Smoking is a well-established risk factor for periodontitis, yet the precise mechanisms by which smoking contributes to periodontal disease remain poorly understood. Recent advances in spatial transcriptomics have enabled a deeper exploration of the periodontal tissue microenvironment at single-cell resolution, offering new opportunities to investigate these mechanisms. In this study, we utilized Visium HD single-cell spatial transcriptomics to profile gingival tissues from 12 individuals, including those with periodontitis, those with smoking-associated periodontitis, and healthy controls. Our analysis revealed that smoking disrupts the epithelial barrier integrity, induces fibroblast alterations, and dysregulates fibroblast-epithelial cell communication, thereby exacerbating periodontitis. The spatial analysis showed that endothelial cells and macrophages are in close proximity and interact, which further promotes the progression of smoking-induced periodontal disease. Importantly, we found that targeting the endothelial CXCL12 signalling pathway in smoking-associated periodontitis reduced the proinflammatory macrophage phenotype, alleviated epithelial inflammation, and reduced alveolar bone resorption. These findings provide novel insights into the pathogenesis of smoking-associated periodontitis and highlight the potential of targeting the endothelial-macrophage interaction as a therapeutic strategy. Furthermore, this study establishes an essential information resource for investigating the effects of smoking on periodontitis, providing a foundation for future research and therapeutic development for this prevalent and debilitating disease.
Humans ; Gingiva/cytology* ; Smoking/adverse effects* ; Male ; Periodontitis/pathology* ; Single-Cell Analysis ; Female ; Adult ; Middle Aged ; Macrophages ; Fibroblasts ; Endothelial Cells ; Case-Control Studies ; Chemokine CXCL12/metabolism*

Objective To observe the clinical efficacy of Shuxin Jieyu Decoction(composed of Chuangxiong Rhizoma,Angelicae Sinensis Radix,Bupleuri Radix,Paeoniae Radix Alba,Paeoniae Radix Rubra,Curcumae Radix,Ziziphi Spinosae Semen,Glycyrrhizae Radix et Rhizoma Praeparata cum Melle,Platycladi Semen,Polygoni Multiflori Caulis,Polygalae Radix,Toosendan Fructus,Corydalis Rhizoma,and Albiziae Cortex)in treating coronary heart disease(CHD)with angina pectoris complicated by anxiety disorder in patients with qi stagnation and blood stasis syndrome.Methods Sixty patients diagnosed with qi stagnation and blood stasis syndrome type of CHD with angina pectoris and anxiety disorder were enrolled from the outpatient and inpatient departments of Taihe Hospital of Traditional Chinese Medicine Affiliated to Anhui University of Chinese Medicine between January 2024 and January 2025.Patients were randomly divided into an observation group(n=30)and a control group(n=30)using a random number table method.The control group received conventional CHD treatment and anxiolytic therapy(Flupentixol and Melitracen Tablets),while the observation group additionally received Shuxin Jieyu Decoction.Both groups were treated for 4 weeks.Changes in traditional Chinese medicine(TCM)syndrome scores and Hamilton Anxiety Rating Scale(HAMA)scores were evaluated before and after treatment.The therapeutic effects of angina pectoris,nitroglycerin reduction/cessation rates,and total adverse event rates were compared between the two groups.Results(1)After 4 weeks of treatment,the total effective rate in the observation group was 93.33％(28/30),compared to 73.33％(22/30)in the control group.The intergroup comparison(by Fisher's precision probability test)showed that the observation group's efficacy was significantly superior to that of the control group(P＜0.05).(2)After treatment,both groups showed significant reductions in TCM syndrome scores(P＜0.05)for symptoms including chest tightness and pain,costal distension,anxiety,palpitations,excessive sighing,irritability,and insomnia.The observation group's reduction was significantly greater than that of the control group(P＜0.05).(3)After 4 weeks,the total reduction/discontinuation rate of nitroglycerin was 90.00％(27/30)in the observation group versus 66.67％(20/30)in the control group.The intergroup comparison(by Fisher's precision probability test)showed that the observation group's reduction rate was significantly higher than that of the control group(P＜0.05,Fisher's precision probability test).(4)After treatment,both groups exhibited reduced Hamilton Anxiety Rating Scale(HAMA)scores(P＜0.05),with the observation group showing a significantly greater improvement(P＜0.05).(5)The total incidence of adverse reactions was 20.00％(6/30)in the observation group and 23.33％(7/30)in the control group,with no statistically significant difference between groups(P＞0.05).Conclusion The combination of Shuxin Jieyu Decoction with conventional western medicine treatment demonstrates superior clinical efficacy compared to conventional western medicine alone in patients with qi stagnation and blood stasis syndrome type of CHD with angina pectoris and anxiety disorder.It effectively alleviates angina symptoms and anxiety disorder,reduces nitroglycerin usage,without increasing adverse effects.

