BACKGROUND:Osteoarthritis is pathologically characterized by progressive degeneration of the articular cartilage and abnormal deformation of the subchondral bone.In recent years,with the deepening of medical research,it has been found that the mitogen-activated protein kinases(MAPK)signaling pathway has a regulatory role in inflammatory cell infiltration,inflammatory factor release,and chondrocyte proliferation,which is particularly important for the treatment of osteoarthritis.OBJECTIVE:To briefly review the main research progress in the mechanism of MAPK signaling pathway regulating osteoarthritis in recent years,aiming to provide new ideas for the treatment of osteoarthritis.METHODS:CNKI,WanFang and PubMed databases were searched for relevant literature using the search terms of"mitogen-activated protein kinases,osteoarthritis,extracellular signal-regulated MAP kinases,p38 mitogen-activated protein kinases,JNK mitogen-activated protein kinase"in Chinese and English.Relevant literature published from January 2019 to November 2024 was searched,and 108 articles were finally included for summary analysis.RESULTS AND CONCLUSION:(1)Various stimuli inside and outside the cells activate the MAPK signaling pathway,regulate gene transcription and protein synthesis,and promote the release of inflammatory factors,such as tumor necrosis factor-α,interleukin-1β,and interleukin-6.The release of these inflammatory factors aggravates the progression of osteoarthritis.(2)The active ingredients of traditional Chinese medicine,mainly saponins and flavonoids,as well as Chinese herbal formulas and preparations with the main effects of activating blood circulation and removing blood stasis,tonifying the liver and kidney,can play a therapeutic role in osteoarthritis by inhibiting the MAPK signaling pathway,regulating the release of matrix metalloproteinases,balancing the homeostatic state of osteogenesis and osteoblastogenesis,attenuating the synovial inflammation,decreasing the release of inflammatory factors and inflammatory vesicles,decreasing cellular pyroptosis,promoting autophagy,and ameliorating oxidative stress.(3)Although traditional Chinese medicine has become popular in the treatment of osteoarthritis by virtue of its own advantages of multi-components,multi-targets,multi-pathways,and low side effects,the use of MAPK signaling pathway to guide the treatment of individual osteoarthritis is the difficulty of the technology,which needs to be continuously researched and explored.(4)Therefore,further development of relevant herbal inhibitors that can modulate the MAPK signaling pathway may be a potential drug strategy for the treatment of osteoarthritis in the future.

BACKGROUND:Osteoarthritis is pathologically characterized by progressive degeneration of the articular cartilage and abnormal deformation of the subchondral bone.In recent years,with the deepening of medical research,it has been found that the mitogen-activated protein kinases(MAPK)signaling pathway has a regulatory role in inflammatory cell infiltration,inflammatory factor release,and chondrocyte proliferation,which is particularly important for the treatment of osteoarthritis.OBJECTIVE:To briefly review the main research progress in the mechanism of MAPK signaling pathway regulating osteoarthritis in recent years,aiming to provide new ideas for the treatment of osteoarthritis.METHODS:CNKI,WanFang and PubMed databases were searched for relevant literature using the search terms of"mitogen-activated protein kinases,osteoarthritis,extracellular signal-regulated MAP kinases,p38 mitogen-activated protein kinases,JNK mitogen-activated protein kinase"in Chinese and English.Relevant literature published from January 2019 to November 2024 was searched,and 108 articles were finally included for summary analysis.RESULTS AND CONCLUSION:(1)Various stimuli inside and outside the cells activate the MAPK signaling pathway,regulate gene transcription and protein synthesis,and promote the release of inflammatory factors,such as tumor necrosis factor-α,interleukin-1β,and interleukin-6.The release of these inflammatory factors aggravates the progression of osteoarthritis.(2)The active ingredients of traditional Chinese medicine,mainly saponins and flavonoids,as well as Chinese herbal formulas and preparations with the main effects of activating blood circulation and removing blood stasis,tonifying the liver and kidney,can play a therapeutic role in osteoarthritis by inhibiting the MAPK signaling pathway,regulating the release of matrix metalloproteinases,balancing the homeostatic state of osteogenesis and osteoblastogenesis,attenuating the synovial inflammation,decreasing the release of inflammatory factors and inflammatory vesicles,decreasing cellular pyroptosis,promoting autophagy,and ameliorating oxidative stress.(3)Although traditional Chinese medicine has become popular in the treatment of osteoarthritis by virtue of its own advantages of multi-components,multi-targets,multi-pathways,and low side effects,the use of MAPK signaling pathway to guide the treatment of individual osteoarthritis is the difficulty of the technology,which needs to be continuously researched and explored.(4)Therefore,further development of relevant herbal inhibitors that can modulate the MAPK signaling pathway may be a potential drug strategy for the treatment of osteoarthritis in the future.

