ObjectiveTo compare the effects of different formulations of Yinqiao Powder （银翘散， YP） on inflammation and immune function in a rat model of acute pharyngitis induced by ammonia water. MethodsA rat model of acute pharyngitis was established by spraying 15% ammonia water into the pharynx of male SD rats using a laryngeal atomizer twice daily （three sprays each time） for three consecutive days. Successfully modeled rats were randomly divided into 5 groups， including a model group （normal saline， 10 ml/kg）， YP decoction group （10.73 g/kg）， YP granule group （10.73 g/kg）， cydiodine group （0.39 mg/kg） and blank control group （normal saline， 10 ml/kg）， with 12 rats in each group. All groups received intragastric administration once daily for 10 consecutive days. After the final gavage administration， frequency of back arching per minute， frequency of vibrissae grooming per minute， and grooming episodes per five minutes were recorded in rats. The cumulative body weight change was calculated as the difference in body weight between day 10 and day 1 of gavage administration. Behavioral observations were performed using the open field test， and the total distance traveled was recorded. After sample collection， the lung index and thymus index were calculated. Histopathological changes in the pharyngeal and tracheal tissues were observed using HE staining. Serum inflammatory markers including eosinophil cationic protein （ECP）， angiotensin-converting enzyme 2 （ACE2）， and C-reactive protein （CRP）， as well as immune parameters including immunoglobulin M （IgM）， immunoglobulin A （IgA）， immunoglobulin G （IgG）， CD4， CD4/CD8 ratio， and CD8 were measured by ELISA. In addition， ELISA was used to determine the levels of inflammatory mediators in pharyngeal tissues， including phospholipase A2 （PLA2）， cyclooxygenase-1 （COX-1）， cyclooxygenase-2 （COX-2）， prostaglandin E2 （PGE2）， vascular cell adhesion molecule-1 （VCAM-1）， C-X-C motif chemokine ligand 1 （CXCL1）， vascular endothelial growth factor （VEGF）， and matrix metalloproteinase-9 （MMP-9）. ResultsCompared to the blank control group， the model group exhibited significantly increased frequencies of back arching per minute， vibrissae grooming per minute， and grooming episodes per five minutes， and lung index， and decreased cumulative body weight change， thymus index， and total distance traveled， as well as elevated serum levels of ECP， ACE2， and CD8， reduced levels of IgM， IgA， IgG， CD4， and CD4/CD8 ratio， and increased levels of PLA， COX-1， COX-2， PGE2， VCAM-1， CXCL1， VEGF， and MMP-9 in pharyngeal tissues （P＜0.05）. Histopathological examination revealed keratinization of the superficial epithelial layer of the pharyngeal mucosa， accompanied by congestion and edema in the lamina propria and infiltration of inflammatory cells； in the tracheal mucosa， extensive inflammatory cell infiltration， ciliary disruption， and goblet cell damage were observed. Compared to the model group， except for CRP， IgG， and CD4， all above mentioned indicators were improved in the YP granule group， YP decoction group， and cydiodine group （P＜0.05）. Histopathological lesions in the pharyngeal and tracheal tissues were also alleviated. Compared to the YP decoction group， rats in the YP granule group exhibited decreased frequencies of back arching per minute， vibrissae grooming per minute， and grooming episodes per five minutes， as well as reduced serum ECP levels. Meanwhile， the cumulative body weight gain and serum levels of IgM， IgA， IgG， and CD4/CD8 increased， whereas CD8 levels decreased （P＜0.05）. ConclusionYP can effectively alleviate symptoms of acute pharyngitis in a rat model， improve inflammatory responses and immune-related indicators， demonstrating superior therapeutic effects in the dosage form of granule.

