Hepatic sinusoidal capillarization is the first event in the process of fibrogenesis， and inhibiting hepatic sinusoidal capillarization can effectively improve the pathological process of liver fibrosis. Various studies have shown that traditional Chinese medicine can significantly inhibit hepatic sinusoidal capillarization. This article systematically reviews the effective constituents， monomers， and compound prescriptions of traditional Chinese medicine， summarizes their mechanism of action in inhibiting hepatic sinusoidal capillarization， and analyzes the theoretical core of traditional Chinese medicine in inhibiting hepatic sinusoidal capillarization from the perspective of traditional Chinese medicine， in order to provide ideas and literature support for the treatment of liver fibrosis.

Objective:To investigate optimal treatment strategy for pT3N0 laryngeal squamous cell carcinoma（SCC）. Methods:A retrospective study of 150 patients with pT3N0 laryngeal SCC treated in the First Affiliated Hospital of Chongqing Medical University was performed. The efficacies of partial laryngectomy and total laryngectomy, as well as surgery alone and postoperative radiotherapy were evaluated. The overall survival（OS）, disease specific survival（DSS） and disease-free survival（DFS） were analyzed with statistical package from SPSS. Results:Among the 108 patients with glottic laryngeal SCC, there were no significant differences in OS, DSS and DFS between the partial laryngectomy group and the total laryngectomy group（Log-rank=0.184, 0.010 and 0.051, P>0.05）. Similarly, there were no significant differences in OS, DSS and DFS between the surgery-alone group and postoperative radiotherapy group（Log-rank=0.214, 0.251 and 0.003, P>0.05）. Among the 38 patients with supraglottic laryngeal SCC, the OS in the total laryngectomy group was significantly higher than that in the partial laryngectomy group（Log-rank=7.338, P=0.007）. The DSS and DFS in the total laryngectomy group were higher than in the partial laryngectomy group, but the differences were not statistically significant（Log-rank=0.895 and 1.792; P>0.05）. The DFS in the postoperative radiotherapy group was significantly higher than in the surgery-alone group（Log-rank=7.172, P=0.007）, but there were no significant differences in OS and DSS between these two groups（Log-rank=0.010 and 0.876, P>0.05）. Conclusion:For pT3N0 glottic laryngeal cancer patients, the efficacy of partial laryngectomy is comparable to total laryngectomy, same as surgery alone and postoperative radiotherapy. For pT3N0 supraglottic laryngeal cancer patients, total laryngectomy could improve the overall survival, and postoperative radiotherapy could reduce the recurrence. Prospectively randomized study with large samples is still needed.
Humans ; Laryngeal Neoplasms/therapy* ; Laryngectomy/methods* ; Retrospective Studies ; Carcinoma, Squamous Cell/surgery* ; Male ; Female ; Middle Aged ; Disease-Free Survival ; Neoplasm Staging ; Aged ; Survival Rate ; Treatment Outcome

Photodynamic immunotherapy is a promising strategy for cancer treatment. However, the dysfunctional tumor vasculature results in tumor hypoxia and the low efficiency of drug delivery, which in turn restricts the anticancer effect of photodynamic immunotherapy. In this study, we designed photosensitive lipid nanoparticles. The synthesized PFBT@Rox Lip nanoparticles could produce type I/II reactive oxygen species (ROS) by electron or energy transfer through PFBT under light irradiation. Moreover, this nanosystem could alleviate tumor hypoxia and promote vascular normalization through Roxadustat. Upon irradiation with white light, the ROS produced by PFBT@Rox Lip nanoparticles in situ dysregulated calcium homeostasis and triggered endoplasmic reticulum stress, which further promoted the release of damage-associated molecular patterns, enhanced antigen presentation, and stimulated an effective adaptive immune response, ultimately priming the tumor microenvironment (TME) together with the hypoxia alleviation and vessel normalization by Roxadustat. Indeed, in vivo results indicated that PFBT@Rox Lip nanoparticles promoted M1 polarization of tumor-associated macrophages, recruited more natural killer cells, and augmented infiltration of T cells, thereby leading to efficient photodynamic immunotherapy and potentiating the anti-primary and metastatic tumor efficacy of PD-1 antibody. Collectively, photodynamic immunotherapy with PFBT@Rox Lip nanoparticles efficiently program TME through the induction of immunogenicity and oxygenation, and effectively suppress tumor growth through immunogenic cell death and enhanced anti-tumor immunity.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

