ObjectiveTo observe the effect of Shenshu Fujian decoction on platelet-derived growth factor （PDGF）/naked cuticle homolog 2 （NKD2） /Wnt signaling pathway in rats with chronic renal failure （CRF）. MethodsSixty male SD rats were randomly divided into normal group， model group， Niaoduqing group （5 g·kg^-1）， low-dose Shenshu Fujian decoction group （5.5 g·kg^-1）， medium-dose Shenshu Fujian decoction group （11 g·kg^-1）， and high-dose Shenshu Fujian decoction group （22 g·kg^-1）， with 10 rats in each group. A CRF rat model was established by feeding a 0.5% adenine diet for 21 days. After successful modeling， intragastric administration was given once daily for 28 consecutive days. After treatment， the renal morphology of rats was observed. Serum creatinine （SCr） and blood urea nitrogen （BUN） levels were detected. Hematoxylin-eosin （HE） staining and Masson staining were used to detect renal histopathological changes， and collagen volume fraction （CVF） was calculated. Serum levels of inflammatory markers interleukin （IL）-1β and IL-6 were measured using enzyme-linked immunosorbent assay （ELISA）. The expressions of fibronectin 1 （FN1）， type Ⅰ collagen （ColⅠ）， α-smooth muscle actin （α-SMA）， platelet-derived growth factor receptor-β （PDGFR-β）， NKD2， dishevelled protein 2 （DVL2） and β-catenin in renal tissue were detected by immunohistochemistry and Western blot. ResultsCompared with the normal group， the model group showed significant renal pathological changes， a markedly increased kidney weight/body weight ratio （P<0.01）， significantly elevated CVF （P<0.01）， and notably increased serum levels of SCr， BUN， IL-1β， and IL-6 （P<0.01）. Expression levels of FN1， ColⅠ， α-SMA， PDGFR-β， NKD2， DVL2， and β-catenin in renal tissue were also significantly increased （P<0.01）. Compared with the model group， all treatment groups showed significantly decreased kidney weight/body weight ratios and CVF （P<0.01）， as well as markedly decreased serum SCr， BUN， IL-1β， and IL-6 levels. Protein expression levels of FN1， ColⅠ， α-SMA， PDGFR-β， NKD2， DVL2， and β-catenin in renal tissue were decreased， with more pronounced effects observed in the Niaoduqing， medium-dose， and high-dose Shenshu Fujian decoction groups （P<0.05， P<0.01）. ConclusionShenshu Fujian decoction improves renal function， reduces inflammation， and reverses renal fibrosis in CRF rats， possibly by downregulating the expression of PDGF/NKD2/Wnt signaling pathway-related proteins.

Objective: To investigate the protective effects and underlying mechanisms of sodium pyruvate (SP) on RBC storage lesions using an oxidative damage model. Methods: Six units of leukocyte-depleted suspended RBCs (discarded for non-infectious reasons within three days post-collection) were randomly assigned to four groups: negative control (NS), positive control (PS), experimental group 1 (SP1), and experimental group 2 (SP2). Oxidative stress was induced in the PS group by the addition of hydrogen peroxide (H O ), while SP1 and SP2 received SP supplementation at different concentrations (25 mM and 50 mM, respectively) in the presence of H O . After 1 hour of incubation, RBC morphology was assessed microscopically, and biochemical indicators including glutathione (GSH), malondialdehyde (MDA), methemoglobin (MetHb), adenosine triphosphate (ATP), and Na /K -ATPase activity were measured. Results: RBCs in the PS group exhibited pronounced morphological damage, including cell shrinkage and echinocyte formation, whereas both SP-treated groups showed significantly reduced structural injury. SP treatment led to elevated GSH levels and decreased concentrations of MDA and MetHb, suggesting attenuation of oxidative stress. Additionally, SP enhanced intracellular ATP levels and Na /K -ATPase activity, thereby contributing to membrane stability. Notably, the SP2 group (50 mM) demonstrated superior protective effects compared to SP1 (25 mM). Conclusion: Sodium pyruvate effectively attenuates oxidative storage lesions in RBCs, primarily through its antioxidant properties, energy metabolism supporting ability, and celluar membrane stabilizing function. These findings suggest SP as a promising additive for enhancing the quality and safety of stored RBCs.

