ObjectiveTo explore the potential mechanism of moxibustion at Guanyuan （CV 4） in delaying skin photoaging. MethodsThirty-two male Wistar rats were randomly divided into four groups， namely blank group， model group， vitamin E group， and moxibustion group， with 8 rats in each group. Except for the blank group， dorsal skin of rats were exposed to ultraviolet （UV） radiation to establish a skin photoaging model. One week after modeling， the moxibustion group received moxibustion at "Guanyuan （CV 4）" once a day， five days per week； the vitamin E group received vitamin E （25 mg/kg·d） once a day by gavage， five days per week； the blank group， model group， and moxibustion group received an equivalent volume of normal saline via gavage； the intervention lasted for 7 weeks. After 7 weeks， dorsal skin tissues were collected to analyze the following indicators， such as skin tissue moisture content， histomorphological changes using hematoxylin-eosin （HE） staining， Collagen Ⅰ and collagen Ⅲ content using ELISA. Malondialdehyde （MDA）， glutathione peroxidase （GSH-Px）， superoxide dismutase （SOD）， hydrogen peroxide （H₂O₂）， and catalase （CAT） activity in skin tissue were dectected. Western Blot was used to determin autophagy-related proteins， including microtubule-associated protein 1A/1B-light chain 3 （LC3）， polyubiquitin-binding protein （p62）， and autophagy-specific gene （Beclin-1）； LC3， p62， and Beclin-1 mRNA expression was detected via qRT-PCR， and autophagosome formation was observed using transmission electron microscopy （TEM）. ResultsHE staining showed that the epidermal structure in the blank group was orderly and evenly thick， while the model group exhibited uneven epidermal thickness. In the moxibustion group， the epidermis was well-structured， smooth， and uniform， with densely arranged dermal layers； the epidermis in the vitamin E group was thicker than that in the model group. Compared with the blank group， the model group exhibited decreased skin moisture content and reduced level of Collagen Ⅰ and collagen Ⅲ， reduced SOD， CAT， and GSH-Px activity in skin tissue， increased H₂O₂ and MDA activity， elevated p62 protein and mRNA expression， reduced LC3 and Beclin-1 protein and mRNA expression （P＜0.05 or P＜0.01）. Compared with the model group， the moxibustion group showed significant improvement in all these indicators （P＜0.05 or P＜0.01）； whereas the vitamin E group did not show a statistically significant difference in Collagen Ⅰ and collagen Ⅲ levels （P＞0.05）. TEM results showed that， compared with the blank group， the model group had atrophic skin cells， extensive mitochondrial vacuolization， and degraded cellular structures； the moxibustion group exhibited crescent- or cup-shaped autophagosomes with a significantly increased number of autophagosomes per unit area， whereas the vitamin E group showed less improvement than the moxibustion group. ConclusionMoxibustion at "Guanyuan （CV 4）" may alleviate skin photoaging by regulating oxidative stress imba-lance， modulating cellular autophagy， and promoting collagen synthesis， thereby slowing the aging process of the skin.

Triple-negative breast cancer (TNBC) represents a distinctive subtype, characterized by the absence of estrogen receptors, progesterone receptors, and human epidermal growth factor receptor 2 (HER2). Due to its high inter-tumor and intra-tumor heterogeneity, TNBC poses significant chanllenges for personalized diagnosis and treatment. The advant of clustered regular interspaced short palindromic repeats (CRISPR) technology has profoundly enhanced our understanding of the structure and function of the TNBC genome, providing a powerful tool for investigating the occurrence and development of diseases. This review focuses on the application of CRISPR/Cas technology in the personalized diagnosis and treatment of TNBC. We begin by discussing the unique attributes of TNBC and the limitations of current diagnostic and treatment approaches: conventional diagnostic methods provide limited insights into TNBC, while traditional chemotherapy drugs are often associated with low efficacy and severe side effects. The CRISPR/Cas system, which activates Cas enzymes through complementary guide RNAs (gRNAs) to selectively degrade specific nucleic acids, has emerged as a robust tool for TNBC research. This technology enables precise gene editing, allowing for a deeper understanding of TNBC heterogeneity by marking and tracking diverse cell clones. Additionally, CRISPR facilitates high-throughput screening to promptly identify genes involved in TNBC growth, metastasis, and drug resistance, thus revealing new therapeutic targets and strategies. In TNBC diagnostics, CRISPR/Cas was applied to develop molecular diagnostic systems based on Cas9, Cas12, and Cas13, each employing distinct detection principles. These systems can sensitively and specifically detect a variety of TNBC biomarkers, including cell-specific DNA/RNA and circulating tumor DNA (ctDNA). In the realm of precision therapy, CRISPR/Cas has been utilized to identify key genes implicated in TNBC progression and treatment resistance. CRISPR-based screening has uncovered potential therapeutic targets, while its gene-editing capabilities have facilitated the development of combination therapies with traditional chemotherapy drugs, enhancing their efficacy. Despite its promise, the clinical translation of CRISPR/Cas technology remains in its early stages. Several clinical trials are underway to assess its safety and efficacy in the treatment of various genetic diseases and cancers. Challenges such as off-target effects, editing efficiency, and delivery methods remain to be addressed. The integration of CRISPR/Cas with other technologies, such as 3D cell culture systems, human induced pluripotent stem cells (hiPSCs), and artificial intelligence (AI), is expected to further advance precision medicine for TNBC. These technological convergences can offer deeper insights into disease mechanisms and facilitate the development of personalized treatment strategies. In conclusion, the CRISPR/Cas system holds immense potential in the precise diagnosis and treatment of TNBC. As the technology progresses and becomes more costs-effective, its clinical relevance will grow, and the translation of CRISPR/Cas system data into clinical applications will pave the way for optimal diagnosis and treatment strategies for TNBC patients. However, technical hurdles and ethical considerations require ongoing research and regulation to ensure safety and efficacy.

