Objective To construct a combined model integrating ultrasonic features and radiomics derived from ultrasound images,and to evaluate its diagnostic performance in re-assessing the benign or malignant nature of Bethesda Ⅲ nodules.Methods A retrospective study was carried out on 442 patients with thyroid nodules classified as Bethesda Ⅲ after fine-needle aspiration biopsy(FNAB)between January 2019 and September 2024.All patients had undergone surgical pathology.The patients were randomly allocated into a training set and a testing set at a ratio of 7∶3.Relevant clinical characteristics were gathered,and regions of interest(ROI)were outlined on the most suspicious slice of the lesion prior to biopsy.Ultrasound radiomics features were extracted,key radiomics features were selected,and radiomics scores(Rad-score)were computed.The ultrasound model,radiomics model,and combined model were constructed.Subsequently,the diagnostic efficacy and clinical application value of each model were evaluated using the area under the receiver operating characteristic curve(AUC)and decision curve analysis(DCA).Results Univariate analysis and multivariate logistic regression analysis findings indicated that microcalci-fication,irregular margin,and Rad-score were independent risk factors for the malignant transformation of BethesdaⅢ nodules.In the testing set,the AUC values of the ultrasound model,radiomics model,and combined model were 0.76,0.71,and 0.81,respectively.The calibration curve of the combined model revealed a good consistency between the predicted values and the actual outcomes.The DCA of the testing set demonstrated that the combined model exhibited high clinical utility.Conclusion The combined model,established based on ultrasonic features and ultrasound radiomics,provides a higher predictive value for evaluating the malignancy risk of Bethesda Ⅲ nodules.

Diabetic nephropathy(DN),a primary cause of end-stage renal disease(ESRD)in diabetic patients,is pathologically characterized by chronic inflammation and renal fibrosis.Chronic inflammation promotes renal cellular damage,epithelial-mesenchymal transition,and extracellular matrix(ECM)accumulation through mechanisms including immune cell activation,pro-inflammatory cytokine secretion,and initiation of multiple sig-naling pathways.Excessive ECM deposition disrupts renal architecture and drives tubulointerstitial expansion,thereby accelerating renal functional decline.Recent studies demonstrate that chronic inflammation and fibrosis synergistically propagate DN progression via bidirectional crosstalk.Inflammation serves as an early driver of fibro-genesis and further amplifies fibrotic processes through positive feedback mechanisms,establishing a self-perpetu-ating inflammation-fibrosis vicious cycle.However,the precise molecular interplay between chronic inflammation and fibrosis remains incompletely elucidated.Thus,in-depth exploration of their interaction mechanisms is crucial for developing novel DN interventions.This review delineates the pathogenic roles of chronic inflamma-tion and fibrosis in DN to advance mechanistic understanding and provide foundational insights for designing in-novative therapeutic strategies.

Objective This study aimed to explore the ability of ultrasonographic radiomics in predicting the occurrence of in-stent restenosis(ISR)after carotid artery stenting(CAS)by analyzing the correlation between radiomic features of responsible plaques in carotid artery stenosis and the incidence of ISR.Methods A retrospective collection was conducted on 206 cases that underwent CAS treatment at our hospital.The enrolled patients were randomly split into a training set(144 cases)and a test set(62 cases)at a 7∶3 ratio.We utilized the Darwin Intelligent Research Platform to extract radiomic features from each region of interest,and then screened 1125 ultrasonographic radiomic features.Different machine learning algorithms were employed to construct diagnostic models,and the best-performing classifier was selected.Various prediction models were established,including a clinical-ultrasonographic feature model,a radiomic model,and a combined clinical-ultrasonographic-radiomic model.Results Multivariate logistic regression analysis in the training set revealed that hypertension,hyperuricemia,triglycerides,and plaque location were independent risk factors for ISR after CAS.For the clinical-ultrasonographic model,the area under the curve(AUC)values for the training and validation sets were 0.896 and 0.644,respectively.The corresponding AUC values for the radiomic model were 0.961 and 0.715,while those for the combined model were 0.947 and 0.727.Conclusion The radiomic model demonstrates superior performance in predicting ISR compared to the traditional clinical-ultrasonographic model.The combined model exhibited an enhanced ability to predict ISR occurrence,thereby improving the diagnostic performance of traditional assessments.