ObjectiveTo study the tumor inhibition and T helper cell （Th）1/Th2 balance regulation effect of modified Wenyang Sanjie prescription on lung cancer tumor-bearing mice and to elaborate its mechanism. MethodsA mouse model bearing a lung cancer tumor was established by subcutaneous injection of Lewis lung cancer cells into the armpit and was randomly divided into lung cancer model group， low-dose， medium-dose， and high-dose groups of modified Wenyang Sanjie prescription， and positive control group， with 12 mice per group. The low-dose， medium-dose， and high-dose groups of modified Wenyang Sanjie prescription were given modified Wenyang Sanjie prescription by dosing at 2.5， 5， 10 g·kg^-1， once a day， respectively. The positive control group was intraperitoneally injected with cisplatin （2 mg·kg^-1）， once every other day， for a total of 30 days. Serum interferon （IFN）-γ， interleukin （IL）-2， IL-4， IL-6， and IL-10 were determined by enzyme-linked immunosorbent assay （ELISA）， and spleen index， thymus index， and tumor growth inhibition rate were calculated. Tumor microvascular density was determined by immunohistochemistry， and tumor hypoxia inducible-factor （HIF）-1α， epidermal growth factor receptor （EGFR）， and vascular endothelial growth factor （VEGF） mRNA were determined by Real-time quantitative polymerase chain reaction （PCR）. The protein levels of HIF-1α， EGFR， and VEGF were determined by Western blot. ResultsCompared with lung cancer model group， IFN-γ and IL-2 were increased in the modified Wenyang Sanjie prescription groups and positive control group， while IL-4， IL-6， IL-10， spleen index， thymus index， tumor weight， and tumor microvascular density were decreased， as well as HIF-1α， EGFR， and VEGF mRNA and protein levels （P<0.05）. Compared to the low-dose group of modified Wenyang Sanjie prescription， IFN-γ and IL-2 were increased in the medium-dose and high-dose groups of modified Wenyang Sanjie prescription， while IL-4， IL-6， IL-10， spleen index， thymus index， tumor weight， and tumor microvascular density were decreased， as well as HIF-1α， EGFR， and VEGF mRNA and protein levels （P<0.05）. IFN-γ and IL-2 were increased in the high-dose group of modified Wenyang Sanjie prescription compared to the medium-dose group of modified Wenyang Sanjie prescription， and IL-4， IL-6， IL-10， spleen index， thymus index， tumor weight， and tumor microvascular density were decreased， as well as HIF-1α， EGFR， and VEGF mRNA and protein levels （P<0.05）. ConclusionModified Wenyang Sanjie prescription can significantly inhibit microangiogenesis， regulate Th1/Th2 balance， inhibit tumor growth， and significantly inhibit the progression of lung cancer in mice.

ObjectiveTo study the tumor inhibition and T helper cell （Th）1/Th2 balance regulation effect of modified Wenyang Sanjie prescription on lung cancer tumor-bearing mice and to elaborate its mechanism. MethodsA mouse model bearing a lung cancer tumor was established by subcutaneous injection of Lewis lung cancer cells into the armpit and was randomly divided into lung cancer model group， low-dose， medium-dose， and high-dose groups of modified Wenyang Sanjie prescription， and positive control group， with 12 mice per group. The low-dose， medium-dose， and high-dose groups of modified Wenyang Sanjie prescription were given modified Wenyang Sanjie prescription by dosing at 2.5， 5， 10 g·kg^-1， once a day， respectively. The positive control group was intraperitoneally injected with cisplatin （2 mg·kg^-1）， once every other day， for a total of 30 days. Serum interferon （IFN）-γ， interleukin （IL）-2， IL-4， IL-6， and IL-10 were determined by enzyme-linked immunosorbent assay （ELISA）， and spleen index， thymus index， and tumor growth inhibition rate were calculated. Tumor microvascular density was determined by immunohistochemistry， and tumor hypoxia inducible-factor （HIF）-1α， epidermal growth factor receptor （EGFR）， and vascular endothelial growth factor （VEGF） mRNA were determined by Real-time quantitative polymerase chain reaction （PCR）. The protein levels of HIF-1α， EGFR， and VEGF were determined by Western blot. ResultsCompared with lung cancer model group， IFN-γ and IL-2 were increased in the modified Wenyang Sanjie prescription groups and positive control group， while IL-4， IL-6， IL-10， spleen index， thymus index， tumor weight， and tumor microvascular density were decreased， as well as HIF-1α， EGFR， and VEGF mRNA and protein levels （P<0.05）. Compared to the low-dose group of modified Wenyang Sanjie prescription， IFN-γ and IL-2 were increased in the medium-dose and high-dose groups of modified Wenyang Sanjie prescription， while IL-4， IL-6， IL-10， spleen index， thymus index， tumor weight， and tumor microvascular density were decreased， as well as HIF-1α， EGFR， and VEGF mRNA and protein levels （P<0.05）. IFN-γ and IL-2 were increased in the high-dose group of modified Wenyang Sanjie prescription compared to the medium-dose group of modified Wenyang Sanjie prescription， and IL-4， IL-6， IL-10， spleen index， thymus index， tumor weight， and tumor microvascular density were decreased， as well as HIF-1α， EGFR， and VEGF mRNA and protein levels （P<0.05）. ConclusionModified Wenyang Sanjie prescription can significantly inhibit microangiogenesis， regulate Th1/Th2 balance， inhibit tumor growth， and significantly inhibit the progression of lung cancer in mice.