AIM: To observe the changes of corneal densitometry(CD)and higher-order aberrations after small incision lenticule extraction(SMILE), and to explore their correlations and influencing factors.METHODS: Prospective study. A total of 62 high-degree myopia and compound myopic astigmatism patients(62 eyes)who underwent SMILE in Urumqi Aier Eye Hospital from December 2022 to November 2023 were collected. The CD, root mean square of corneal higher-order aberrations(RMS HOA), spherical aberration, vertical coma, horizontal coma, and corneal epithelial thickness(CET)of the patients were measured before surgery, and at 1 d, 1 wk, 1, 3, and 6 mo after surgery, respectively.RESULTS:There were 4 patients lost to follow-up during the period, all due to failure to attend scheduled reexaminations. The number of complete and valid cases was 58 eyes. The CD in the central and paracentral regions of the anterior, middle, and total layer of the cornea increased significantly on the first day after surgery(all P<0.003). At 6 mo after surgery, there was a slight but statistically significant decrease in the CD of the central and paracentral regions of the anterior and the total anterior layer(all P<0.003). Compared with the preoperative baseline values, the RMS HOA, spherical aberration, and vertical coma significantly increased at 6 mo after surgery(all P<0.003), while the change in horizontal coma was not statistically significant. Compared with the preoperative baseline values, the CET in the central, paracentral, and peripheral regions of the cornea, as well as the total average CET in the 0-7 mm range of the cornea increased at 6 mo after surgery(all P<0.003). At 1 d after surgery, CD of the anterior layer and total layer in the central region of the cornea were positively correlated with the CET in the central region(rs=0.327, rs=0.250, all P<0.05). At 6 mo after the surgery, the CD of the middle layer and posterior layer in the central corneal region were negatively correlated with the preoperative spherical equivalent and the change of RMS HOA(all P<0.05).CONCLUSION:The anterior CD decreases at 6 mo after SMILE for high myopia correction, and there is a certain correlation between the changes in CD and some clinical parameters.

Knee osteoarthritis is a common joint disease within osteoarthritis,characterized by pain,swelling,and limited functionality as the main clinical manifestations.In severe cases,it affects daily life and falls under the category of"impediment syndrome"or"bone impediment"in TCM.The author believes that the theory of"bones,tendons,and muscles"is closely related to this disease.Treatment should focus on simultaneously nourishing the liver,spleen and kidneys,considering tendons,bones and muscles,while also dispelling wind,cold and dampness.The clinical application of Sanbi Decoction has shown good efficacy,and this discussion aimed to provide ideas for the diagnosis and treatment of knee osteoarthritis.

Objective:To evaluate the diagnostic efficacy of conventional ultrasound combined with contrast-enhanced ultrasound (CEUS) for detecting cervical lymph node metastasis in head and neck squamous cell carcinoma (HNSCC).Methods:This retrospective case control study included 259 patients (249 males and 10 females,aged 40-88 years with a median age of 63 years) who were pathologically diagnosed with HNSCC at the First Affiliated Hospital of Chongqing Medical University from April 2022 to August 2024. A total of 259 lymph nodes were assessed(78 pathologically positive nodes and 181 pathologically negative ones). Receiver operating characteristic (ROC) curves were plotted to compare the diagnostic efficacies of conventional ultrasound combined with CEUS and CT, MRI, or conventional ultrasound for cervical lymph node metastasis. Patients were randomly assigned to a training group ( n=208) and a validation group ( n=51) (8∶2). Univariate and multivariate Logistic regression were used to analyze the independent risk factors for lymph node metastasis prediction. A nomogram model was constructed based on independent risk factors. The model predictive efficacy was assessed by ROC curve, and model′s fit was evaluated by Hosmer-Lemeshow test. Results:The area under the curve (AUC) for conventional ultrasound combined with CEUS in predicting cervical lymph node metastasis in HNSCC was 0.923 (95% CI: 0.880-0.965), which was significantly higher than those for enhanced CT, cervical enhanced MRI, and conventional ultrasound [AUC were 0.820 (95% CI: 0.753-0.886), 0.802 (95% CI: 0.737-0.866), and0.836 (95% CI: 0.774-0.899), respectively].There were no statistically significant differences in clinical data between the two groups (all P>0.05). Univariate Logistic regression analysis showed that, among contrast-enhanced ultrasound features, the centripetal perfusion pattern, irregular perfusion defect type, and uneven distribution of contrast agent were significantly associated with cervical lymph node metastasis (all P<0.05). Among conventional ultrasound features, L/S ratio≤1.5, heterogeneous internal echoes, uneven cortex thickening, blurred corticomedullary boundary, loss of lymphatic gate structure, and peripheral or mixed type on color Doppler flow imaging were significantly associated with cervical lymph node metastasis (all P<0.05). Multivariate Logistic regression analysis indicated that the centripetal perfusion pattern, heterogeneous internal echoes, and uneven cortical thickening were independent risk factors for cervical lymph node metastasis (all P<0.05). A nomogram model was constructed based on the above independent risk factors, and offered an AUC of 0.933 (95% CI:0.890-0.976) in the training group, which was significantly higher than that for enhanced CT, enhanced MRI, conventional ultrasound, and conventional ultrasound combined with CEUS [AUC were 0.818 (95% CI:0.747-0.890), 0.807 (95% CI:0.739-0.875), 0.842 (95% CI: 0.777-0.908), and 0.921 (95% CI:0.876-0.967), respectively]. In the validation group, the AUC was 0.866 (95% CI:0.703-1.000), which was higher than that for cervical enhanced CT, enhanced MRI, and conventional ultrasound [AUC were 0.820 (95% CI:0.613-1.000), 0.711 (95% CI:0.478-0.943), and 0.748 (95% CI:0.515-0.982), respectively]. Conclusion:The combination of conventional ultrasound and CEUS has significant clinical application value in predicting cervical lymph node metastasis in HNSCC.