The 2024 World Conference on Lung Cancer (WCLC) and the European Society for Medical Oncology (ESMO) Annual Meeting, two of the most prestigious events in oncology, have concluded sequentially. As the most authoritative annual gatherings in lung cancer and the entire oncology field, the WCLC and ESMO conferences brought together top oncology experts and scientists from around the world to share, discuss, and publish the latest cutting-edge advancements in oncology. In both conferences, lung cancer immunotherapy remained a hot topic of considerable interest. This article aims to summarize and discuss the important research progress on perioperative immunotherapy for non-small cell lung cancer reported at the two conferences.

Objective:To evaluate the clinical outcome of umbilicoplasty with longitudinal umbilical fixation and provide a basis for constructing an umbilicus that conforms to the aesthetic characteristics of Chinese women.Methods:Patients undergoing umbilicoplasty with longitudinal umbilical fixation between December of 2021 and November of 2023 were retrospectively analyzed at Department of Plastic and Aesthetic Surgery, Xi’an International Medical Center Hospital. All patients underwent abdominoplasty to reshape the abdominal contour and umbilicoplasty with longitudinal umbilical fixation to construct a new umbilical. The preoperative and postoperative body mass index (BMI), waist-hip ratio (waist circumference/hip circumference), umbilical contour, and longitudinal and transverse diameter of the umbilical cord were collected. The patients themselves used a 5-point Likert scale to evaluate the satisfaction of umbilicus (from the four aspects of umbilicus size, shape, position, and overall abdominal coordination and aesthetics), abdominal contour satisfaction rate [satisfaction rate= (very satisfied+ satisfed) patients/(total patients)×100%], and the subjective evaluation of umbilicus scar (very not obvious, not obvious, average, obvious, and very obvious). SPSS 25.0 statistical software was used for statistical analysis. Paired t-test or χ 2 test was used for preoperative and postoperative comparison. P<0.05 was considered statistically significant. Results:A total of 438 female patients were included, aged (33.4±5.5) years, including the pregnancy childbirth patients (428 cases) and weight loss patients (10 cases). The median follow-up time was 216(194, 266) days. Preoperative umbilical appearance mainly for the circle, longitudinal oval, transverse oval and convex. After operation, it was mainly longitudinal oval and circle. Early complications related to the umbilical cord were mainly blood circulation disturbance (8 cases). Long-term umbilical complication was mainly periumbilical scar (6 cases). The BMI [(19.96±2.03)kg/m 2 vs. (20.44±2.18)kg/m 2], waist-hip ratio[(0.78±0.04) vs. (0.88±0.08)], transverse diameter of the umbilicus [(0.68±0.26) cm vs. (1.11±0.44) cm] and longitudinal diameter of the umbilicus[(1.66±0.35) cm vs. (1.29±0.44) cm] after the operation were compared with those before the operation, and the differences were statistically significant ( P<0.01). The number of people satisfied with umbilical position [31.51%(138/438)vs. 97.26%(426/438)], umbilical size[11.19%(49/438)vs. 87.44%(383/438)], umbilical shape[7.76%(34/438)vs. 82.19%(360/438)], overall evaluation[(11.42%(50/438)vs. 86.30%(378/438)] and abdominal contour evaluation [12.79%(56/438)vs. 89.04%(390/438)]increased significantly, and the differences were statistically significant compared with those before operation ( P<0.01). The subjective evaluation of periumbilical scar was very not obvious in 171 cases, not obvious in 163 cases, average in 98 cases, and obvious in 6 cases. Conclusion:Umbilicoplasty with longitudinal umbilical fixation is suitable for Chinese women. The vertical oval umbilical constructed by this surgical method demonstrates appropriate size and position, significantly enhancing the overall abdominal aesthetic effect. The patient satisfaction was high and the postoperative effect was stable.

