Objective:To explore the predictive value of preoperative peripheral hematological parameters combined with clinicopathological features for cervical lymph node metastasis（CLNM） in patients with laryngeal squamous cell carcinoma（LSCC）, and to construct and validate a nomogram model for CLNM. Methods:A retrospective analysis was conducted on the clinical data of 264 LSCC patients who underwent surgical treatment and were pathologically confirmed, collected from the Second Affiliated Hospital of Shandong First Medical University and Taian 88 Hospital. Specifically, 161 patients from one hospital were allocated to the training cohort, while 103 patients from another hospital constituted the validation cohort. Based on postoperative pathological results, patients were categorized into CLNM-positive and CLNM-negative groups. The general clinical data, clinicopathological features, and hematological parameters of the two groups were analyzed and compared. A preoperative predictive model for CLNM was developed using logistic regression analysis, followed by validation and sensitivity analysis to evaluate the robustness of the model's predictive performance. Results:The results showed that there were significant differences in tumor location, tumor size, tumor differentiation, neutrophil percentage, lymphocyte count, lymphocyte percentage, c-reactive protein（CRP）, fibrinogen, neutrophil-to-lymphocyte ratio（NLR）, platelet-to-lymphocyte ratio（PLR）, systemic immune-inflammation index（SII）, systemic inflammation response index（SIRI）, and prognostic inflammatory index（PIV） between the CLNM-positive and CLNM-negative groups（P<0.05）. Lasso regression identified tumor location, clinical T stage, tumor size, tumor differentiation degree, red blood cell distribution width（RDW） -coefficient of variation（RDW-CV）, CRP, FIB, D-dimer, NLR, and lymphocyte-to-monocyte ratio（LMR） were the most predictive parameters. Multivariate logistic regression revealed that tumor location, tumor size, tumor differentiation degree, CRP, and NLR were independent risk factors for CLNM in LSCC patients（P<0.05）. A nomogram was constructed based on these five factors. The model demonstrated excellent discrimination, with a C-index of 0.837（95%CI 0.766-0.908） in the training cohort and 0.809（95%CI 0.698-0.920） in the validation cohort. Calibration curves and DCA curves in both cohorts confirmed the clinical utility of the model. Sensitivity analysis further supported the robustness of the results, showing good discrimination and calibration across different age and BMI subgroups. Conclusion:Tumor location, tumor size, tumor differentiation degree, CRP, and NLR were independent risk factors for CLNM in LSCC patients. The nomogram based on these variables exhibits strong discrimination, calibration, and clinical applicability, and may serve as a valuable tool for preoperative risk assessment and individualized treatment planning.
Humans ; Nomograms ; Laryngeal Neoplasms/blood* ; Retrospective Studies ; Lymphatic Metastasis ; Carcinoma, Squamous Cell/blood* ; Lymph Nodes/pathology* ; Male ; Female ; Middle Aged ; Neck ; C-Reactive Protein ; Aged ; Logistic Models ; Neutrophils ; Prognosis

OBJECTIVES: To study the impact of SURF4 expression level on long-term prognosis of gastric cancer (GC) and biological behaviors of GC cells. METHODS: SURF4 expression level in GC and its association with long-term patient prognosis were analyzed using publicly available databases and in 155 GC patients with low and high SURF4 expressions detected immunohistochemically. The Cox proportional hazard model and Kaplan-Meier survival curves were used to analyze independent prognostic predictors of GC and the 5-year survival rate of the patients with different SURF4 expression levels. Informatics analyses were conducted to explore the correlation of SURF4 expression level with immune cell infiltration in GC, SURF4-related differential genes and their associated pathways. In cultured GC cell line HGC-27, the effects of SURF4 knockdown and overexpression on proliferation, migration, invasion and epithelial-mesenchymal transition (EMT) were investigated. RESULTS: Analysis of GEPIA dataset and immunohistochemical results suggested significant SURF4 overexpression in GC (P<0.05), which was associated with shortened 5-year survival time of the patients (χ²=38.749, P<0.001). The prognosis of GC was closely related to tumor stage T3-4, N2-3, CEA≥5 μg/L and CA19-9≥37 kU/L (P<0.05). SURF4 expression level was negatively correlated with activated B cells, NK cells and CD8⁺ effector memory T cells (P<0.05) and positively correlated with CD4⁺ T cells (P<0.05). GO and KEGG enrichment analysis suggested that SUFR4 may participate in GC carcinogenesis by promoting EMT through the tight junction pathway. In HGC-27 cells, SURF4 overexpression significantly decreased E-cadherin expression, increased N-cadherin expression, inhibited ZO-1 and claudin-1 expressions, and promoted cell proliferation, migration and invasion. CONCLUSIONS SURF4 is highly expressed in GC, and its overexpression is associated with a shortened 5-year survival of the patients possibly by enhancing tumor cell proliferation, migration and invasion via inhibiting tight junction proteins and promoting EMT.