Psoriasis is an incurable chronic inflammatory disease that requires new interventions. Here, we found that fibroblasts exacerbate psoriasis progression by promoting macrophage recruitment via CCL2 secretion by single-cell multi-omics analysis. The natural small molecule celastrol was screened to interfere with the secretion of CCL2 by fibroblasts and improve the psoriasis-like symptoms in both murine and cynomolgus monkey models. Mechanistically, celastrol directly bound to the low-density lipoprotein receptor-related protein 1 (LRP1) β-chain and abolished its binding to the transcription factor c-Jun in the nucleus, which in turn inhibited CCL2 production by skin fibroblasts, blocked fibroblast-macrophage crosstalk, and ameliorated psoriasis progression. Notably, fibroblast-specific LRP1 knockout mice exhibited a significant reduction in psoriasis like inflammation. Taken together, from clinical samples and combined with various mouse models, we revealed the pathogenesis of psoriasis from the perspective of fibroblast-macrophage crosstalk, and provided a foundation for LRP1 as a novel potential target for psoriasis treatment.

The liver regenerative capacity is crucial for patients with end-stage liver disease following partial hepatectomy (PHx). The specific bacteria and mechanisms regulating liver regeneration post-PHx remain unclear. This study demonstrated dynamic changes in the abundance of Parabacteroides distasonis (P. distasonis) post-PHx, correlating with hepatocyte proliferation. Treatment with live P. distasonis significantly promoted hepatocyte proliferation and liver regeneration after PHx. Targeted metabolomics revealed a significant positive correlation between P. distasonis and β-hydroxybutyric acid (BHB), as well as hyodeoxycholic acid and 3-hydroxyphenylacetic acid in the gut after PHx. Notably, treatment with BHB, but not hyodeoxycholic acid or 3-hydroxyphenylacetic acid, significantly promoted hepatocyte proliferation and liver regeneration in mice after PHx. Moreover, STAT3 inhibitor Stattic attenuated the promotive effects of BHB on cell proliferation and liver regeneration both in vitro and in vivo. Mechanistically, P. distasonis upregulated the expression of fatty acid oxidation-related proteins, and increased BHB levels in the liver, and then BHB activated the STAT3 signaling pathway to promote liver regeneration. This study, for the first time, identifies the involvement of P. distasonis and its associated metabolite BHB in promoting liver regeneration after PHx, providing new insights for considering P. distasonis and BHB as potential strategies for promoting hepatic regeneration.

Pain management is an important component of military medical support during wartime.Early pain management for wounded soldiers can effectively alleviate pain,which is critical to maintaining combat effectiveness,promoting physiological and psychological recovery of wounded soldiers,preventing chronic pain,and helping them return to the battle field.In recent years,the U.S.Armed Forces have increasingly emphasized prehospital pain management.They have been updating the relevant pain management guidelines to establish a practical system in order to ensure that the pain of wounded soldiers is effectively controlled.This paper reviews the current research on prehospital pain management in the U.S.Armed Forces and summarizes the advanced and practical technologies for prehospital pain management.It provides references for research on prehospital pain management,and optimization of prehospital pain management strate-gies suited to China's operational context,and for the design of related training programs.

Objective To investigate the effect of Kaixinsan(KXS,a traditional Chinese medicine formula)for alleviating adriamycin-induced depression-like behaviors in mice bearing breast cancer xenografts and explore the pharmacological mechanism.Methods Forty female BALB/c mice were randomized equally into control group,model group,and low-and high-dose KXS treatment groups,and in the latter 3 groups,mouse models bearing orthotopic breast cancer 4T1 cell xenografts were established and treated with adriamycin along with saline or KXS via gavage.Depression-like behaviors of the mice were assessed using open field test and elevated plus-maze test,and the changes in serum levels of depression-related factors were examined.RNA-seq analysis and transmission electron microscopy were used and ferroptosis-related factors were detected to explore the mechanisms of adriamycin-induced depression and the therapeutic mechanism of KXS.The results were verified in SH-SY5Y cells using ferroptosis inhibitor Fer-1 as the positive control.Results KXS significantly alleviated depression-like behaviors and depression-related serological changes induced by adriamycin in the mouse models.RNA-seq results suggested that KXS alleviated chemotherapy-induced depression by regulating oxidative stress,lipid metabolism and iron ion binding in the prefrontal cortex.Pathological analysis and detection of ferroptosis-related factors showed that KXS significantly reduced ferroptosis in the prefrontal cortex of adriamycin-treated mice.In SH-SY5Y cells,both KXS-medicated serum and the ferroptosis inhibitor were capable of attenuating adriamycin-induced cell ferroptosis.Conclusion KXS alleviates adriamycin-induced depression-like behaviors in mice by reducing ferroptosis in the prefrontal cortex of breast cancer-bearing mice.