Objective To analyze the relationship between small dense low-density lipoprotein(sd-LDL)and lipoprotein(a)and carotid plaque stability in patients with acute cerebral infarction(ACI).Methods A total of 160 elderly ACI patients admitted in our hospital from February 2020 to February 2024 were retrospectively recruited.All of them received cervical color Doppler ultra-sound examination,and according to carotid plaque status,they were divided into non-plaque group(43 cases),stable plaque group(56 cases)and unstable plaque group(61 cases).Another 40 healthy individuals taking physical examination in our hospital during the same period served as control group.The clinical data and sd-LDL and Lp(a)levels were compared among the 4 groups to evaluate the predictive value of sd-LDL and Lp(a)levels for unstable plaques.Results When compared with the non-plaque group,the NIHSS score and LDL-C level were significantly in-creased in the stable and unstable plaque groups,and the TC level was obviously elevated while that of HDL-C was notably reduced in the unstable plaque group,and the NIHSS score and TC,TG and LDL-C levels were remarkably declined while that of HDL-C elevated in the control group(P＜0.05).The NIHSS score and LDL-C,sdLDL and Lp(a)levels were elevated while that of HDL-C was lowered in the unstable plaque group than the stable plaque group(P＜0.05),and the Lp(a)level in the control group was obviously decreased than that of the stable plaque group(P＜0.05).Pearson correlation analysis showed that sd-LDL and Lp(a)levels were positively cor-related with NIHSS score and TC,TG and LDL-C(P＜0.05,P＜0.01),and negatively with HDL-C(P＜0.01).Binary logistic regression analysis revealed that NIHSS score and LDL-C,sd-LDL and Lp(a)levels were risk factors,and HDL-C was a protective factor for unstable carotid plaque in ACI patients(P＜0.01).ROC curve analysis indicated that the AUC value of sd-LDL,Lp(a)and their combination in predicting carotid plaque stability was 0.830,0.847 and 0.921,respectively,and the sensitivity of combined detection was higher than that of sd-LDL or Lp(a)alone(93.44％vs 88.52％and 86.89％,P=0.000).Conclusion Plasma sd-LDL and Lp(a)levels have a certain association with carotid plaque stability in ACI patients,and they can be used as relevant reference indicators in clinical practice.

Objective To analyze the relationship between small dense low-density lipoprotein(sd-LDL)and lipoprotein(a)and carotid plaque stability in patients with acute cerebral infarction(ACI).Methods A total of 160 elderly ACI patients admitted in our hospital from February 2020 to February 2024 were retrospectively recruited.All of them received cervical color Doppler ultra-sound examination,and according to carotid plaque status,they were divided into non-plaque group(43 cases),stable plaque group(56 cases)and unstable plaque group(61 cases).Another 40 healthy individuals taking physical examination in our hospital during the same period served as control group.The clinical data and sd-LDL and Lp(a)levels were compared among the 4 groups to evaluate the predictive value of sd-LDL and Lp(a)levels for unstable plaques.Results When compared with the non-plaque group,the NIHSS score and LDL-C level were significantly in-creased in the stable and unstable plaque groups,and the TC level was obviously elevated while that of HDL-C was notably reduced in the unstable plaque group,and the NIHSS score and TC,TG and LDL-C levels were remarkably declined while that of HDL-C elevated in the control group(P＜0.05).The NIHSS score and LDL-C,sdLDL and Lp(a)levels were elevated while that of HDL-C was lowered in the unstable plaque group than the stable plaque group(P＜0.05),and the Lp(a)level in the control group was obviously decreased than that of the stable plaque group(P＜0.05).Pearson correlation analysis showed that sd-LDL and Lp(a)levels were positively cor-related with NIHSS score and TC,TG and LDL-C(P＜0.05,P＜0.01),and negatively with HDL-C(P＜0.01).Binary logistic regression analysis revealed that NIHSS score and LDL-C,sd-LDL and Lp(a)levels were risk factors,and HDL-C was a protective factor for unstable carotid plaque in ACI patients(P＜0.01).ROC curve analysis indicated that the AUC value of sd-LDL,Lp(a)and their combination in predicting carotid plaque stability was 0.830,0.847 and 0.921,respectively,and the sensitivity of combined detection was higher than that of sd-LDL or Lp(a)alone(93.44％vs 88.52％and 86.89％,P=0.000).Conclusion Plasma sd-LDL and Lp(a)levels have a certain association with carotid plaque stability in ACI patients,and they can be used as relevant reference indicators in clinical practice.

