The health of the human body is the result of the dynamic interplay between immunity and various microorganisms. Furthermore, the health of the mitochondrial grid determines the strength of immunity. Mitochondrial imbalance leads to the metabolic remodeling of intracellular nutrients, which accelerates the occurrence and development of tumors. The theory of yin and yang and the theory of visceral outward manifestation are the foundation and core of traditional Chinese medicine (TCM) theory, which guides the clinical diagnosis and treatment of TCM. Yang Qi is the driving force behind the metabolism and physiological functions of the human body; it is also the adenine nucleoside triphosphate produced efficiently by mitochondrial aerobic respiration. The main transport of spleen refers to the biological oxidation process of food in the mitochondria, and its normal function is closely related to the integrity of the mitochondrial structure and function of the cell. Therefore, warming yang and strengthening the spleen essentially means restoring the high production capacity of the mitochondria. Rebuilding damaged mitochondrial function, improving efficiency, and boosting the energy level of the neuro-endocrine-immune network are the key factors contributing to the body’s ability to resist disease and return to health.

BACKGROUND: The proportion of patients with non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations is relatively high in China. However, these patients currently lack significant benefits from available neoadjuvant treatment options. This study aims to explore the potential application value of neoadjuvant targeted therapy by evaluating its efficacy and safety in patients with EGFR-mutant resectable lung adenocarcinoma. METHODS: A multicenter retrospective study was used to analyze the treatment effect of patients with stage IIA-IIIB EGFR-mutant lung adenocarcinoma who underwent surgical resection after receiving neoadjuvant targeted therapy from July 2019 to October 2024. RESULTS: A total of 24 patients with EGFR-mutant lung adenocarcinoma from three centers were included in this study. All patients successfully underwent surgery and achieved R0 resection of 100.0%. The objective response rate (ORR) was 83.3% (20/24) . The major pathologic response (MPR) rate was 37.5% (9/24), with 2 patients (8.3%) achieving pathological complete response (pCR). During neoadjuvant therapy, 13 out of 24 patients (54.2%) experienced adverse events of grade 1-2, with no occurrences of ≥ grade 3. The most common treatment-related adverse events were rash (n=4, 16.7%), mouth sores (n=2, 8.3%), and diarrhea (n=2, 8.3%). The median follow-up time was 33.0 months, no deaths occurred in all patients, and the overall survival (OS) rate was 100.0%. The 1-year disease-free survival (DFS) rate was 91.1%, and the 2-year DFS rate remained at 86.2%. CONCLUSIONS The application of neoadjuvant targeted therapy in patients with EGFR-mutant resectable lung adenocarcinoma is safe and feasible, and is expected to become a highly promising neoadjuvant treatment option for the patients with EGFR-mutant lung adenocarcinoma.
Humans ; ErbB Receptors/metabolism* ; Male ; Female ; Middle Aged ; Adenocarcinoma of Lung/surgery* ; Neoadjuvant Therapy ; Lung Neoplasms/surgery* ; Aged ; Retrospective Studies ; Mutation ; Adult

Objective To analyse and explore whether there is a causal association without confounding factors between malignant haematological diseases and frailty based on a bidirectional Mendelian randomisation(MR)analysis,and to provide a theoretical basis for clinical management of the frailty associated with malignant haematological diseases.Methods In December 2023,the IEU OpenGWAS database(https://gwas.mrcieu.ac.uk/)was searched to acquire the datasets in genome-wide association studies(GWAS)derived from non-overlapping multi-ethnic populations based on Mendelian Randomisation(MR)analysis.The bidirectional causal association was verified utilising the two-sample MR approach.Single nucleotide polymorphisms(SNPs)of the frailty index(FI)(n=175,226),haematological malignancies(n=212,453),multiple myeloma/malignant plasmacytoma(n=218,792),and follicular lymphoma(n=181,278)were used as the study instruments.Results The analysis with the statistic inverse variance weighted method(IVW)showed that haematological malignancies(OR=1.00,95%CI:0.98-1.00,P=0.797),multiple myeloma/malignant plasma cell tumours(OR=1.00,95%CI 0.99～1.01,P=0.982),and follicular lymphoma(OR=1.00,95%CI:0.99～1.01,P=0.314)were not causally associated with genetically predicted FI.Similarly,FI was not significantly or causally correlated with haematological malignancies(OR=0.89,95%CI:0.25～3.12,P=0.861),multiple myeloma/malignant plasma cell tumours(OR=0.52,95%CI:0.00～3.13,P=0.473),and follicular lymphoma(OR=1.06,95%CI:0.00～5.19,P=0.944).Conclusion No causal relationship between the malignant haematological diseases and frailty was found in this study.It suggests that other factors might exist to cause the malignant haematological frailty.