Aim To apply coronary angiography derived index of microcirculatory resistance(caIMR)to evaluate the effect of coronary microcirculation perfusion on myocardial remodeling after interventional therapy in patients with acute anterior ST segment elevation myocardial infarction(STEMI).Methods This was a cross-sectional study.The analysis was performed among the patients who were hospitalized for acute anterior STEMI in the First Department of the Second Affiliated Hospital of Dalian Medical University from January 2021 to July 2022 and received percutaneous coro-nary intervention(PCI)with regtelar follow-up visits.The patients were divided into low caIMR(L-caIMR)group,me-dium caIMR(M-caIMR)group and high caIMR(H-caIMR)group according to the results of caIMR.The results of ech-ocardiography at perioperative period,1 month,3 months,6 months and 1 year were analyzed and compared,including left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDD),interventricular septum thickness(IVST),mitral orifice flow velocity E/A,mitral annular septum e'and mitral annular wall e',etc.The difference of interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and other inflammatory factors in peripheral blood of the three groups were also compared.Results A total of 75 patients diagnosed with acute anterior STEMI were recrui-ted,including 55 males.The L-caIMR group,M-caIMR group,and H-caIMR group had 26,26 and 23 cases,respec-tively.Compared with the L-caIMR group,the LAD and IVST in the M-caIMR group and the H-caIMR group exhibited an increasing tendency one month after PCI,and the increase in the H-caIMR group was more significant than that in the M-caIMR group(P＜0.05).The ejection fraction in the H-caIMR group was notably lower than that in the L-caIMR group and the M-caIMR group at 1 and 3 months after PCI(P＜0.05).Compared with the L-caIMR group,the mitral flow velocity E/A at 6 months after PCI,and the e'at the septal side and the lateral wall of the mitral annulus at 1,3,and 6 months after PCI were significantly reduced in the M-caIMR and H-caIMR groups(P＜0.05).Compared with the L-caIMR group,the levels of IL-1β,IL-6,and TNF-α showed an increasing trend in the M-caIMR group and the H-caIMR group,and the increase was greater in the H-caIMR group than that in the M-caIMR group(P＜0.05).Multivariate anal-ysis revealed that caIMR was a factor influencing the levels of IL-1 β and IL-6(P＜0.05).Conclusion CMD may be involved in the process of myocardial remodeling in patients with acute anterior STEMI after PCI,in which inflammation plays a role.