OBJECTIVE To investigate the characteristics of influenza A and influenza B viruses infections in the children aged between 0 and 14 years old after COVID-19 was downgraded to category B management of infectious diseases.METHODS From Jan.2023 to Feb.2024,a total of 2349 children aged between 0 and 14 years old who were treated in Beijing Hospital of Traditional Chinese Medicine,Capital Medical University due to influenza-like symptoms of infection and received nucleic acid testing for influenza A and influenza B viruses were recruited as the research subjects.The gender and age of the children as well as the seasons were observed by chi-square test.RESULTS Totally 2349 children were included in the study,and the total positive rate of influenza was 49.85％(1171/2349);the positive rate of influenza A virus was 36.36％(854/2349),the positive rate of influenza B virus was 13.92％(327/2349),and the positive rate of the mixed infections of influenza A virus and influenza B virus was 0.43％(10/2349).The positive rate of influenza A of the girls was the highest(44.17％)(x2=8.980,P=0.011)among the children aged less than 5 years old;the positive rate of influenza B of the boys was the highest(17.19％)(x2=8.378,P=0.015)among the children aged between 5 and 10 years old.There was significant difference in the positive rate of influenza A virus among the seasons in 2023 to 2024(x2=268.12,P＜0.001);the prevalence rate was 60.93％in spring,44.40％in autumn,22.01％in winter.There was significant difference in the positive rate of influenza B virus among the seasons in 2023 to 2024(x2=373.16,P＜0.001),and the preva-lence rate was 25.44％in winter.CONCLUSIONS The influenza viruses are prevalent in spring,autumn and winter from 2023 to 2024,and the influenza A is dominant.The positive rate of influenza viruses shows an upward trend among the children aged between 0 and 14 years old after the COVID-19 is downgraded to category B management of infectious diseases,with the peak of prevalence lagging behind.

Objective To compare the efficacy and the effects on cardiac function of heated humidified high-flow nasal cannula(HHHFNC)and nasal continuous positive airway pressure(NCPAP)as initial treatment for preterm infants with neonatal respiratory dis-tress syndrome(NRDS).Methods The preterm infants with NRDS,gestational age＜35 weeks and requiring noninvasive ventilation ad-mitted to Xuzhou Central Hospital from January 2021 to November 2023 were enrolled for a prospective study and were randomly divided into the HHHFNC group and NCPAP group.The initial treatment was performed using HHHFNC and NCPAP respectively.The efficacy,safety and effects on cardiac function were compared.Results 55 cases were enrolled in HHHFNC group,and 53 cases were enrolled in NCPAP group.There were no statistically significant difference between the two groups in the number and total dose of the use of pulmona-ry surfactant,the number of apneas within 24hours of enrollment,the duration of noninvasive ventilation,the cases of noninvasive ventila-tion failure,the age achieving total enteral nutrition,the length and costs of hospitalization(P＞0.05).The incidence of nasal injury in the HHHFNC group was significantly lower than that in the NCPAP group(0 vs 11.3％,P=0.032).There were no statistically signifi-cant difference between the two groups in the pneumothorax,stage Ⅱ-Ⅲ necrotizing enterocolitis,hemodynamically significant patent ductus arteriosus,grade Ⅱ-Ⅳ intraventricular hemorrhage,bronchopulmonary dysplasia,and retinopathy of prematurity requiring treat-ment at the first screening(P＞0.05).There were no statistically significant difference between the two groups in fraction of inspired oxy-gen and arterial partial pressure of carbon dioxide,Plasma B-type natriuretic peptide(183.9±48.5ng/L vs 187.8±51.4ng/L,189.4±50.9ng/L vs 180.2±45.1ng/L)and Tei index of right ventricle(0.38±0.05 vs 0.40±0.06,0.38±0.06 vs 0.39±0.06)at 24±6h and 48±6h after noninvasive ventilation(P＞0.05).Conclusion In the initial treatment for preterm infants(gestational age＜35 weeks)with NRDS who need noninvasive ventilation,the efficacy of HHHFNC was similar to that of NCPAP,and the rate of nasal injury was lower.Other safety indexes and the effects on cardiac function were similar.

