ObjectivePost-ischemic acute inflammation and the subsequent persistent dysregulation of the immune microenvironment represent major pathological drivers that aggravate neuronal injury and severely restrict functional recovery following ischemic stroke. Although current reperfusion therapies partially restore blood flow, they fail to effectively modulate the secondary inflammatory cascade and oxidative stress, which remain critical barriers to neurological restoration. To address this challenge, this study aimed to engineer and systematically evaluate a biomimetic nanosystem composed of transforming growth factor-β1 (TGF-β1)-loaded platelet membrane-camouflaged lipid nanoparticles (PLP). This nanosystem was designed to achieve dual lesion-targeted delivery and immune microenvironment remodeling. By verifying its spatiotemporal accumulation, anti-inflammatory activity, and neuroprotective efficacy, we sought to establish an integrated therapeutic strategy that simultaneously enables lesion targeting, immune regulation, and functional recovery after ischemic injury. MethodsThe physicochemical properties of PLP, including hydrodynamic particle size, zeta potential, structural stability, and morphology, were characterized using dynamic light scattering, zeta potential analysis, and transmission electron microscopy. The preservation of platelet membrane-derived adhesion and immunoregulatory proteins was confirmed by SDS-PAGE through comparative analysis of protein band profiles between PLP and native platelet membranes. The in vitro biological activities of PLP were evaluated using two complementary cellular models. LPS-induced M1-polarized RAW264.7 macrophages were employed to assess inflammatory modulation, while oxygen glucose deprivation/reperfusion (OGD/R)-induced BV2 microglial cells and SH-SY5Y neuronal cells were utilized to investigate neuroinflammatory regulation and neuronal protection. For in vivo validation, a transient middle cerebral artery occlusion (tMCAO) mouse model was established to mimic ischemia-reperfusion injury. The spatiotemporal biodistribution and lesion-targeting capability of the PLP were monitored through live fluorescence imaging. Therapeutic efficacy was comprehensively evaluated by triphenyltetrazolium chloride (TTC) staining, glial fibrillary acidic protein (GFAP) immunofluorescence analysis, body weight monitoring, and neurological severity score (NSS) assessment. ResultsPLP nanoparticles displayed a uniform spherical morphology, nanoscale particle size distribution, and stable negative surface charge, indicating favorable colloidal stability and circulation potential. SDS-PAGE results confirmed the effective retention of key platelet membrane proteins associated with endothelial adhesion, immune evasion, and inflammatory regulation, demonstrating the successful biomimetic construction. Optimal therapeutic concentrations were determined in OGD/R-induced BV2 cells, where PLP exhibited excellent cytocompatibility and anti-inflammatory activity.In vitro experiments demonstrated that PLP significantly inhibited the polarization of RAW264.7 macrophages toward the pro-inflammatory M1 phenotype and markedly reduced neuronal apoptosis under ischemia-reperfusion conditions. In vivo fluorescence imaging revealed that PLP rapidly accumulated in the ischemic brain hemisphere and maintained prolonged retention for up to 7 d, suggesting enhanced lesion-specific targeting and sustained drug release. Compared with control group, PLP treatment significantly reduced cerebral infarct volume, attenuated reactive astrogliosis, improved weight recovery, and accelerated neurological functional restoration, as reflected by significantly improved NSS scores. ConclusionThis study establishes a multifunctional biomimetic nanoplatform that integrates platelet membrane-mediated active targeting with the anti-inflammatory, antioxidative, and neuroprotective properties of TGF-β1. The PLP system enables rapid lesion homing and long-term retention while synergistically regulating the post-stroke inflammatory microenvironment by suppressing pro-inflammatory immune activation, reducing neuronal apoptosis, and limiting excessive astrocyte reactivity. Importantly, this study proposes a conceptually therapeutic paradigm that combines targeted delivery with immune microenvironment remodeling to achieve comprehensive neurovascular protection. These findings provide strong experimental evidence supporting the translational potential of biomimetic nanotherapeutics as next-generation precision interventions for ischemic stroke.