Aim To apply coronary angiography derived index of microcirculatory resistance(caIMR)to evaluate the effect of coronary microcirculation perfusion on myocardial remodeling after interventional therapy in patients with acute anterior ST segment elevation myocardial infarction(STEMI).Methods This was a cross-sectional study.The analysis was performed among the patients who were hospitalized for acute anterior STEMI in the First Department of the Second Affiliated Hospital of Dalian Medical University from January 2021 to July 2022 and received percutaneous coro-nary intervention(PCI)with regtelar follow-up visits.The patients were divided into low caIMR(L-caIMR)group,me-dium caIMR(M-caIMR)group and high caIMR(H-caIMR)group according to the results of caIMR.The results of ech-ocardiography at perioperative period,1 month,3 months,6 months and 1 year were analyzed and compared,including left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDD),interventricular septum thickness(IVST),mitral orifice flow velocity E/A,mitral annular septum e'and mitral annular wall e',etc.The difference of interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and other inflammatory factors in peripheral blood of the three groups were also compared.Results A total of 75 patients diagnosed with acute anterior STEMI were recrui-ted,including 55 males.The L-caIMR group,M-caIMR group,and H-caIMR group had 26,26 and 23 cases,respec-tively.Compared with the L-caIMR group,the LAD and IVST in the M-caIMR group and the H-caIMR group exhibited an increasing tendency one month after PCI,and the increase in the H-caIMR group was more significant than that in the M-caIMR group(P＜0.05).The ejection fraction in the H-caIMR group was notably lower than that in the L-caIMR group and the M-caIMR group at 1 and 3 months after PCI(P＜0.05).Compared with the L-caIMR group,the mitral flow velocity E/A at 6 months after PCI,and the e'at the septal side and the lateral wall of the mitral annulus at 1,3,and 6 months after PCI were significantly reduced in the M-caIMR and H-caIMR groups(P＜0.05).Compared with the L-caIMR group,the levels of IL-1β,IL-6,and TNF-α showed an increasing trend in the M-caIMR group and the H-caIMR group,and the increase was greater in the H-caIMR group than that in the M-caIMR group(P＜0.05).Multivariate anal-ysis revealed that caIMR was a factor influencing the levels of IL-1 β and IL-6(P＜0.05).Conclusion CMD may be involved in the process of myocardial remodeling in patients with acute anterior STEMI after PCI,in which inflammation plays a role.

Objective:To evaluate the clinical outcome of umbilicoplasty with longitudinal umbilical fixation and provide a basis for constructing an umbilicus that conforms to the aesthetic characteristics of Chinese women.Methods:Patients undergoing umbilicoplasty with longitudinal umbilical fixation between December of 2021 and November of 2023 were retrospectively analyzed at Department of Plastic and Aesthetic Surgery, Xi’an International Medical Center Hospital. All patients underwent abdominoplasty to reshape the abdominal contour and umbilicoplasty with longitudinal umbilical fixation to construct a new umbilical. The preoperative and postoperative body mass index (BMI), waist-hip ratio (waist circumference/hip circumference), umbilical contour, and longitudinal and transverse diameter of the umbilical cord were collected. The patients themselves used a 5-point Likert scale to evaluate the satisfaction of umbilicus (from the four aspects of umbilicus size, shape, position, and overall abdominal coordination and aesthetics), abdominal contour satisfaction rate [satisfaction rate= (very satisfied+ satisfed) patients/(total patients)×100%], and the subjective evaluation of umbilicus scar (very not obvious, not obvious, average, obvious, and very obvious). SPSS 25.0 statistical software was used for statistical analysis. Paired t-test or χ 2 test was used for preoperative and postoperative comparison. P<0.05 was considered statistically significant. Results:A total of 438 female patients were included, aged (33.4±5.5) years, including the pregnancy childbirth patients (428 cases) and weight loss patients (10 cases). The median follow-up time was 216(194, 266) days. Preoperative umbilical appearance mainly for the circle, longitudinal oval, transverse oval and convex. After operation, it was mainly longitudinal oval and circle. Early complications related to the umbilical cord were mainly blood circulation disturbance (8 cases). Long-term umbilical complication was mainly periumbilical scar (6 cases). The BMI [(19.96±2.03)kg/m 2 vs. (20.44±2.18)kg/m 2], waist-hip ratio[(0.78±0.04) vs. (0.88±0.08)], transverse diameter of the umbilicus [(0.68±0.26) cm vs. (1.11±0.44) cm] and longitudinal diameter of the umbilicus[(1.66±0.35) cm vs. (1.29±0.44) cm] after the operation were compared with those before the operation, and the differences were statistically significant ( P<0.01). The number of people satisfied with umbilical position [31.51%(138/438)vs. 97.26%(426/438)], umbilical size[11.19%(49/438)vs. 87.44%(383/438)], umbilical shape[7.76%(34/438)vs. 82.19%(360/438)], overall evaluation[(11.42%(50/438)vs. 86.30%(378/438)] and abdominal contour evaluation [12.79%(56/438)vs. 89.04%(390/438)]increased significantly, and the differences were statistically significant compared with those before operation ( P<0.01). The subjective evaluation of periumbilical scar was very not obvious in 171 cases, not obvious in 163 cases, average in 98 cases, and obvious in 6 cases. Conclusion:Umbilicoplasty with longitudinal umbilical fixation is suitable for Chinese women. The vertical oval umbilical constructed by this surgical method demonstrates appropriate size and position, significantly enhancing the overall abdominal aesthetic effect. The patient satisfaction was high and the postoperative effect was stable.