Objective To investigate the clinical efficacy and mechanism of Weiwei Decoction in treating patients with precancerous lesions of gastric cancer(PLGC)differentiated as deficiency-stasis-turbidity syndrome.Methods From August 2021 to August 2023,a clinical observation was performed on 60 patients diagnosed as chronic atrophic gastritis accompanied by mild to moderate dysplasia and differentiated as deficiency-stasis-turbidity syndrome through traditional Chinese medicine(TCM)syndrome differentiation,electronic gastroscopy,and histopathological examination at the Department of Gastroenterology,Guangdong Second Traditional Chinese Medicine Hospital.The patients were randomly divided into a treatment group and a control group using a random number table,with 30 patients in each group.The control group was treated with oral use of Weifuchun Tablets,while the treatment group was given modified Weiwei Decoction according to syndrome differentiation.The treatment course lasted 24 weeks.Before and after treatment,the changes in TCM syndrome scores,gastroscopy and histopathological grading,and expression levels of markers of cancer-associated fibroblasts(CAFs)in gastric mucosal tissues of the two groups were observed.After treatment,the efficacy of TCM syndromes and medication safety were evaluated in both groups.Results(1)After 24 weeks of treatment,the total effective rate in the treatment group was 93.33%(28/30),and that in the control group was 63.33%(19/30).The TCM syndrome efficacy in the treatment group was significantly superior to that in the control group(P＜0.05).(2)After treatment,the TCM syndrome scores in both groups were significantly decreased compared to those before treatment(P＜0.01),and the decrease in the treatment group was significantly superior to that in the control group(P＜0.05).(3)After treatment,the histopathological grading of gastric mucosal atrophy,intestinal metaplasia,and dysplasia in the treatment group was significantly improved compared to that before treatment(P＜0.05),while no significant improvement was presented in the control group(P＞0.05).The improvement in histopathological grading of gastric mucosal atrophy,intestinal metaplasia,and dysplasia in the treatment group was significantly superior to that in the control group(P＜0.05 or P＜0.01).(4)After treatment,the expression levels of CAFs markers of fibroblast activation protein(FAP)and α-smooth muscle actin(α-SMA)in the treatment group were significantly decreased(P＜0.05),while the expression levels of FAP and α-SMA in the control group were significantly increased(P＜0.05)compared to those before treatment.The decrease in FAP and α-SMA expression levels of the treatment group was significantly greater than that of the control group(P＜0.01).(5)During the treatment period,no adverse drug events occurred in either group,indicating high safety.Conclusion Weiwei Decoction has significant therapeutic effect on PLGC patients with deficiency-stasis-turbidity syndrome.Its mechanism may be related to the down-regulation of FAP and α-SMA levels and inhibition of the expression of CAFs.

Diabetic nephropathy(DN),a primary cause of end-stage renal disease(ESRD)in diabetic patients,is pathologically characterized by chronic inflammation and renal fibrosis.Chronic inflammation promotes renal cellular damage,epithelial-mesenchymal transition,and extracellular matrix(ECM)accumulation through mechanisms including immune cell activation,pro-inflammatory cytokine secretion,and initiation of multiple sig-naling pathways.Excessive ECM deposition disrupts renal architecture and drives tubulointerstitial expansion,thereby accelerating renal functional decline.Recent studies demonstrate that chronic inflammation and fibrosis synergistically propagate DN progression via bidirectional crosstalk.Inflammation serves as an early driver of fibro-genesis and further amplifies fibrotic processes through positive feedback mechanisms,establishing a self-perpetu-ating inflammation-fibrosis vicious cycle.However,the precise molecular interplay between chronic inflammation and fibrosis remains incompletely elucidated.Thus,in-depth exploration of their interaction mechanisms is crucial for developing novel DN interventions.This review delineates the pathogenic roles of chronic inflamma-tion and fibrosis in DN to advance mechanistic understanding and provide foundational insights for designing in-novative therapeutic strategies.

With the change of infectious disease incidence pattern and the development of related technologies, progresses have been made in the research of infectious disease epidemiology. In recent years, due to the change in the requirements of infectious disease prevention and control, the research focus has expanded from common infectious diseases to diseases which have been eliminated or might be eliminated, as well as emerging and re-emerging infectious diseases. Infectious disease data has been characterized by multiple sources and modalities. Along with the rapid development of pathogen detection methods, infectious disease surveillance has shifted from a single disease-targted one to a comprehensive one. Moreover, novel technologies such as multi-omics and artificial intelligence have been applied in infectious disease epidemiology research. The international cooperation in this field has become increasingly crucial, and the revision of the International Health Regulations and the negotiation of pandemic agreement will have a profound impact. In the future, infectious disease epidemiology research will develop with more powerful tools to improve its capabilities.

Kidney stone is a common urological disorder with an increasing annual incidence，posing a heavy social burden. Previous studies have demonstrated that diverse cell death modalities，including ferroptosis and apoptosis，induce renal tubular epithelial cell injury and thereby promote kidney stone formation. Emerging evidence in recent years has further revealed that immune-inflammatory responses driven by interactions among renal microenvironment components also contribute to kidney stone pathogenesis. This review systematically summarizes current research advances on the mechanisms by which inflammatory cellular components（e.g.，macrophages，T cells），inflammatory mediators（e.g.，inflammasomes，cytokines），microbiota，and their synergistic interactions influence kidney stone development within the renal microenvironment.