Objective:To evaluate the diagnostic efficacy of conventional ultrasound combined with contrast-enhanced ultrasound (CEUS) for detecting cervical lymph node metastasis in head and neck squamous cell carcinoma (HNSCC).Methods:This retrospective case control study included 259 patients (249 males and 10 females,aged 40-88 years with a median age of 63 years) who were pathologically diagnosed with HNSCC at the First Affiliated Hospital of Chongqing Medical University from April 2022 to August 2024. A total of 259 lymph nodes were assessed(78 pathologically positive nodes and 181 pathologically negative ones). Receiver operating characteristic (ROC) curves were plotted to compare the diagnostic efficacies of conventional ultrasound combined with CEUS and CT, MRI, or conventional ultrasound for cervical lymph node metastasis. Patients were randomly assigned to a training group ( n=208) and a validation group ( n=51) (8∶2). Univariate and multivariate Logistic regression were used to analyze the independent risk factors for lymph node metastasis prediction. A nomogram model was constructed based on independent risk factors. The model predictive efficacy was assessed by ROC curve, and model′s fit was evaluated by Hosmer-Lemeshow test. Results:The area under the curve (AUC) for conventional ultrasound combined with CEUS in predicting cervical lymph node metastasis in HNSCC was 0.923 (95% CI: 0.880-0.965), which was significantly higher than those for enhanced CT, cervical enhanced MRI, and conventional ultrasound [AUC were 0.820 (95% CI: 0.753-0.886), 0.802 (95% CI: 0.737-0.866), and0.836 (95% CI: 0.774-0.899), respectively].There were no statistically significant differences in clinical data between the two groups (all P>0.05). Univariate Logistic regression analysis showed that, among contrast-enhanced ultrasound features, the centripetal perfusion pattern, irregular perfusion defect type, and uneven distribution of contrast agent were significantly associated with cervical lymph node metastasis (all P<0.05). Among conventional ultrasound features, L/S ratio≤1.5, heterogeneous internal echoes, uneven cortex thickening, blurred corticomedullary boundary, loss of lymphatic gate structure, and peripheral or mixed type on color Doppler flow imaging were significantly associated with cervical lymph node metastasis (all P<0.05). Multivariate Logistic regression analysis indicated that the centripetal perfusion pattern, heterogeneous internal echoes, and uneven cortical thickening were independent risk factors for cervical lymph node metastasis (all P<0.05). A nomogram model was constructed based on the above independent risk factors, and offered an AUC of 0.933 (95% CI:0.890-0.976) in the training group, which was significantly higher than that for enhanced CT, enhanced MRI, conventional ultrasound, and conventional ultrasound combined with CEUS [AUC were 0.818 (95% CI:0.747-0.890), 0.807 (95% CI:0.739-0.875), 0.842 (95% CI: 0.777-0.908), and 0.921 (95% CI:0.876-0.967), respectively]. In the validation group, the AUC was 0.866 (95% CI:0.703-1.000), which was higher than that for cervical enhanced CT, enhanced MRI, and conventional ultrasound [AUC were 0.820 (95% CI:0.613-1.000), 0.711 (95% CI:0.478-0.943), and 0.748 (95% CI:0.515-0.982), respectively]. Conclusion:The combination of conventional ultrasound and CEUS has significant clinical application value in predicting cervical lymph node metastasis in HNSCC.

Knee osteoarthritis is a common joint disease within osteoarthritis,characterized by pain,swelling,and limited functionality as the main clinical manifestations.In severe cases,it affects daily life and falls under the category of"impediment syndrome"or"bone impediment"in TCM.The author believes that the theory of"bones,tendons,and muscles"is closely related to this disease.Treatment should focus on simultaneously nourishing the liver,spleen and kidneys,considering tendons,bones and muscles,while also dispelling wind,cold and dampness.The clinical application of Sanbi Decoction has shown good efficacy,and this discussion aimed to provide ideas for the diagnosis and treatment of knee osteoarthritis.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.