ObjectiveTo observe the clinical efficacy of Shentong Zhuyutang combined with Dilongtang in the treatment of lumbar disc herniation （LDH） with Qi stagnation and blood stasis syndrome， and its effect on nucleus pulposus reabsorption and immune-inflammatory factors， exploring its therapeutic mechanism from the perspective of reabsorption. MethodsA total of 120 patients with LDH from the Fourth Clinical Medical College of Guangzhou University of Chinese Medicine， treated between June 2020 and January 2023， were randomly divided into the control group （52 cases， with 8 dropouts） and the observation group （49 cases， with 11 dropouts） according to a random number table. The control group received routine treatment， while the observation group was treated with Shentong Zhuyutang combined with Dilongtang in addition to routine treatment. Visual Analogue Scale （VAS）， Oswestry Disability Index （ODI）， Japanese Orthopaedic Association （JOA） score， and traditional Chinese medicine （TCM） syndrome score were measured before treatment and after 3 courses of treatment. Venous blood samples were collected for the determination of serological indexes. MR examination was performed during the 6-month follow-up to calculate the absorption rate. ResultsAfter treatment， both groups showed significant reductions in VAS， ODI， TCM syndrome score， serum tumor necrosis factor （TNF）-α， matrix metalloproteinase （MMP）-9， and vascular endothelial growth factor （VEGF） levels， and a significant increase in JOA score compared with pre-treatment values （P<0.05）. Compared with the control group， the observation group showed significantly lower VAS， ODI， TCM syndrome score， serum TNF-α， MMP-9， and VEGF levels， and a significantly higher JOA score （P<0.05）. The proportion of nucleus pulposus reabsorption in the observation group was 57.14% （28/49）， significantly higher than 21.15% （11/52） in the control group （χ²=6.161， P<0.05）. ConclusionShentong Zhuyutang combined with Dilongtang can effectively relieve pain， improve lumbar function， and alleviate TCM clinical symptoms in LDH patients with Qi stagnation and blood stasis syndrome. Imaging findings suggest that the treatment promotes the reabsorption of nucleus pulposus protrusion， while laboratory testing shows reduced serum levels of TNF-α， MMP-9， and VEGF， which contribute to the rehabilitation of patients.

This article summarized the current status and challenges of manipulation therapy for musculoskeletal pain and its placebo effect in clinical trials, analyzing the impact of the placebo effect on the evaluation of therapeutic efficacy. The efficacy of different manual manipulation techniques remains uncertain, and the degree of blinding and patient expectations play a crucial role in efficacy assessment. The article suggested improving trial design through standardized placebo intervention design, comprehensive investigation of patient expectations and psychological states, rigorous training of practitioners, and optimized diagnostic and treatment scenarios and doctor-patient relationship, to ensure consistency between intervention and placebo groups. Specific measures include the application of the DITTO (Deconstruct, Identify, Take out, Think, Optimize) framework, the use of standardized questionnaire tools, and multi-center, large-sample randomized controlled trials to enhance the external validity and statistical power of research results, thereby providing more scientifically reliable evidence for clinical practice.

Objective To analyze white matter hyperintensities(WMH)and 11C-CFT PET/CT characteristics in patients with PD,and explore their relationship.Methods A total of 84 PD pa-tients admitted to our department between March 2021 and March 2025 were retrospectively en-rolled,and they were divided into young group(33 cases)and elderly group(aged＞65 years,51 cases)and also into non-WMH group(22 cases)and WMH group(62 cases)based on the severity of WMH.The degree of white matter lesions was scored,including periventricular white matter hyperintense(PVH)score and deep white matter hyperintense(DWMH)score.All patients un-derwent head MRI and 11C-CFT-PET/CT scanning.The T/N value and asymmetry index were calculated.Results The elderly PD patients exhibited significantly advanced age and higher H-Y stages,but lower T/N values of affected side of caudate nucleus,contralateral caudate nucleus,affected side of anterior putamen,contralateral anterior putamen and contralateral posterior puta-men,and posterior putamen asymmetry index than the young patients(P＜0.05,P＜0.01).Simi-lar results were observed in the WMH group when compared with the non-WMH group(P＜0.05,P＜0.01).The PVH score was negatively correlated with the T/N values of affected side of caudate nucleus(r=-0.282,P=0.009),contralateral caudate nucleus(r=-0.215,P=0.049),affected side of anterior putamen(r=-0.249,P=0.022),contralateral anterior putamen(r=-0.280,P=0.010)and contralateral posterior putamen(r=-0.285,P=0.009),and DWMH score was also negatively correlated with the T/N values in the affected side of caudate nucleus and affected side of anterior putamen(P＜0.05).Conclusion Both age and disease severity impact WMH and dopaminergic system in PD patients.A higher WMH load is associated with dopamin-ergic neuronal damage.