Background: High-mobility group box protein 1 (HMGB1) is a chromatin-binding protein involved in arthritis, ischemia, sepsis, atherosclerosis, neurodegenerative disorders, meningitis, and cancer. HMGB1 exhibits dual roles in cancer, acting as either a tumor suppressor or oncoprotein depending on context. Objective: This research aimed to elucidate HMGB1’s functional significance in cutaneous squamous cell carcinoma (cSCC). Methods: We overexpressed HMGB1 in cSCC cell lines using recombinant adenovirus and examined its effects on cell proliferation, colony formation, and cell migration. Results: Immunohistochemical analysis revealed elevated HMGB1 expression levels in cSCC tissue relative to normal epidermis. To assess the influence of HMGB1, we employed recombinant adenoviruses expressing HMGB1 to transduce SCC cell lines (SCC12 and SCC13). Enhanced HMGB1 expression significantly promoted cellular proliferation and colony formation capacity.Notably, HMGB1 overexpression elevated the levels of proliferation regulators, including P63, SOX2, CDK4 and CDK6. Furthermore, HMGB1 overexpression substantially enhanced tumor invasiveness, accompanied by upregulation of epithelial-mesenchymal transition (EMT) biomarkers. Mechanistically, overexpression of HMGB1 enhanced transforming growth factor-β signaling by increasing phosphorylation of SMAD2/3, the key mediators of EMT. Conclusion These data imply that HMGB1 acts as a tumor-promoting factor in cSCC.

Objective To analyze the global burden of occupational noise-induced hearing loss (ONHL) from 1990 to 2021 and to predict its trends for 2025 to 2035. Methods Data on disability-adjusted life years (DALYs), age-standardized DALYs rates, and summary exposure values for ONHL were extracted from the Global Burden of Disease database. An age-period-cohort model was used to assess age, period, and cohort effects. Joinpoint regression was applied to calculate the annual percentage change in ASDRs. An autoregressive integrated moving average (ARIMA) model was employed to forecast DALY trends from 2025 to 2035. Results Global DALYs attributable to ONHL increased from 3.838 1 million person-years in 1990 to 7.847 4 million person-years in 2021, representing a 104.46% increase. DALYs attributable to ONHL increased by 64.93%, 94.30%, 111.51%, 114.64%, and 129.08% in high-, high-middle-, middle-, low-middle-, and low-Socio-demographic Index (SDI) regions, respectively. DALYs counts were consistently higher in males than in females. DALYs counts peaked in the older age group (60-64 years), whereas the DALYs rate of peaked in the older age group (70-74 years). Age-period-cohort model analysis revealed significant overall age effects in all five SDI regions (all P<0.01). There were a significant overall period and cohort effects in the high-middle SDI region (all P<0.01), but not in the other regions (all P>0.05). The ARIMA model projected that global DALYs due to ONHL would reach 9.650 0 million person-years by 2035, an increase of 22.97% compared with 2021, with the largest increase expected among individuals aged 55-59 years. Conclusion The global burden of ONHL has continuously increased from 1990 to 2021, particularly among male workers in low-SDI regions. This burden is expected to continue rising over the next decade.

Objective: To explore the association between executive function and emotional and behavioral problems in first-grade elementary school students, so as to provide a reference for promoting children s mental health. Methods: From March to May 2024, 423 first-grade elementary school students from 6 primary schools aged 6-7 were selected by using stratified cluster random sampling in Shanxi, Shanghai, Shandong, Guangxi, Xinjiang, and Jiangxi. Data were collected by using the Executive Function Assessment Scale and the Strengths and Difficulties Questionnaire. An independent samples t-test was used to analyze differences in executive function of different genders and differences in emotional and behavioral problems among first-grade school students with varying executive function levels; a linear regression model was employed to analyze the association between children s executive function and emotional and behavioral problems. Results: A total of 42 first-grade elementary school students (9.9%) were identified as having executive function deficits. Students in the executive function deficit group scored higher on internalizing behavior (7.50±0.52), externalizing behavior (11.26±0.52), and total difficulties (18.52± 0.93 ) were significantly higher than those of children without deficits (4.37±0.14, 6.69±0.17, 10.64±0.27) ( t =5.79, 8.50, 9.23, all P <0.05). Results of linear regression analysis showed that, after controlling for relevant covariates such as gender, age, family economic status, being an only child, and body mass index, the factor scores, dimensional scores, and total scores of executive function were all positively correlated with scores for externalizing problems, internalizing problems, and total difficulties ( β =0.07-0.32, all P <0.05). Conclusions Children s executive function is closely associated with emotional and behavioral problems, and those with poorer executive function exhibit more pronounced emotional and behavioral problems. Improving children s executive function may help promote their mental health.