Humans ; Stomach Neoplasms/metabolism* ; Cell Proliferation ; Cell Movement ; Epithelial-Mesenchymal Transition ; Cell Line, Tumor ; Neoplasm Invasiveness ; Prognosis ; Tight Junction Proteins/metabolism* ; Membrane Proteins/metabolism* ; Female ; Male

Objective To observe the clinical efficacy of Dan Qi Yishen Prescription in treating diabetic nephropathy(DN)and explore its renal protective mechanism.Methods A total of 150 patients with DN of qi-yin deficiency complicated with blood stasis syndrome who admitted to Sanya Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine from October 2021 to April 2023 were divided into a control group and an observation group according to the random number table method,with 75 patients in each group.Both groups were given conventional therapies such as dietary treatment,blood glucose control,blood pressure control,lipid-lowering treatment and treatment of complications.Additionally,the control group was given intravenous injection of reduced glutathione,while the observation group was given oral use of the decoction of Dan Qi Yishen Prescription and ionic introduction of Dan Qi Yishen Prescription in renal region.Thirty days constituted one course of treatment,and both groups were treated for three courses.Before and after treatment,the scores of traditional Chinese medicine(TCM)syndrome,and the levels of renal function indicators,renal hemodynamic indicators,coagulation and fibrinolysis indicators,and vascular endothelial function indicators in the two groups were observed.Results(1)After treatment,the scores of TCM symptoms such as fatigue and weakness,palpitations and shortness of breath,dizziness and tinnitus,spontaneous sweating and night sweating,restlessness and insomnia,and thirst with preference for drinks in the two groups were decreased compared with those before treatment(P<0.01),and the decrease in the observation group was significantly superior to that in the control group(P<0.01).(2)After treatment,the levels of renal function indicators such as blood urea nitrogen(BUN),serum creatinine(SCr),collagen Ⅳ(CⅣ),and plasma laminin(LN)of patients in the two groups were improved compared with those before treatment(P<0.01),and the improvement in the observation group was significantly superior to that in the control group(P<0.01).(3)After treatment,the levels of renal hemodynamic indicators such as systolic maximum blood flow velocity(Vsmax)and diastolic minimum blood flow velocity(Vdmin)of the main renal artery(MRA)and interlobar artery(IRA)in the two groups were increased compared with those before treatment(P<0.05 or P<0.01),while the resistance index(RI)and pulsatility index(PI)of MRA and RI of IRA in the two group as well as PI of IRA in the observation group were decreased compared with those before treatment(P<0.05 or P<0.01).The increase of Vsmax and Vdmin of MRA and IRA as well as the decrease of RI and PI of MRA and IRA in the observation group was significantly superior to that in the control group(P<0.05 or P<0.01).(4)After treatment,the levels of coagulation and fibrinolysis indicators such as prothrombin time(PT),activated partial thromboplastin time(APTT),D-dimer(D-D),and fibrinogen(FIB)in the two groups were improved compared with those before treatment(P<0.01),and the improvement in the observation group was significantly superior to that in the control group(P<0.01).(5)The analysis of vascular endothelial function indicators showed that after treatment,the serum vasohibin 1(VASH-1)level in the two groups was increased compared with that before treatment(P<0.01),and the serum vascular endothelial growth factor(VEGF)and endothelin 1(ET-1)levels were decreased compared with those before treatment(P<0.01),and the increase of serum VASH-1 level as well as the decrease of serum VEGF and ET-1 levels in the observation group was significantly superior to that in the control group(P<0.01).Conclusion Dan Qi Yishen Prescription exerts good clinical efficacy in treating patients with DN of qi-yin deficiency complicated with blood stasis syndrome,and it has protective effect on renal function probably by improving the coagulation and fibrinolysis system and vascular endothelial function of the patients.