In recent years,significant breakthroughs have been achieved in the immunotherapy for Alzheimer's disease.In line with global advancements,two anti-amyloid-β monoclonal antibodies have been approved and successfully launched in China for clinical use.Lecanemab and Donanemab were officially used in June 2024 and April 2025 in China,respectively.In order to standardize the rational and safe application of anti-amyloid-β monoclonal antibodies for Alzheimer's disease in China,this article integrates recom-mendations from the clinical trials and real-world experience from the author's team and domestic peers to further update the recom-mendations for the clinical use of anti-amyloid-β monoclonal antibody based on the 2024 version.It includes indications for therapy,pre-treatment evaluation and preparation,administration protocols and safety measures during treatment,and post-treatment monitor-ing strategies.

Objective To analyze white matter hyperintensities(WMH)and 11C-CFT PET/CT characteristics in patients with PD,and explore their relationship.Methods A total of 84 PD pa-tients admitted to our department between March 2021 and March 2025 were retrospectively en-rolled,and they were divided into young group(33 cases)and elderly group(aged＞65 years,51 cases)and also into non-WMH group(22 cases)and WMH group(62 cases)based on the severity of WMH.The degree of white matter lesions was scored,including periventricular white matter hyperintense(PVH)score and deep white matter hyperintense(DWMH)score.All patients un-derwent head MRI and 11C-CFT-PET/CT scanning.The T/N value and asymmetry index were calculated.Results The elderly PD patients exhibited significantly advanced age and higher H-Y stages,but lower T/N values of affected side of caudate nucleus,contralateral caudate nucleus,affected side of anterior putamen,contralateral anterior putamen and contralateral posterior puta-men,and posterior putamen asymmetry index than the young patients(P＜0.05,P＜0.01).Simi-lar results were observed in the WMH group when compared with the non-WMH group(P＜0.05,P＜0.01).The PVH score was negatively correlated with the T/N values of affected side of caudate nucleus(r=-0.282,P=0.009),contralateral caudate nucleus(r=-0.215,P=0.049),affected side of anterior putamen(r=-0.249,P=0.022),contralateral anterior putamen(r=-0.280,P=0.010)and contralateral posterior putamen(r=-0.285,P=0.009),and DWMH score was also negatively correlated with the T/N values in the affected side of caudate nucleus and affected side of anterior putamen(P＜0.05).Conclusion Both age and disease severity impact WMH and dopaminergic system in PD patients.A higher WMH load is associated with dopamin-ergic neuronal damage.

Objective To explore the biomechanical mechanism of pseudoaneurysm formation at the anastomotic site of vascular patch and the inhibitory effect of transforming growth factor(TGF β1)hydrogel on aneurysm.Methods The vascular patch model and the pseudoaneurysm model were constructed separately,and the two-way fluid-structure interaction method was used to numerically simulate the blood-vessel wall dynamic response at the anastomosis.Based on the analysis of mechanical parameters such as postoperative blood velocity,vessel wall shear stress and aneurysm wall displacement,the mechanisms of postoperative pseudoaneurysm formation and inhibition were studied.Results The numerical simulation results showed that the wall shear stress increased when the blood flowed through the front end of the patch.When the pseudoaneurysm has been formed after surgery,the aneurysm wall became significantly thicker following the injection of TGF β1 hydrogel into the aneurysmal wall,and the intratumoral shear stress and the aneurysmal wall displacement were decreased.Conclusion Pseudoaneurysms are easy to form at the front end of the anastomosis after surgery,and the injection of TGF β1 hydrogel into the aneurysm wall can effectively inhibit the formation and progression of pseudoaneurysm.The numerical simulation study provides a numerical basis for the mechanical mechanism study of the formation and progression of pseudoaneurysm after patch angioplasty.