Objective To analyse and explore whether there is a causal association without confounding factors between malignant haematological diseases and frailty based on a bidirectional Mendelian randomisation(MR)analysis,and to provide a theoretical basis for clinical management of the frailty associated with malignant haematological diseases.Methods In December 2023,the IEU OpenGWAS database(https://gwas.mrcieu.ac.uk/)was searched to acquire the datasets in genome-wide association studies(GWAS)derived from non-overlapping multi-ethnic populations based on Mendelian Randomisation(MR)analysis.The bidirectional causal association was verified utilising the two-sample MR approach.Single nucleotide polymorphisms(SNPs)of the frailty index(FI)(n=175,226),haematological malignancies(n=212,453),multiple myeloma/malignant plasmacytoma(n=218,792),and follicular lymphoma(n=181,278)were used as the study instruments.Results The analysis with the statistic inverse variance weighted method(IVW)showed that haematological malignancies(OR=1.00,95%CI:0.98-1.00,P=0.797),multiple myeloma/malignant plasma cell tumours(OR=1.00,95%CI 0.99～1.01,P=0.982),and follicular lymphoma(OR=1.00,95%CI:0.99～1.01,P=0.314)were not causally associated with genetically predicted FI.Similarly,FI was not significantly or causally correlated with haematological malignancies(OR=0.89,95%CI:0.25～3.12,P=0.861),multiple myeloma/malignant plasma cell tumours(OR=0.52,95%CI:0.00～3.13,P=0.473),and follicular lymphoma(OR=1.06,95%CI:0.00～5.19,P=0.944).Conclusion No causal relationship between the malignant haematological diseases and frailty was found in this study.It suggests that other factors might exist to cause the malignant haematological frailty.

Objective:To study the relationship between human leukocyte antigen (HLA) Ⅱ and nuclear factor κB (NF-κB) gene polymorphisms and susceptibility to community-acquired pneumonia in children and the therapeutic effect of amoxicillin clavulanate potassium.Methods:A total of 120 children with community-acquired pneumonia admitted to the Baoding Second Central Hospital from February 2018 to January 2021 were selected as the study objects (observation group). According to the effect of amoxicillin and clavulanate potassium treatment, they were divided into effective group and ineffective group, and 120 healthy children in the same period were selected as the control group. The polymorphisms of HLAⅡ and NF-κB gene were compared between the two groups, and the correlation between the polymorphisms of HLAⅡ and NF-κB gene and the susceptibility of children to community-acquired pneumonia and the therapeutic effect of amoxicillin clavulanate potassium was analyzed.Results:The gene frequency of HLA-DQA1*0201 [86(71.67%) vs 40(33.33%)], HLA-DQA1*0301 [72(60.00%) vs 20(16.67%)] of the observation group was significantly higher than that of the control group, the gene frequency of HLA-DQA1*0401 [30(25.00%) vs 96(80.00%)] was significantly lower than that of control group (all P<0.05). The gene frequency of HLA-DRB1*07 [92(76.67%) vs 48(40.00%)], HLA-DRB1*15 [72(60.00%) vs 40(33.33%)], HLA-DRB1*16 [96(80.00%) vs 76(63.33%)] of the observation group was significantly higher than that of the control group, and the gene frequency of HLA-DRB1*11 [36(30.00%) vs 104(86.67%)] was significantly lower than that of control group (all P<0.05). The expression of 94ins/delATTG*II in the observation group was significantly higher than that in the control group [40(33.33%) vs 24(20.00%), P<0.05]. The gene frequency of HLA-DQA1*0201 [12(38.71%) vs 74(83.15%)], HLA-DQA1*0301 [9(29.03%) vs 63(70.79%)] in the ineffective group was significantly lower than that of the effective group, the gene frequency of HLA-DQA1*0401 [18(58.06%) vs 12(13.48%)] was significantly higher than that of the effective group (all P<0.05). The gene frequency of HLA-DRB1*07 [29(93.55%) vs 63(70.79%)], HLA-DRB1*15 [29(93.55%) vs 43(48.31%)], HLA-DRB1*16 [29(93.55%) vs 67(75.28%)] of the ineffective group was significantly higher than that of the effective group, and the gene frequency of HLA-DRB1*11 [17(54.84%) vs 19(21.35%)] was significantly higher than that of the effective group (all P<0.05). The expression of 94ins/delATTG*II gene in the ineffective group was significantly higher than that in the effective group [15(48.39%) vs 25(28.09%), P<0.05]. Conclusions:Polymorphisms of HLAⅡ and NF-κB genes are associated with susceptibility to community-acquired pneumonia and efficacy of amoxicillin and clavulanate potassium in children.