This study aims to evaluate the preventive effect of the exogenous protein chIFN-γ-chCD154 against Salmonella typhimurium(S.typhimurium)infection in White Leghorn chick-ens,and the potential mechanism.In this study,Escherichia coli was used to express the proteins chIFN-γ,chCD154 and chIFN-γ-chCD154.Before S.typhimurium infection,the White Leghorn chickens were pre-immunized via drinking water for three consecutive days,and infected with S.typhimurium by gavage.The results from Western blot,quantitative real-time PCR(qRT-PCR)analysis and histopathology analysis showed that compared to chIFN-γ and chCD154,chIFN-γ-chCD154 pre-treatment could synergistically increase the survival rate of infected chickens,reduce the bacterial load in the liver and cecum,and attenuate the pathological damage of liver and cecum.Moreover,chIFN-γ-chCD154 significantly decreased the mRNA expression of Toll-like receptor-4(TLR-4)and myeloid differentiation primary response gene 88(MyD88)in the cecum,and then inhibited the mRNA expression of NF-κB and pro-inflammatory cytokines(TNF-α and IL-6),and maintained the integrity of the intestinal tight junction proteins(zo-1,claudin-1,occlu-din).Compared with single protein pretreatment,chIFN-γ-chCD154 pretreatment significantly up-regulated the mRNA expression of the genes related to the vitamin D(VD)pathway(cyp27b1,VD receptor VDR,antimicrobial peptide AvBD7 and cathelicidin-b1)in S.typhimurium-infected peripheral blood mononuclear cells(PBMCs).The results of colony counting showed that the num-ber of S.typhimurium in the chIFN-γ-chCD154 group were the lowest.Also,chIFN-γ-chCD154 could up-regulate the relative abundance of beneficial bacteria such as Blautia,Ruminococcus,En-terococcus and Faecalibacterium,while down-regulate the relative abundance of harmful bacteria such as Staphylococcaceae in the cecum and improve the intestinal dysbiosis.In conclusion,chIFN-γ-chCD154 could activate the VD-antimicrobial peptide pathway and inhibit the TLR-4/MyD88/NF-κB inflammatory signaling pathway in S.typhimurium-infected chickens,which significantly improve the intestinal barrier function,reduce the inflammatory damage of liver and cecum,im-prove the structure of cecum microbial,promote the health of intestinal tract,and provide theoreti-cal basis for the development of chIFN-γ-chCD154 as a safe and effective alternative antibiotic.

Objective To establish a reliable prediction model for radiation pneumonitis(RP)based on multi-regional radiomics analysis of localizable CT images.Methods A retrospective analysis was conducted on 185 patients who received radiotherapy from January 2021 to June 2023 in the Department of Radiotherapy,Xuzhou Cancer Hospital.Patients were classified as having RP or not based on imaging combined with clinical diagnosis.Three regions of interest(ROI)were defined in the localizable CT images:Lung,Lung-PTV and PTV,and their radiomics features were extracted.After feature screening using methods such as Mann-Whitney Utest,recursive feature elimination,and Lasso,a prediction model was established using support vector machine classification algorithm.The model performance was validated using 6 evaluation metrics:the area under the receiver operating characteristic curve(AUC),accuracy,specificity,sensitivity,positive predictive value,and negative predictive value.Results The prediction model consisted of 7 radiomics features.The clinical model of target-to-lung ratio,PTV model,Lung model,and Lung-PTV model achieved AUC values of 0.535,0.801,0.672,and 0.706 in the test set,respectively.The AUC value and accuracy of PTV model reached 0.843 and 0.775 in the training set,while 0.801 and 0.750 in the test set.PTV model was superior to Lung model,Lung-PTV model,and clinical model in predictive performance.The AUC values of the combined PTV+(Lung-PTV)model in the training and test sets were 0.867 and 0.806,respectively,higher than those of PTV model and Lung-PTV model.Conclusion The predictive ability of the prediction models constructed from radiomics features in different ROI for symptomatic RP varies.The radiomics prediction model using PTV as ROI exhibits superior predictive performance,and the combined multi-regional radiomics model can further improve the predictive ability for RP.