This consensus was developed by the Orthodontic Society of the Chinese Stomatological Association to provide a systematic, scientific, and practical guideline for informed consent in orthodontic care. Orthodontic treatment is typically lengthy, highly individualized, and involves multiple factors such as growth and development, occlusal function, and facial esthetics. Rapid technological advances and diverse risk profiles make the traditional reliance on orthodontist experience or institutional templates insufficient to ensure patients′ full understanding and autonomous decision-making. To address this, the expert panel conducted extensive reviews of domestic and international guidelines, analyzed representative dispute cases, and performed multicenter patient-clinician surveys. Using a multi-round Delphi method, the group established a standardized informed consent framework covering the initial consultation, treatment, and retention phases. The consensus emphasizes that informed consent is not only a fundamental legal and ethical requirement but also a key step in building trust, improving patient compliance, and enhancing treatment satisfaction. Orthodontists should clearly and comprehensively explain treatment plans, potential risks, uncertainties, and associated costs, while respecting the autonomy of patients or guardians, and maintain continuous communication and dynamic evaluation throughout the treatment process. The release of this consensus provides unified and authoritative guidance for clinical orthodontics, helping to standardize informed consent, enhance its transparency, safeguard patient rights, reduce medical risks, and promote high-quality, sustainable development of orthodontic practice.

Objective To design a dynamic monitoring platform for mastering the changes of outpatient service in public tertiary grade A hospitals.Methods An outpatient dynamic monitoring platform was designed with B/S architecture and developed with Java platform,which used Oracle 11g database for data storage and hypertext transfer protocol encapsulated as WebAPI to realize data transmission with systems.There were five functional modules involved in the platform for patient flow monitoring,doctor attendance monitoring,public service monitoring,outpatient medical staff communication and data storage and analysis for decision making.Results The platform developed realized comprehensive monitoring and closed-loop management of the outpatient department,and enhanced the quality and efficiency of patient service.Conclusion The platform developed solves the problems of outpatient management in terms of monitoring and early warning,personnel communication and assisted decision making,and improves outpatient management in intellectualization and automation.[Chinese Medical Equipment Journal,2025,46(5):39-47]

Objective:To evaluate the role of spinal serum and glucocorticoid-inducible kinase 1(SGK-1)/Kalirin-7/N-methyl-D-aspartate receptor 2B(NR2B) signaling pathway in the type 2 diabetic neuropathic pain(DNP) in rats.Methods:Clean-grade male Sprague-Dawley rats, aged 6 weeks, weighing 120-160 g, were randomized to receive a normal diet(normal control group [group C, n=12]) or a high-fat and high-glucose diet( n=60). Diabetes mellitus was induced by single intraperitoneal injection of streptozotocin 35 mg/kg after 8 weeks of a high-fat and high-glucose diet. The successful DNP model was defined as a decrease in the pain threshold(mechanical paw withdrawal threshold [MWT] and thermal paw withdrawal latency [TWL]) to less than 85% of the baseline value in type 2 diabetic rats. Twelve non-DNP(pain threshold above 85% of the baseline value) rats with type 2 diabetes mellitus were randomly selected and included in non-DNP group(NDNP group). Thirty-six rats with DNP were divided into 3 groups( n=12 each) using a random number table method: DNP group, DNP plus SGK1 inhibitor GSK-650394 group(DNP+ G group), and DNP plus solvent control group(DNP+ SC group). At day 14 after STZ injection, GSK-650394(10 μl) 300 nmol/L was intrathecally injected once a day for 14 consecutive days in DNP+ G group. DNP group did not receive any treatment, and the rats in DNP+ SC group received intrathecal injection of the equal volume of dimethyl sulfoxide. The MWT and TWL were measured after 8 weeks of feeding, at 14 days after STZ injection, and at 3, 7 and 14 days after intrathecal injection(at 17, 21 and 28 days after STZ injection). After 7 days of intrathecal injection, the lumbar enlargement tissues of the spinal cord were collected for determination of the expression of SGK-1, phosphorylated SGK-1(Ser422-SGK1), Kalirin-7, phosphorylated NR2B(Tyr1472-NR2B), and NR2B by Western blot. The ratios of Ser422-SGK1 to SGK1 and Tyr1472-NR2B to NR2B were calculated. Results:Compared with C group, the MWT was significantly decreased and TWL was shortened at 14 days after STZ injection and at the corresponding time points of intrathecal injection, and the ratios of spinal Ser422-SGK1 to SGK1 and Tyr1472-NR2B to NR2B were increased, and the expression of Kalirin-7 was up-regulated in DNP group( P<0.05), and no statistically significant change was found in the aforementioned parameters in NDNP group( P>0.05). Compared with DNP group, the MWT was significantly increased and TWL was prolonged at 3, 7 and 14 days of intrathecal injection, the ratios of Ser422-SGK1 to SGK1 and Tyr1472-NR2B to NR2B in the spinal cord tissue were decreased, Kalirin-7 expression was down-regulated( P<0.05), and no statistically significant differences were found in the aforementioned parameters in DNP+ SC group( P>0.05). Conclusions:The enhanced phosphorylation of SGK-1 in the spinal cord of DNP rats may play an important role in the occurrence and maintenance of DNP probably by activating the Kalirin-7/NR2B signaling pathway.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