Objective To investigate the effect and mechanism of Xuanfu Daizhe Decoction on the proliferation,migration,and invasion activities of esophageal cancer cells.Methods Human e-sophageal cancer cell line EC 109 was treated with Xuanfu Daizhe Decoction at different concentrations,and the cells were divided into high-concentration group(200 μg/mL),medium-concentration group(100 μg/mL),low-concentration group(50 μg/mL),and blank group(0 μg/mL)based on the concentration.CCK-8 assay,wound healing assay,and Transwell invasion assay were used to detect the proliferation,migration,and invasion activities of the cells in each group,respectively.Western blot and cellular immunofluorescence staining were employed to detect the protein expression levels of glycolysis-related enzymes[hexokinase 2(HK2),lactate dehydrogenase A(LDHA),and phospho-fructokinase 1(PFK1)]in the cells of each group,and real-time quantitative fluorescent polymerase chain reaction(qRT-PCR)was used to detect the relative expression levels of mRNA encoding these enzymes.A nude mouse tumor-bearing model was established and divided into control group and Xuanfu Daizhe Decoction-fed group(20 mg/kg)to observe the effect of Xuanfu Daizhe Decoction on the growth of esophageal cancer in vivo.Results The results of CCK-8 assay,wound healing as-say,and Transwell invasion assay showed that Xuanfu Daizhe Decoction could inhibit the prolifera-tion,migration,and invasion activities of EC 109 cells in a concentration-dependent manner.West-ern blot and cellular immunofluorescence analysis revealed that compared with the blank group,the protein expression levels of HK2,LDHA,and PFK1 in the low-concentration,medium-concentra-tion,and high-concentration groups were decreased(P＜0.05).The qRT-PCR results showed that compared with the blank group,the relative expression levels of HK2 mRNA,LDHA mRNA,and PFK1 mRNA in the low-concentration,medium-concentration,and high-concentration groups were all reduced(P＜0.01 or P＜0.000 1).The tumor volume in the subcutaneous tissue on the back of nude mice in the Xuanfu Daizhe Decoction-fed group was smaller than that in the control group,and the protein expression level of LDHA in the tumor tissue of the Xuanfu Daizhe Decoction-fed group was lower than that in the control group,while the expression level of the pro-apoptotic protein Bax was higher than that in the control group(P＜0.05).Conclusion Xuanfu Daizhe Decoction can inhibit the glycolysis process of esophageal cancer cells in a concentration-dependent manner,there-by inhibiting cell proliferation,migration,invasion,and tumor growth in vivo.

BACKGROUND:Extracellular vesicles have received extensive attention in the field of bone defect regeneration and repair in recent years.However,natural extracellular vesicles have deficiencies in sustained controlled release,tissue targeting,and drug loading capacity.Therefore,the introduction of engineering strategies to modify extracellular vesicles to enhance their therapeutic efficacy has become a research hotspot.OBJECTIVE:To review the role and application progress of engineered extracellular vesicles in the regeneration and repair of bone defects.METHODS:PubMed,Web of Science,CNKI,and WanFang databases were searched for relevant articles published in the past fifteen years.The search terms were"engineering,extracellular vesicles,exosomes,bone defect,bone regeneration,bone repair"in Chinese and English.After removal of poorly related,outdated,and duplicate studies by screening,93 articles were finally included for review according to inclusion criteria.RESULTS AND CONCLUSION:(1)Extracellular vesicles are primarily isolated based on their density,size,immunoaffinity,and surface charge.After isolation,extracellular vesicles are characterized using imaging techniques,size-and counting-based techniques,and flow cytometry.(2)Extracellular vesicles stimulate bone regeneration by regulating immunity,angiogenesis,and proliferation and differentiation of target cells.(3)The engineering strategies of extracellular vesicles include surface modification and cargo loading.(4)The introduction of bone morphogenetic protein 2,mutant hypoxia-inducible factor-1α,vascular endothelial growth factor,miRNA and other bioactive factors into extracellular vesicles through engineering strategies can enhance their regenerative repair ability for bone defects.