Objective:To investigate the impact of neuroendocrine function on postoperative complications and nutritional status in gastric cancer patients.Methods:Clinical data of 102 gastric cancer patients who underwent radical gastrectomy at the Department of General Surgery, First Affiliated Hospital of Soochow University, from Aug 2021 to Jun 2022 were retrospectively analyzed.Results:Among the 102 gastric cancer patients, 18 (17.6%) suffered from postoperative complications. Univariate analysis indicated that age, BMI, preoperative plasma ghrelin concentration, and preoperative hemoglobin levels were associated with early postoperative complications following radical gastrectomy. Multivariate analysis revealed that age, BMI, and preoperative plasma ghrelin concentration ( P<0.05) were independent risk factors for postoperative complications in gastric cancer patients. Differential analysis of ghrelin concentration demonstrated correlations with hemoglobin levels, skeletal muscle index, albumin, and creatinine, and a positive correlation with the skeletal muscle index. Conclusions:Reduced preoperative neuroendocrine hormone ghrelin concentration is an independent risk factor for postoperative complications in gastric cancer patients. Ghrelin concentration is correlated with the skeletal muscle index in these patients.

Objective:To systematically evaluate the perioperative risk factors for deep vein thrombosis (DVT) in aged patients with hip fractures.Methods:A comprehensive search was conducted in CNKI, VIP, Wanfang, PubMed, Web of Science, Cochrane Library, and Embase for studies on DVT risk factors in aged patients with hip fractures. The search timeframe was from January 1, 2000, to January 31, 2023.Results:A total of 55 studies were included, comprising 41 case-control studies and 14 cohort studies. Meta-analysis results showed that age, female, body mass index, hypertension, hyperlipidemia, diabetes, pulmonary disease, cerebrovascular disease, smoking history, thrombosis history, combined anesthesia, intraoperative bleeding, intraoperative blood transfusion, hemoglobin, albumin, activated partial thromboplastin time, D-dimer, fibrinogen, intertrochanteric fractures, high-energy injury, prolonged bed rest, time from injury to admission, and time from injury to surgery were risk factors for DVT in aged hip fracture patients ( P<0.05) ; the use of anticoagulants was found to be a protective factor ( P<0.05) . Conclusions:The occurrence of DVT in aged hip fracture patients is influenced by multiple factors. Nursing staff should enhance the assessment and screening for DVT and take measures to minimize its incidence in this patient population.

Objective:To retrieve, evaluate, and integrate evidence related to balance function management in stroke patients with hemiplegia.Methods:A systematic search was conducted on BMJ Best Practice, UpToDate, National Institute for Health and Care Excellence, Guidelines International Network, Scottish Intercollegiate Guidelines Network, Australia Joanna Briggs Institute Evidence-Based Practice Center, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, VIP, China Biology Medicine disc, PubMed, Web of Science, Medlive, and other websites or data platforms for relevant guidelines, best practices, evidence summaries, systematic reviews, and Meta-analyses on balance function management in stroke patients with hemiplegia, with a retrieval period from March 2014 to March 2024. Two researchers trained in evidence-based practices evaluated the methodological quality of the literature and extracted and summarized the relevant evidence.Results:Based on the inclusion and exclusion criteria, a total of eight guidelines and seven systematic reviews were included, yielding 29 pieces of best evidence across nine aspects: the importance of balance function training, organizational management, assessment tools, assessment timing, assessment content, assessment frequency, balance exercise programs, exercise duration, and health education.Conclusions:This study summarizes the best evidence for balance function management in stroke patients with hemiplegia, providing accurate evidence-based support for clinical practice among medical professionals. It is recommended that healthcare providers appropriately apply this evidence based on clinical scenarios to improve measures related to balance function management in stroke patients with hemiplegia.