Background Mitochondrial dynamin-related protein 1 (DRP1) regulates mitochondrial division and plays an important role in maintaining hepatocyte function. However, the role of DRP1 in cadmium exposure-induced maternal liver damage in pregnant mice remains unclear. Objective To investigate the role and mechanism of DRP1 in maternal liver damage induced by cadmium exposure during pregnancy. Methods This study consisted of animal experiments and cell experiments. (1) Animal experiments. Mice at 14 days of gestation were randomly divided into three groups: a control group, a low-dose cadmium group (LCd group: 2.5 mg·kg⁻¹), and a high-dose cadmium group (HCd group: 5 mg·kg⁻¹). The pregnant mice were intraperitoneally injected with cadmium chloride (CdCl₂) for 6 and 24 h in the next morning. The weights of pregnant mice, uterus, maternal liver, and fetal mice were recorded after sacrifice. Serum and liver of pregnant mice were collected, the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in serum were detected, and liver tissues were stained with HE to observe changes in liver function and liver tissue structure. The expressions of oxidative phosphorylation-related proteins, hypoxia inducible factor-1α (HIF-1α) and DRP1 proteins in liver of pregnant mice were detected by Western blotting. (2) Cell experiments. AML12 cells were treated with CdCl₂ (10 μmol·L⁻¹) for 0, 2, 6, 12, and 24 h. The expressions of oxidative phosphorylation-related proteins, DRP1, and hypoxia inducible factor-1α (HIF-1α) proteins were detected. AML12 cells were pretreated with DRP1 inhibitor Mdivi-1 for 1 h and then CdCl₂ (10 μmol·L⁻¹) for 12 h to detect the expression of oxidative phosphorylation-related proteins and DRP1 protein. AML12 cells were treated with Hif-1α siRNA for 48 h and CdCl₂ (10 μmol·L⁻¹) for 6 h to detect the expression of HIF-1α and DRP1 proteins. Results The results of animal experiments showed that cadmium exposure in pregnant mice had no effects on maternal liver weight and liver coefficient. However, the histomorphological changes and necrosis in hepatocytes were observed. Compared with the control group, the serum ALT and AST levels of pregnant mice in the LCd group were significantly increased after 6 h (P＜0.05), and the levels in the HCd group were significantly increased after 6 and 24 h (P＜0.05). Cadmium exposure during pregnancy significantly up-regulated HIF-1α and DRP1 expressions and down-regulated the expressions of oxidative phosphorylation-related proteins in maternal livers. In vitro cell experiments showed that the expressions of oxidative phosphorylation-related proteins was significantly decreased and HIF-1α and DRP1 protein expressions were significantly increased in the AML12 cells treated with CdCl₂ for 6 h. Mdivi-1 pretreatment significantly antagonized the inhibitory effect of cadmium on the expressions of oxidative phosphorylation-related proteins in AML12 cells, while Hif-1α siRNA pretreatment significantly antagonized the up-regulative effect of cadmium on DRP1 expression in AML12 cells. Conclusion Cadmium exposure in pregnant mice may up-regulate DRP1 expression by activating HIF-1α signaling, then inhibit oxidative phosphorylation level of hepatic cells, and ultimately lead to maternal liver damage.