Objective:To investigate the current application status of prophylactic anti-infective drugs during the perioperative period in liver transplantation centers and provide data references for further standardizing prophylactic regimens.Methods:A questionnaire comprising 53 questions across 5 dimensions was designed and released using the WJX platform. The dimensions included basic information about medical institutions, perioperative pathogenic microorganisms, current status of empirical antibacterial prophylaxis, adjustments to prophylactic anti-infective strategies, and an overview of prophylactic measures against other pathogens. Based on the survey results, the types of common perioperative pathogens in liver transplantation, types of prophylactic antibacterial drugs, timing and duration of administration, upgraded prophylaxis strategies (such as escalation of antibiotic classes or extension of drug application duration), and prevention strategies for other pathogens were summarized.Results:A total of 13 completed questionnaires from pharmacists at liver transplantation centers were collected. The most common pathogens during the perioperative period were Gram-negative bacilli, including Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii. The most frequently used prophylactic antibacterial drugs were cefoperazone/sulbactam and piperacillin/tazobactam. Regarding the timing of administration, 9 centers administered drugs 0.5 to 1.0 hour before surgery, 3 within 0.5 hour, and 1 within 1 hour preoperatively. The prophylactic duration was within 7 days postoperatively for living donor liver transplantation in 10 centers, while for cadaveric donor liver transplantation, only 6 centers adhered to the 7-day duration. When donors had infections with sensitive bacteria, 9 centers upgraded prevention strategies: 2 centers escalated the antibiotic class or adjusted regimens, 5 centers extended the duration of prophylaxis, 2 centers implemented donor-specific susceptibility-guided antibacterial treatments regardless of colonization or infection, and 5 centers administered prophylaxis only in cases of colonization based on donor susceptibility results. When donors had multi-drug resistance bacterial infections, 11 centers upgraded prevention strategies: 7 escalated the antibiotic class or adjusted regimens, 4 extended prophylaxis duration, 6 implemented susceptibility-guided treatments irrespective of colonization or infection, 1 administered prophylaxis only for colonization based on donor susceptibility results, and 2 abandoned transplantations. 7 centers routinely applied antifungal prophylactic measures, including 1 for preoperative prophylaxis and 6 for postoperative prophylaxis, using caspofungin (4 centers), fluconazole (2 centers), posaconazole (1 center), and micafungin (1 center). 6 centers initiated antifungal prophylaxis in cases with donor or recipient fungal infection history or active fungal infections detected during liver procurement. Most antifungal prophylaxis was administered within 72 hours postoperative (11 centers), with durations mostly within 14 days (12 centers). For viral infections, 6 centers adopted routine postoperative prophylactic measures. Conclusions:Currently, the perioperative prophylactic anti-infective strategies in 13 liver transplantation centers are not standardized. High-quality multicenter clinical studies are needed to compare the effectiveness of different prophylactic regimens, aiming to further standardize the types and durations of prophylactic drug use.