Objective:To study the relationship between human leukocyte antigen (HLA) Ⅱ and nuclear factor κB (NF-κB) gene polymorphisms and susceptibility to community-acquired pneumonia in children and the therapeutic effect of amoxicillin clavulanate potassium.Methods:A total of 120 children with community-acquired pneumonia admitted to the Baoding Second Central Hospital from February 2018 to January 2021 were selected as the study objects (observation group). According to the effect of amoxicillin and clavulanate potassium treatment, they were divided into effective group and ineffective group, and 120 healthy children in the same period were selected as the control group. The polymorphisms of HLAⅡ and NF-κB gene were compared between the two groups, and the correlation between the polymorphisms of HLAⅡ and NF-κB gene and the susceptibility of children to community-acquired pneumonia and the therapeutic effect of amoxicillin clavulanate potassium was analyzed.Results:The gene frequency of HLA-DQA1*0201 [86(71.67%) vs 40(33.33%)], HLA-DQA1*0301 [72(60.00%) vs 20(16.67%)] of the observation group was significantly higher than that of the control group, the gene frequency of HLA-DQA1*0401 [30(25.00%) vs 96(80.00%)] was significantly lower than that of control group (all P<0.05). The gene frequency of HLA-DRB1*07 [92(76.67%) vs 48(40.00%)], HLA-DRB1*15 [72(60.00%) vs 40(33.33%)], HLA-DRB1*16 [96(80.00%) vs 76(63.33%)] of the observation group was significantly higher than that of the control group, and the gene frequency of HLA-DRB1*11 [36(30.00%) vs 104(86.67%)] was significantly lower than that of control group (all P<0.05). The expression of 94ins/delATTG*II in the observation group was significantly higher than that in the control group [40(33.33%) vs 24(20.00%), P<0.05]. The gene frequency of HLA-DQA1*0201 [12(38.71%) vs 74(83.15%)], HLA-DQA1*0301 [9(29.03%) vs 63(70.79%)] in the ineffective group was significantly lower than that of the effective group, the gene frequency of HLA-DQA1*0401 [18(58.06%) vs 12(13.48%)] was significantly higher than that of the effective group (all P<0.05). The gene frequency of HLA-DRB1*07 [29(93.55%) vs 63(70.79%)], HLA-DRB1*15 [29(93.55%) vs 43(48.31%)], HLA-DRB1*16 [29(93.55%) vs 67(75.28%)] of the ineffective group was significantly higher than that of the effective group, and the gene frequency of HLA-DRB1*11 [17(54.84%) vs 19(21.35%)] was significantly higher than that of the effective group (all P<0.05). The expression of 94ins/delATTG*II gene in the ineffective group was significantly higher than that in the effective group [15(48.39%) vs 25(28.09%), P<0.05]. Conclusions:Polymorphisms of HLAⅡ and NF-κB genes are associated with susceptibility to community-acquired pneumonia and efficacy of amoxicillin and clavulanate potassium in children.

Objective:To evaluate the efficacy and safety of oral anisodine hydrobromide tablets in the treatment of nonarteritic anterior ischemic optic neuropathy (NAION).Methods:A multicenter nonrandomized controlled trial was conducted.A total of 282 acute NAION patients (282 eyes) were recruited from 16 hospitals in China from July 2020 to May 2021.Patients were divided into two groups according to treatment methods, which were control group (124 cases, 124 eyes) receiving regular treatment including citicoline sodium plus Ginkgo biloba leaf liquid extract or Ginkgo biloba leaf extract tablets plus mecobalamin, and experimental group (158 cases, 158 eyes) receiving treatment in control group plus oral anisodine hydrobromide tablets 1 mg, twice daily for 2 to 3 months.Best corrected visual acuity (BCVA), visual field index (VFI), peripapillary retinal nerve fiber layer (pRNFL) and radial peripapillary capillary vessel density (RPC) were assessed at 1, 2, 3, and 6 months after enrollment using the standard decimal visual acuity chart, 750i Humphery visual field analyzer, Cirrus HD-OCT 4000/Cirrus HD-OCT 5000, RTVue-XR optical coherence tomography respectively.The primary outcomes were BCVA and VFI, and the secondary outcomes were pRNFL, RPC, and the side effects during the follow-up.The study adhered to the Declaration of Helsinki.All patients were fully informed about the treatment and purpose of this study and voluntarily signed the informed consent form.The study protocol was approved by Chinese PLA General Hospital (No.S2020-021-01). Results:In all, 242 patients (242 eyes) completed the follow-up of BCVA, and 98 patients (98 eyes) completed the VFI follow-up.In terms of visual function, BCVA and VFI improved significantly over time in the two groups, and BCVA and VFI were better in experimental group than in control group at various follow-up time points (all at P<0.05). In terms of structure, pRNFL gradually decreased in both groups with the extension of treatment, and pRNFL was significanthy thinner in experimental group than in control group at various follow-up time points (all at P<0.05). There was no significant difference in RPC between the two groups at the last follow-up ( P>0.05). There were two cases with side effects and one case was discontinued due to side effects 25 days after enrollment. Conclusions:Oral anisodine hydrobromide can improve visual acuity and visual field in NAION and accelerate the regression of optic disc edema, with good safety.