Objective To explore the application value of different deep learning models in predicting the lung cancer spread through air spaces(STAS).Methods A total of 203 patients with stage Ⅰ—Ⅱ primary lung cancer were included,of which 74 were STAS-positive and 129 were STAS-negative.Patients were randomly divided into training set(142 cases)and test set(61 cases)at a 7∶3 ratio.Region of interest(ROI)was outlined using ITK-SNAP software,facilitating the extraction of tumor and peritumoral images.The Resnet18,Inception_v3,and Vision Transformer(Vit)were employed for model training and feature extraction.Feature selection was performed by the least absolute shrinkage and selection operator(LASSO)algorithm and Spearman correlation coefficient,followed by the establishment of a predictive model using the Naive Bayes machine learning algorithm.The receiver operating characteristic(ROC)curve was drawn to compare the prediction performance of each model.The assessment of calibration was performed using calibration curves,and the evaluation of clinical application value was conducted using decision curve analysis(DCA).Results The area under the curve(AUC)for the training and test sets were as follows:the training set Resnet18 0.849-0.930,Inception_v3 0.848-0.888,Vit 0.747-0.842;and the test set Resnet18 0.796-0.846,Inception_v3 0.783-0.804,Vit 0.690-0.796.In tumor-peritumoral images,Resnet18 had a higher calibration and better clinical net benefit,while Vit showed superior calibration and clinical net benefit when only tumor tissue was considered.Conclusion Deep learning models can effectively predict lung cancer STAS,providing more decision support for the preoperative diagnosis and treatment of stages Ⅰ—Ⅱ lung cancer.

In recent decades,the incidence of human papillomavirus(HPV)-associated oropharyngeal squamous cell carcinoma(OPSCC)has shown a marked increase.Significant changes have also occurred in the OPSCC diagnosis and treatment paradigm.Deter-mining HPV status prior to treatment is now essential,and radiotherapy/chemotherapy,immunotherapy,and minimally invasive surgical techniques have progressively emerged as key modalities for managing OPSCC.However,alongside these paradigm shifts,a comprehen-sive technical consensus guiding the entire diagnostic and therapeutic process for OPSCC patients is currently lacking.Given China's large population base and the rising incidence of OPSCC,an expert panel convened to develop a clinical technical consensus on OPSCC diagno-sis and management tailored to China's specific context.This consensus aims to further enhance and standardize understanding of OPSCC management techniques among relevant healthcare professionals.

Objective To explore the value of CT signs and quantitative parameters of artificial intelligence (AI) in predicting the efficacy of neoadjuvant chemotherapy for colorectal cancer. Methods A total of 349 colorectal cancer patients who received neoadjuvant chemotherapy at Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province from January 2022 to January 2025 were selected and and divided into the effective group (n = 267) and the ineffective group (n = 82) according to the evaluation criteria for the efficacy of solid tumors. Conduct a CT examination and extract AI quantitative parameters from the CT images based on the lesion. The data were analyzed using SPSS21.0 software, Logistic regression was used to screen the influencing factors of ineffective neoadjuvant chemotherapy in patients with colorectal cancer, and separate and combined models of CT signs and AI quantitative parameters were established. The predictive effect of the model was verified by using the ROC curve, calibration curve and decision curve. Results Compared with the effective group, the proportion of regular tumor morphology and the proportion of non-enlarged lymph nodesin the ineffective group were smaller. The tumor volume, peak value and entropy value were larger (P < 0.05). Multivariable analysis showed that irregular shape (OR= 4.216), presence of lymph node enlargement (OR = 8.998), larger tumor volume (OR = 1.109), higher average CT value (OR = 1.120), elevated peak value (OR = 2.528), and increased entropy value (OR = 1.390) were independent risk factors for ineffective neoadjuvant chemotherapy in colorectal cancer (P < 0.05). The areas under the ROC curves of the individual and combined models of CT signs and AI quantitative parameters were 0.777, 0.818, and 0.877, respectively(P < 0.05). The calibration curve showed a Brier score of 0.091. The decision curve showed that the threshold was between 0.10 and 0.85, and the combined model achieved a relatively high net clinical benefit. Conclusion CT signs combined with AI quantitative parameters has a predictive value for the efficacy of neoadjuvant chemotherapy in colorectal cancer. To provide evidence-based basis for clinical screening of the population benefiting from chemotherapy and optimization of treatment strategies.