Objective:To improve the quality standards for Portulaca oleracea medicinal materials and decoction pieces.Methods:Fourteen batches of P.oleracea medicinal materials and 20 batches of its decoction pieces from different producing areas across the country were collected.In accordance with the relevant methods in the general chapters of the Chinese Pharmacopoeia(2020 Edition,Volume Ⅰ),the thin-layer chromatography(TLC)identi-fication method was optimized.The contents of impurities,moisture,total ash,acid-insoluble ash,heavy metals and harmful elements,and extracts were determined.Meanwhile,the HPLC feature chromatograms and content determination methods for P.oleracea medicinal materials and decoction pieces were established.Results:The optimized TLC method showed clear spots,good separation effect and reproducibility.The average contents of impurities,moisture,total ash,acid-insoluble ash,and extracts in the 14 batches of P.oleracea medicinal materi-als were 0.01％,8.48％,21.68％,5.33％,and 28.44％respectively.The average contents of impurities,moisture,total ash,acid-insoluble ash,and extracts in the 20 batches of P.oleracea decoction pieces were 0.01％,7.00％,21.09％,3.60％,and 29.63％respectively.The results of the tests for heavy metals and harmful elements showed that the contents of lead,cadmium,arsenic,mercury and copper in 34 batches of samples varied greatly.Moreover,the contents of cadmium,arsenic and copper in some samples exceeded the limit guid-ance values specified in the Pharmacopoeia.Nine common peaks were calibrated in the established HPLC feature chromatogram of P.oleracea,and an HPLC method for simultaneously determining the contents of norepinephrine and dopamine was established.Conclusion:It is recommended to modify the developing solvent for the thin-layer identification of P.oleracea and its proportion to water-saturated n-butanol-acetone-glacial acetic acid-water=4∶1∶1∶1,and change the extraction method of the test sample to ultrasonic extraction for 30 minutes.It is proposed to add the stipulations that the total ash of P.oleracea medicinal materials and decoction pieces should not exceed 25.0％,the acid-insoluble ash should not exceed 6.0％,and the water-soluble extract should not be lower than 20.0％.For P.oleracea decoction pieces,the total ash should not exceed 28.0％,the acid-insoluble ash should not exceed 6.0％,and the water-soluble extract should not be lower than 20.0％.This study provides an experi-mental basis for the improvement of the quality standards of P.oleracea.

Objective:To analyze the epidemiological characteristics and delay in detection of reported brucellosis cases in Nangang District of Harbin City, Heilongjiang Province, in order to provide a basis for improving targeted measures for brucellosis prevention and control.Methods:Data on brucellosis reported in Nangang District of Harbin City between 2018 and 2022 were obtained from the China Disease Prevention and Control Information System. A descriptive analysis was conducted to outline the epidemiological status, epidemiological features, and sources of cases. Seasonal patterns of brucellosis were assessed using the concentration degree and seasonal index methods. Joinpoint regression model was used to analyze the trend of delay in detection.Results:From 2018 to 2022, a total of 4 428 cases of brucellosis were reported in Nangang District, with 1 183 cases (26.72%) reported in 2018 and 528 cases (11.92%) reported in 2022. The gender ratio of the cases was 2.80 ∶ 1.00 (3 264 ∶ 1 164). Most cases occurred in individuals aged 30 to 59 years (73.19%, 3 241/4 428). Occupationally, farmers comprised the majority of cases (88.73%, 3 929/4 428), followed by homemakers/unemployed individuals (3.73%, 165/4 428), and students (2.03%, 90/4 428). Regarding case origin, 31.48% (1 394/4 428) were from Harbin City, while 64.97% (2 877/4 428) originated from other cities within Heilongjiang Province, predominantly from Suihua City (38.89%, 1 722/4 428). Additionally, 157 cases (3.55%, 157/4 428) were reported from outside Heilongjiang Province, all of which were from Inner Mongolia Autonomous Region and Jilin Province. Brucellosis incidence showed weak seasonality ( M = 0.230), with the epidemic period spanning from March to August. During this period, seasonal indices C exceeded 100%, peaking in July (168.02%). From 2018 to 2022, the average annual delay rate in case detection was 20.14% (892/4 428). The delayed detection rates of brucellosis cases in each year were 30.68% (363/1 183), 17.86% (200/1 120), 17.23% (117/679), 12.75% (117/918), and 17.99% (95/528), respectively (average annual percentage change = - 17.52%, P = 0.090). Conclusions:Brucellosis in Nangang District of Harbin Citydemonstrates weak seasonality, with peak incidence occurring from March to August. Detection delays remain a concern, highlighting the need for sustained surveillance and the implementation of integrated, multi-sectoral prevention and control measures.

