amylin is alleviated,although it is weaker compared to the group with solely LC damage,and the thermogenic capacity of IBAT is reduced.Thus,the study demonstrates that the LC is also one of the sites of action for exogenous amylin and is crucial for maintaining amylin-induced thermo-genesis.These findings expand the understanding of amylin's central actions and ultimately provide potential targets for obesity treatment.