AIM:To evaluate the effects of liposo-mal bupivacaine for interscalene brachial plexus block on postoperative analgesia and diaphragmat-ic function in patients undergoing arthroscopic ro-tator cuff repair surgery based on a randomized controlled trial.METHODS:Forty patients who scheduled to undergo arthroscopic rotator cuff re-pair surgery,regardless of gender,aged 18 to 65 years,ASA grade Ⅰ or Ⅱ were selected from October 2023 to February 2024.The patients were random-ly divided into bupivacaine liposome group(group LB)and the levobupivacaine group(group BV),with 20 cases in each group.Patients in both groups re-ceived an ultrasound-guided interscalene brachial plexus block,15 mL mixed liquids(bupivacaine lipo-some 10 mL+0.5％levobupivacaine 10 mL)were in-jected into the level of C5-C6 nerve roots and 5 mL onto the surface of prevertebral fascia in the LB group,and same volume of 0.375％levobupiva-caine were injected at the same sites in the BV group respectively.Standardized general anesthe-sia and standardized postoperative analgesia were followed.The primary outcome measures included 48 h rest/motor numerical rating scale(NRS)scores after surgery and the incidence of hemidiaphrag-matic paralysis(HDP)after block.The secondary outcome measures included rest/motor NRS scores at other time points after surgery,pulse oxygen sat-uration(SpO2)30 min after block,duration of sen-sory and motor block,number of analgesic pump presses,time of first postoperative used of opioid drugs and opioid consumption,use of additional analgesics in the wards,satisfaction with analgesia,and the occurrence of perioperative adverse ef-fects and neurological complications.RESULTS:Compared with group BV,patients in LB group showed lower rest NRS scores at 48 h postopera-tion(P＜0.05)and higher incidence of HDP at 24 h after block(45％vs.5.3％,P＜0.05).However,there was no significant difference in motor NRS scores at 48 h,HDP incidence at 30 min and 6 h after block between the two groups(P＞0.05).Both groups showed a decrease in SpO2 after block com-pared to before block(P＜0.05).Compared with BV group,patients in LB group had a significantly lon-ger duration of sensory and motor block(P＜0.01),fewer effective presses with the analgesic pump(P＜0.01),delay in first opioid use and less opioid con-sumption(P＜0.05),higher level of satisfaction with analgesia(P＜0.01),and a lower rate of use of addi-tional analgesics in the ward(P＜0.05).There was no statistically significant difference in the total in-traoperative remifentanil consumption,incidence of perioperative adverse reactions and neurological complication between the two groups(P＞0.05).CONCLUSION:Compared with using levobupiva-caine alone,the addition of liposomal bupivacaine for interscalene brachial plexus block in arthroscop-ic rotator cuff repair can reduce postoperative NRS scores,decrease postoperative opioid dosage and significantly prolong blockduration,but can easily lead to longer duration of HDP in patients.