Gastric cancer is one of the most common malignant tumors in the world, and its incidence and mortality are among the top of malignant tumors in China. Since Kitano et al com-plete the first laparoscopic radical gastrectomy for gastric cancer in the world in 1992, the laparos-copic technology has developed rapidly. After more than 30 years of exploration and practice, the clinical diagnosis and treatment of gastric cancer in China has also made considerable progress. A large number of clinical studies at home and abroad have confirmed that laparoscopic radical gas-trectomy is no less effective than traditional open surgery in the short and long term. Laparoscopic radical gastrectomy has the characteristics of less trauma, faster recovery of gastrointestinal func-tion, less postoperative pain, and shorter average hospital stay. It has gradually replaced open surgery as the mainstream surgical method for gastric cancer. As the concept of surgical treatment for gastric cancer continues to update, emerging minimally invasive technologies continue to emerge, including robotic surgery systems and indocyanine green tracing technology, which are increasingly used in gastric cancer surgery, making gastric cancer surgery more minimally invasive and accurate, the quality of perigastric lymph node dissection and the domestic gastric cancer surgery technology further improving. Based on the relevant research at home and abroad, the authors review and summarize the latest progress in recent years with the topic of minimally invasive surgery for gastric cancer, aiming to systematically describe the current situation and future prospects of gastric cancer surgery. It is believed that in the future, the clinical diagnosis and treatment of gastric cancer in China will be more standardized, minimally invasive and accurate, more high-quality multicenter clinical research will be carry out and the diagnosis and treatment of gastric cancer will be further improved in China.

Objective:To investigate the effects of TRIB3 activation of Wnt/β-catenin signaling pathway on the growth and pro-liferation of laryngeal carcinoma TU686 cells in vitro and expression of peripheral immunosuppressive molecules in transplanted mice.Methods:Protein and RNA expressions of TRIB3 were detected in vitro cells(human immortalized epidermal cell line HaCat and laryngeal carcinoma cell line TU686)and tissues(laryngeal carcinoma and adjacent tissues),respectively.Laryngeal carcinoma TU686 cells were cultured in vitro and divided into negative control group(NC group)and TRIB3 knockdown group(sh-TRIB3 group),total protein and RNA of cells were extracted to verify the expression level of TRIB3 in two groups.After successful verifica-tion,proliferation ability of TU686 cells was detected by CCK-8,colony cloning and flow cytometry.Protein expression levels of Wnt,Cyclin-D1,C-myc,β-catenin and p-β-catenin in two groups were detected by Western blot.Correlation analysis verified the correla-tion between TRIB3 and Wnt,Cyclin-D1,C-myc,β-catenin,p-β-catenin protein expressions.TRIB3-low expressing nude mouse transplanted tumor model(TRIB3 sgRNA group)was constructed by knockdown the TRIB3 core plasmid,and a parallel control group(Control sgRNA group)was set up,tumor growth volume and weight were observed,and serum immunosuppressive molecules expres-sions was determined by ELISA.Results:Compared with HaCat cells and normal paracarcinoma tissues,TRIB3 was highly expressed in TU686 cells and laryngeal carcinoma tissues.Compared with negative control group,proliferation ability of TU686 cells was signifi-cantly inhibited after TRIB3 knockdown,and cell growth was blocked in G1/S phase.Expressions of Wnt,Cyclin-D1,C-myc andβ-catenin protein in Wnt/β-catenin signaling pathway were decreased significantly,while expression of p-β-catenin was increased significantly.TRIB3 was significantly correlated with protein expression levels of Wnt,Cyclin-D1,β-catenin and p-β-catenin.The in vivo results showed that compared with Control sgRNA group,tumor growth volume and weight of mice in TRIB3 sgRNA group were significantly decreased,and expressions of serum immunosuppressive molecules IL-4,IL-6,IL-10,TGF-β and PGE2 were signifi-cantly decreased.Conclusion:TRIB3 is highly expressed in TU686 cells,and TRIB3 can inhibit growth and proliferation of TU686 cells and transplanted tumors by activating Wnt/β-catenin-related signaling pathways,and reverse tumor immunosuppressive microen-vironment,suggesting that TRIB3 may be an effective target for laryngeal cancer.