Objective To investigate the clinical effect of shoulder arthroscopic rotator cuff repair combined with shoulder three needles in treatment of rotator cuff injury.Methods 86 patients with rotator cuff injury from June 2021 to May 2023 were divided into two groups using a random number table method.The research group received 43 cases of rotator cuff repair under arthroscopy combined with shoulder three needles rotator cuff repair,while the control group received 43 cases of rotator cuff repair under arthroscopy combined with placebo needling.Then compare the pain level,shoulder joint function,and shoulder joint range of motion between the two groups before and 6 months after surgery,and calculate the excellent and good shoulder joint function rates between the two groups at 6 months after surgery,and compare the changes in inflammatory factors between the two groups at before and 4 weeks after surgery.Results 6 months after surgery,the visual analogue scale(VAS)score of both groups was lower than that before surgery,and the VAS score in research group(including the moderate tearing subgroup and the major tearing subgroup)was lower than that of the control group(including the moderate tearing subgroup and the major tearing subgroup),while the American Shoulder and Elbow Surgeons(ASES)score and shoulder joint range of motion were higher than those before surgery,and the ASES score and shoulder joint range of motion in research group(including the moderate tearing subgroup and the major tearing subgroup)were higher than those of the control group(including the moderate tearing subgroup and the major tearing subgroup),the differences were statistically significant(P＜0.05).6 months after surgery,the excellent and good rate of shoulder joint function in the research group was higher than that in the control group,the difference was statistically significant(P＜0.05).At 4 weeks after surgery,the levels of tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6),and interleukin-8(IL-8)in both groups were lower than those before surgery,and the research group(including the moderate tearing subgroup and the major tearing subgroup)were lower than those of control group(including the moderate tearing subgroup and the major tearing subgroup),the differences were statistically significant(P＜0.05).Conclusion Arthroscopic rotator cuff repair combined with shoulder three needles can alleviate the pain level of patients with rotator cuff injury,improve shoulder joint function and range of motion,increase the excellent and good rate of shoulder joint function,and reduce inflammatory reaction.It is worthy of clinical application.

With the change of infectious disease incidence pattern and the development of related technologies, progresses have been made in the research of infectious disease epidemiology. In recent years, due to the change in the requirements of infectious disease prevention and control, the research focus has expanded from common infectious diseases to diseases which have been eliminated or might be eliminated, as well as emerging and re-emerging infectious diseases. Infectious disease data has been characterized by multiple sources and modalities. Along with the rapid development of pathogen detection methods, infectious disease surveillance has shifted from a single disease-targted one to a comprehensive one. Moreover, novel technologies such as multi-omics and artificial intelligence have been applied in infectious disease epidemiology research. The international cooperation in this field has become increasingly crucial, and the revision of the International Health Regulations and the negotiation of pandemic agreement will have a profound impact. In the future, infectious disease epidemiology research will develop with more powerful tools to improve its capabilities.

Objective To investigate the clinical effect of shoulder arthroscopic rotator cuff repair combined with shoulder three needles in treatment of rotator cuff injury.Methods 86 patients with rotator cuff injury from June 2021 to May 2023 were divided into two groups using a random number table method.The research group received 43 cases of rotator cuff repair under arthroscopy combined with shoulder three needles rotator cuff repair,while the control group received 43 cases of rotator cuff repair under arthroscopy combined with placebo needling.Then compare the pain level,shoulder joint function,and shoulder joint range of motion between the two groups before and 6 months after surgery,and calculate the excellent and good shoulder joint function rates between the two groups at 6 months after surgery,and compare the changes in inflammatory factors between the two groups at before and 4 weeks after surgery.Results 6 months after surgery,the visual analogue scale(VAS)score of both groups was lower than that before surgery,and the VAS score in research group(including the moderate tearing subgroup and the major tearing subgroup)was lower than that of the control group(including the moderate tearing subgroup and the major tearing subgroup),while the American Shoulder and Elbow Surgeons(ASES)score and shoulder joint range of motion were higher than those before surgery,and the ASES score and shoulder joint range of motion in research group(including the moderate tearing subgroup and the major tearing subgroup)were higher than those of the control group(including the moderate tearing subgroup and the major tearing subgroup),the differences were statistically significant(P＜0.05).6 months after surgery,the excellent and good rate of shoulder joint function in the research group was higher than that in the control group,the difference was statistically significant(P＜0.05).At 4 weeks after surgery,the levels of tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6),and interleukin-8(IL-8)in both groups were lower than those before surgery,and the research group(including the moderate tearing subgroup and the major tearing subgroup)were lower than those of control group(including the moderate tearing subgroup and the major tearing subgroup),the differences were statistically significant(P＜0.05).Conclusion Arthroscopic rotator cuff repair combined with shoulder three needles can alleviate the pain level of patients with rotator cuff injury,improve shoulder joint function and range of motion,increase the excellent and good rate of shoulder joint function,and reduce inflammatory reaction.It is worthy of clinical application.