Objective To establish a finite element model of thoracolumbar kyphosis(TLK)for young patients with idiopathic Scheuermann's disease(SD),validate its effectiveness,and perform fi-nite element analysis to identify biomechanical factors contributing to low back pain caused by SD.Methods One TLK patient(26 years old)and one healthy(30 years old)subject were recruited.Spi-nal DICOM data were reconstructed three-dimensionally using Mimics software.Surface repair and fit-ting were performed in Geomagic Studio 2017,followed by modeling of intervertebral discs and end-plates in 3-matic software.Volume meshing and ligament construction were completed in Hypermesh 2017.Static simulations of the T8-S1 spinal segments for both groups were conducted in ANSYS.Af-ter validating the model using mechanical data,stress and strain distributions across vertebral bodies,intervertebral discs,and facet joint cartilage were calculated under identical constraints and loads.Re-sults 1)Significant differences were observed between the TLK patient and healthy subject in the me-chanical distribution of the T8-S1 segments of the spine.The healthy spine exhibited a peak strain of 1.62 mm,while the TLK patient showed a peak strain of 6.97 mm,330.2%higher than the former.Moreover,the peak stress in the TLK patient(10.51 MPa)exceeded the healthy subject(9.07 MPa)by 16.0%.2)Both groups demonstrated peak vertebral stress at the L5 level(9.07 MPa in the healthy individual vs.10.51 MPa in the TLK patient,15.8%higher).Stress distribution in the TLK patient was markedly uneven,with significant concentrations at the pedicles and laminae of L2,L3,and L4 vertebrae.3)Peak disc stress in the TLK patient was consistently higher,most notably at the L5/S1 segment(0.78 MPa in the TLK patient vs.0.16 MPa in the healthy subject,387.5%higher).4)Facet joint cartilage stress distribution in the TLK patient was abnormal.The healthy subject exhib-ited peak stress at L5/S1(1.53 MPa),whereas TLK patient showed peak stress at L1/L2(7.44 MPa),14.18 times higher than the former.Conclusion This study validates the finite element model of TLK deformity,confirming its utility for TLK-related research.Moreover,significant differences in stress-strain distribution and magnitude are observed between the TLK patient and healthy subject.Meanwhile,prolonged abnormal biomechanical loading,particularly localized stress concentrations in the L1-S1 vertebral bodies,discs,and facet joints,may accelerate degenerative changes and elevate the risk of low back pain.

Oral squamous cell carcinoma(OSCC)is a malignant lesion originating from the oral mucosal squamous epithelium,account-ing for over 80％of oral and maxillofacial malignancies.Key etiological factors include tobacco,alcohol abuse,and betel quid chewing.In China,its incidence has shown an overall upward trend,posing a significant threat to public health.OSCC exhibits high local invasive-ness,making early diagnosis critical for improving prognosis.Its clinical management requires close multidisciplinary collaboration among oral and maxillofacial surgery,head and neck surgery,radiation oncology,medical oncology,reconstructive surgery,radiology,patholo-gy,and nutritional support teams.Given the increasing disease burden of OSCC and rapid development of multidisciplinary collaborative models,an expert panel has formulated this integrated management consensus based on evidence-based medicine and extensive deliber-ation.Centered on the'Prevention-Screening-Diagnosis-Treatment-Rehabilitation'framework,the consensus provides comprehensive guidance for the entire disease course of OSCC patients,aiming to standardize clinical practice.