BACKGROUND:Compensatory changes in sagittal parameters of the cervicothoracic spine after orthopedic surgery in patients with lumbar degenerative scoliosis and their intrinsic relationship,as well as the impact of these changes on quality of life,are still lacking.OBJECTIVE:To evaluate the compensatory alignment of cervical and thoracic vertebrae after correction of lumbar degenerative scoliosis.METHODS:103 patients who underwent surgical correction of lumbar degenerative scoliosis were included in this study.Patients'demographic characteristics and spinal sagittal parameters were assessed,and prediction equations between changes in cervical sagittal parameters and lumbar deformity correction were attempted.Simultaneously,the SRS-22 scale was used to assess the quality of life of patients and to explore the relationship between the compensatory changes of the cervical and thoracic spine after correction and the patients'health-related quality of life.RESULTS AND CONCLUSION:(1)At 3 months and 2 years after surgery,all indicators of the cervical spine and thoracic spine were significantly improved compared with those before surgery(P＜0.05),but there was no significant change at 3 months after surgery compared with 2 years after surgery(P＞0.05).At 3 months and 2 years after surgery,the lumbar spine parameters including lumbar lordosis,C7-S1 sagittal vertical axis,and pelvic incident-lumbar lordosis had significant changes compared with those before surgery(P＜0.05),but the change was not significant at 3 months after surgery compared with 2 years after surgery(P＞0.05).(2)Correlation analysis showed that the lumbar lordosis was highly correlated with the C3-C7 cervical lordosis,C1-C7 cervical lordosis,C2-7 sagittal vertical axis,thoracic inlet angle,and C7-S1 sagittal vertical axis(|r|≥ 0.5,P＜0.000 1).The lumbar lordosis was correlated with the thoracic kyphosis(r=-0.280).(3)Two prediction formulas were established for compensatory changes in cervical spine:cervical lordosis=0.524x,lumbar lordosis=-6.612,C2-7 sagittal vertical axis=-0.263x,and lumbar lordosis=-5.436(P＜0.05,R2＞0.6).(4)When postoperative C2-7 sagittal vertical axis was between 14.4 and 26.8 mm;cervical lordosis was between 9° and 41°,lumbar lordosis was between 42.7° and 68.7°,and sagittal vertical axis was between-40 and 40 mm,patients had better quality of life recovery.(5)It is indicated that significant compensatory changes in the sagittal plane of the cervical spine can be observed after correction of lumbar degenerative scoliosis.We found that each 1° increase in lumbar lordosis was associated with a corresponding increase of about 0.5° in cervical lordosis and a corresponding decrease of about 0.3 mm in the vertical axis of the C2-7 sagittal plane.Patient satisfaction was higher if compensatory changes were closer to normal sagittal plane.

Objective:To investigate the prognostic value of deep learning-based automated quantification of tumor-stroma ratio (TSR) in patients undergoing neoadjuvant therapy (NAT) for breast cancer.Methods:Specimens were collected from 209 breast cancer patients who received NAT at Renmin Hospital of Wuhan University from October 2019 to June 2023. TSR levels in pre-NAT biopsy specimens were automatically computed using a deep learning algorithm and categorized into low stroma (TSR≤30%), intermediate stroma (TSR 30% to ≤60%), and high stroma (TSR>60%) groups. Residual cancer burden (RCB) grading of post-NAT surgical specimens was determined to compare the relationship between TSR expression levels and RCB grades. The correlation of TSR with NAT efficacy was analyzed, and the association between TSR expression and patient prognosis was further investigated.Results:There were 85 cases with low stroma (TSR≤30%), 93 cases with intermediate stroma (TSR 30% to ≤60%), and 31 cases with high stroma (TSR>60%). Different TSR expression levels showed significant differences between various RCB grades ( P<0.05). Logistic univariate and multivariate analyses showed that TSR was a risk factor for obtaining a complete pathological remission from neoadjuvant therapy for breast cancer when it was used as a continuous variable ( P<0.05); COX regression and survival analyses showed that the lower the percentage of tumorigenic mesenchyme was, the better the prognosis of the patient was ( P<0.05). Conclusions:The deep learning-based model enables automatic and accurate quantification of TSR. A lower pre-treatment tumoral stroma is associated with a lower RCB score and a higher rate of pathologic complete response, indicating that TSR can predict the efficacy of neoadjuvant therapy in breast cancer and thus holds prognostic significance. Therefore, TSR may serve as a biomarker for predicting therapeutic outcomes in breast cancer neoadjuvant therapy.