BACKGROUND:Extracellular vesicles have received extensive attention in the field of bone defect regeneration and repair in recent years.However,natural extracellular vesicles have deficiencies in sustained controlled release,tissue targeting,and drug loading capacity.Therefore,the introduction of engineering strategies to modify extracellular vesicles to enhance their therapeutic efficacy has become a research hotspot.OBJECTIVE:To review the role and application progress of engineered extracellular vesicles in the regeneration and repair of bone defects.METHODS:PubMed,Web of Science,CNKI,and WanFang databases were searched for relevant articles published in the past fifteen years.The search terms were"engineering,extracellular vesicles,exosomes,bone defect,bone regeneration,bone repair"in Chinese and English.After removal of poorly related,outdated,and duplicate studies by screening,93 articles were finally included for review according to inclusion criteria.RESULTS AND CONCLUSION:(1)Extracellular vesicles are primarily isolated based on their density,size,immunoaffinity,and surface charge.After isolation,extracellular vesicles are characterized using imaging techniques,size-and counting-based techniques,and flow cytometry.(2)Extracellular vesicles stimulate bone regeneration by regulating immunity,angiogenesis,and proliferation and differentiation of target cells.(3)The engineering strategies of extracellular vesicles include surface modification and cargo loading.(4)The introduction of bone morphogenetic protein 2,mutant hypoxia-inducible factor-1α,vascular endothelial growth factor,miRNA and other bioactive factors into extracellular vesicles through engineering strategies can enhance their regenerative repair ability for bone defects.

Objective:To improve the quality standards for Portulaca oleracea medicinal materials and decoction pieces.Methods:Fourteen batches of P.oleracea medicinal materials and 20 batches of its decoction pieces from different producing areas across the country were collected.In accordance with the relevant methods in the general chapters of the Chinese Pharmacopoeia(2020 Edition,Volume Ⅰ),the thin-layer chromatography(TLC)identi-fication method was optimized.The contents of impurities,moisture,total ash,acid-insoluble ash,heavy metals and harmful elements,and extracts were determined.Meanwhile,the HPLC feature chromatograms and content determination methods for P.oleracea medicinal materials and decoction pieces were established.Results:The optimized TLC method showed clear spots,good separation effect and reproducibility.The average contents of impurities,moisture,total ash,acid-insoluble ash,and extracts in the 14 batches of P.oleracea medicinal materi-als were 0.01％,8.48％,21.68％,5.33％,and 28.44％respectively.The average contents of impurities,moisture,total ash,acid-insoluble ash,and extracts in the 20 batches of P.oleracea decoction pieces were 0.01％,7.00％,21.09％,3.60％,and 29.63％respectively.The results of the tests for heavy metals and harmful elements showed that the contents of lead,cadmium,arsenic,mercury and copper in 34 batches of samples varied greatly.Moreover,the contents of cadmium,arsenic and copper in some samples exceeded the limit guid-ance values specified in the Pharmacopoeia.Nine common peaks were calibrated in the established HPLC feature chromatogram of P.oleracea,and an HPLC method for simultaneously determining the contents of norepinephrine and dopamine was established.Conclusion:It is recommended to modify the developing solvent for the thin-layer identification of P.oleracea and its proportion to water-saturated n-butanol-acetone-glacial acetic acid-water=4∶1∶1∶1,and change the extraction method of the test sample to ultrasonic extraction for 30 minutes.It is proposed to add the stipulations that the total ash of P.oleracea medicinal materials and decoction pieces should not exceed 25.0％,the acid-insoluble ash should not exceed 6.0％,and the water-soluble extract should not be lower than 20.0％.For P.oleracea decoction pieces,the total ash should not exceed 28.0％,the acid-insoluble ash should not exceed 6.0％,and the water-soluble extract should not be lower than 20.0％.This study provides an experi-mental basis for the improvement of the quality standards of P.oleracea.