Objective:To further improve the understanding of paroxysmal nocturnal hemoglobinuria (PNH), we retrospectively analyzed and summarized the clinical characteristics, treatment status, and survival status of patients with PNH in Zhejiang Province.Methods:This study included 289 patients with PNH who visited 20 hospitals in Zhejiang Province. Their clinical characteristics, comorbidity, laboratory test results, and medications were analyzed and summarized.Results:Among the 289 patients with PNH, 148 males and 141 females, with a median onset age of 45 (16-87) years and a peak onset age of 20-49 years (57.8% ). The median lactic dehydrogenase (LDH) level was 1 142 (604-1 925) U/L. Classified by type, 70.9% (166/234) were classical, 24.4% (57/234) were PNH/bone marrow failure (BMF), and 4.7% (11/234) were subclinical. The main clinical manifestations included fatigue or weakness (80.8%, 235/289), dizziness (73.4%, 212/289), darkened urine color (66.2%, 179/272), and jaundice (46.2%, 126/270). Common comorbidities were hemoglobinuria (58.7% ), renal dysfunction (17.6% ), and thrombosis (15.0% ). Moreover, 82.3% of the patients received glucocorticoid therapy, 70.9% required blood transfusion, 30.7% used immunosuppressive agents, 13.8% received anticoagulant therapy, and 6.3% received allogeneic hematopoietic stem cell transplantation. The 10-year overall survival (OS) rate was 84.4% (95% CI 78.0% -91.3% ) . Conclusion:Patients with PNH are more common in young and middle-aged people, with a similar incidence rate between men and women. Common clinical manifestations include fatigue, hemoglobinuria, jaundice, renal dysfunction, and recurrent thrombosis. The 10-year OS of this group is similar to reports from other centers in China.

By analyzing information such as the number of publications，authors，institutions and keywords in the literature on the integration of traditional Chinese medicine（TCM）culture into ideological and political education in the past 10 years，it was found that the overall number of publications showed an increasing trend. As the main research fronts，TCM colleges and universities had not yet formed teams in cooperation with other universities. The research hotspots were relatively concentrated，but the research horizons were not broad enough. It is suggested that in the future，policy should be taken as the guide to build a cross-regional interdisciplinary cooperation system，horizontally and vertically extend research subjects，innovate and construct diversified teaching models，continue to deeply explore and organically integrate ideological and political education elements，continuously improve the evaluation system of educational functions，and further enhance the timeliness of integrating traditional Chinese medicine culture into ideological and political education. So as to make greater contributions to cultivating talents in the new era and promoting the inheritance and innovation of TCM culture.

Objective:To construct a risk prediction model for urinary retention in patients undergoing radical cervical cancer surgery based on machine learning, and the prediction effect of the model was internally verified and evaluated, in order to provide reference for the early prevention and treatment of urinary retention in patients undergoing radical cervical cancer surgery.Methods:A total of 981 patients who underwent radical cervical cancer surgery in the First Affiliated Hospital of Anhui Medical University from June 2017 to February 2022 were selected and divided into the training set (687 cases) and the test set (294 cases) according to a ratio of 7∶3. Through literature review and risk factor analysis, the influencing factors of urinary retention after radical treatment of cervical cancer were explored, and the risk prediction model of urinary retention was constructed by using XGBoost, random forest, support vector machine and decision tree in machine learning. The accuracy rate, recall rate, F1 value and AUC of four machine learning algorithms were calculated by using the method of 10-fold cross-validation, and the model with the highest predictive efficiency was selected.Results:Among the 981 patients included, the incidence of urinary retention after radical cervical cancer surgery was 18.86% (185/981). The median age of urinary retention group was 51 years old, and that of non urinary retention group was 50 years old. Statistically significant variables in the univariate analysis and influencing factors summarized by literature review were featured, including patient age, intraoperative blood loss, body mass index (BMI), cancer stage, surgical method, surgical resection scope, whether pelvic lymph node dissection was performed, comorbidities and residual urine. Among the four model building methods of machine learning, the random forest model has the best effect, its training set F1 value was 0.94, the test set F1 value was 0.77, the ROC was plotted and the AUC was calculated to be 0.73. Age, intraoperative blood loss, BMI, cancer stage and surgical method contributed significantly to the classification of random forest model.Conclusions:The prediction model of urinary retention risk after radical cervical cancer surgery based on random forest method has the best efficacy. It is useful to help nursing personnel evaluate the risk of the uroschesis for a patient and then take targeted nursing interventions to actively prevent postoperative urinary retention.