Objective:To clarify peripheral Th17 level in SSc patients and its correlation with disease.Methods:Chinese databases CNKI, CBM, Wanfang and VIP, and English databases PubMed, EMBASE, Web of Science, Cochrane Library and Science Direct were searched to collect a case-control study on the content of Th17 cells in peripheral blood of patients with SSc. The papers published when the database was first developed in 25 February 2021. Meta-analysis was conducted using Stata 12.0 software, and I2 and Egger tests were used to evaluate the heterogeneity and publication bias between studies. Results:A total of 26 case-controls were included in the study, including 1 160 patients with SSc and 778 healthy controls. Overall, the percentage of Th17 cells in SSc patients was higher than in healthy controls [SMD(95% CI)=1.85 (1.33, 2.38), P<0.001], which was most significant in IL-17 +Th17 concentration [SMD(95% CI)=1.88 (1.28, 2.48), P<0.001]. As for disease activity, the proportion of Th17 cells in active SSc patients was much higher than those of patients in remission [SMD(95% CI)=1.92 (1.12, 2.71), P<0.001]. SSc patients had a reduced Th17 level after receiving DMARDs treatment [SMD(95% CI)=-0.74 (-1.05, -0.42), P=0.029]. Conclusion:The number of Th17 cells increase significantly in the peripheral blood of patients with SSc, and is related to disease activity. DMARDs can be used to treat this disease by downregulating Th17 levels.

Background: and Purpose Collateral circulation is considered an important factor affecting the risk of stroke, but the factors that affect collateral circulation remain unclear. This study was performed to identify the factors associated with collateral circulation, especially blood lipids. Methods: The study involved patients who had undergone digital subtraction angiography and were confirmed as having severe unilateral stenosis or occlusion of the internal carotid artery (ICA). We classified the collateral circulation status of each patient as good (Grade 3 or 4) or poor (Grade 0, 1, or 2) according to the grading system of the American Society of Interventional and Therapeutic Neuroradiology/American Society of Interventional Radiology. We collected data on patients’ characteristics and identified the factors that affect collateral circulation. Results: This study included 212 patients. The multivariate logistic regression analysis showed that the high-density lipoprotein cholesterol (HDL-C) concentration and a complete anterior half of the circle of Willis were independent protective factors for good collateral circulation, whereas elevated lipoprotein(a) [Lp(a)] and serum creatinine concentrations were independent risk factors for good collateral circulation. The area under the receiver operating characteristics curve (AUC) was 0.68 (95% confidence interval [CI], 0.61–0.76) for HDL-C and 0.69 (95% CI, 0.62–0.76) for Lp(a). A binary logistic regression model analysis of the joint factor of HDL-C and Lp(a) yielded an AUC of 0.77 (95% CI, 0.71–0.84). Conclusions In patients with severe unilateral ICA stenosis or occlusion, the combination of HDL-C and Lp(a) is a useful predictor of collateral circulation.

Neoadjuvant therapy has become the first choice for locally advanced esophageal carcinoma. Patients with post-neoadjuvant positive lymph node staging (ypN+) have poor prognosis, and there is no effective adjuvant therapy. Programmed death protein-1 (PD-1) antibody can obtain better clinical efficacy in the treatment of advanced esophageal cancer. The authors designed a multicenter, prospective, randomized controlled clinical trial of Toripalimab (PD-1 antibody) adjuvant therapy on esophageal squamous cell carcinoma patients with ypN+ after the treatment of neoadjuvant chemotherapy combined with surgical resection, in order to provide clinical practices for the adjuvant treatment of ypN+ patients.