This study aims to investigate the therapeutic effects of the Coptidis Rhizoma-Scutellariae Radix on cytokine storm secondary lung injury(CSSLI) induced by CpG1826 in mice, and to elucidate the potential molecular mechanisms by which its major active components, i.e., coptisine and wogonin, alleviate CSSLI by inhibiting the mitochondrial permeability transition pore(mPTP)/nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3) inflammasome pyroptosis pathway. In vivo, a mouse model of CSSLI was established by CpG1826 induction. Pulmonary edema was assessed by lung wet-to-dry weight ratio(W/D), lung injury was evaluated by hematoxylin-eosin(HE) staining, and ultrastructural changes in lung tissue were observed by transmission electron microscopy(TEM). The levels of interleukin(IL)-1β, high mobility group box 1 protein(HMGB1), IL-18, and IL-1α in bronchoalveolar lavage fluid were measured by enzyme-linked immunosorbent assay(ELISA). The results showed that the decoction of the Coptidis Rhizoma-Scutellariae Radix significantly reduced pulmonary edema, alleviated lung injury, and decreased the concentrations of related cytokines in BALF more effectively than either single herb alone, thereby improving CSSLI. In vitro, a CpG1826-induced CSSLI model was established in mouse alveolar macrophage MH-S cells. Calcein-AM quenching was used to screen for the most effective monomer components from the herb pair in inhibiting mPTP opening. Coptisine(5, 10, 20 μmol·L~(-1)) and wogonin(10, 20, 40 μmol·L~(-1)) markedly inhibited mPTP opening, with optimal effects and a clear dose-dependent pattern. These components suppressed mPTP opening, thereby reducing the release of mitochondrial DNA(mtDNA) and the accumulation of reactive oxygen species(ROS), effectively reversing the CpG1826-induced decrease in mitochondrial membrane potential(MMP). Further studies revealed that both coptisine and wogonin inhibited pyroptosis and downregulated the expression of key proteins in the NLRP3/Caspase-1/gasdermin D(GSDMD) pathway. In conclusion, the Coptidis Rhizoma-Scutellariae Radix improves CpG1826-induced CSSLI in mice, and this effect is associated with the inhibition of the mPTP/NLRP3 pyroptosis pathway, providing scientific evidence for its clinical application and further development.
Animals ; Mice ; Drugs, Chinese Herbal/administration & dosage* ; Pyroptosis/drug effects* ; NLR Family, Pyrin Domain-Containing 3 Protein/immunology* ; Male ; Lung Injury/immunology* ; Cytokines/immunology* ; Scutellaria baicalensis/chemistry* ; Oligodeoxyribonucleotides/adverse effects* ; Mice, Inbred C57BL ; Coptis chinensis

Objective:To investigate the clinical efficacy of robotic surgery via the bilateral axillo-breast approach（BABA） in lateral lymph node dissection for papillary thyroid carcinoma（PTC）. Methods:Clinicopathological records of 324 PTC patients receiving unilateral neck dissection in Tianjin Medical University Cancer Institute and Hospital from December 2020 to November 2024 were retrospectively analyzed. Of these patients, 108 underwent robotic surgery via BABA（robotic group）, while the remaining patients underwent conventional open surgery（open group）. The extent of lateral neck lymph node dissection included level Ⅱ, Ⅲ and Ⅳ. The differences in surgical indexes, postoperative complication rates and cosmetic outcomes of incisions were compared between two groups. Results:All study subjects completed the operation successfully, and there was no conversion in the robotic group. The average age of patients in the robotic group was lower than that in the open group, and the proportion of female patients was higher in the robotic group compared to the open group（P<0.05）. Patients in the robotic group had a greater number of dissected lymph nodes in level ⅡB and higher cosmetic scores（P<0.05）. There were no statistically significant differences between the two groups in the average dissection time of lateral cervical lymph nodes, the number of dissected lymph nodes and metastatic lymph nodes in level ⅡA, Ⅲ, and Ⅳ, average postoperative drainage volume, average postoperative hospital stay, and postoperative complication rates（P>0.05）. Conclusion:The application of robotic surgical system via BABA in lateral neck lymph node dissection for PTC is safe and feasible, with superior advantages in level ⅡB dissection and better postoperative cosmetic outcomes.
Humans ; Thyroid Neoplasms/surgery* ; Robotic Surgical Procedures/methods* ; Female ; Retrospective Studies ; Neck Dissection/methods* ; Lymph Node Excision/methods* ; Male ; Thyroid Cancer, Papillary ; Axilla/surgery* ; Thyroidectomy/methods* ; Breast/surgery* ; Middle Aged ; Adult ; Lymph Nodes/surgery* ; Treatment Outcome

OBJECTIVES: This study aims to evaluate the changes in the mandibular canal following the treatment of large odontogenic keratocysts through decompression and curettage, providing a theoretical basis for sequential treatment. METHODS: Twenty patients were selected for each decompression and curettage treatment of large odontogenic keratocysts in the mandible. Postoperative follow-up with was conducted every three months, during which cone beam computed tomography (CBCT) scans were performed. Then, the data were imported into MIMICS software to observe 3D changes in the position and structure of the mandibular nerve canal, followed by a comparative analysis. RESULTS: The total displacement of the mandibular canal was (1.89±0.21) mm on the decompression side and (0.80±0.19) mm on the curettage side. Vertically, the displacement range of the mandibular canal on the decompression side (M=1.03, SD=0.17) was larger than on the curettage side (M=0.52, SD=0.010) within nine months post-operation. In the buccal-lingual direction, the ratio of the thickness of the buccal plate to the lingual plate gradually increased with time. The amount of bone reconstruction at the part of the mandibular nerve canal closest to the cyst was (1.75±0.15) mm on the decompression side and (1.45±0.09) mm on the curettage side after nine months. CONCLUSIONS The mandibular nerve canal showed varying degrees of recovery and "relocation" after two surgical procedures. Osteogenesis around the mandibular nerve canal was more remarkable after decompression than after curettage. Therefore, for large odontogenic keratocyst, decompression is recommended as the initial treatment, followed by secondary curettage nine months later.
Humans ; Odontogenic Cysts/diagnostic imaging* ; Retrospective Studies ; Cone-Beam Computed Tomography ; Decompression, Surgical/methods* ; Mandibular Nerve/surgery* ; Mandible/innervation* ; Curettage ; Male ; Female ; Adult ; Middle Aged

Objective To optimize the platelet enrichment method,and to analyze the concentration changes of key molecules in platelet-rich plasma(PRP)before and after activation,as well as the impact of its activated products on the proliferation of rat endothelial progenitor cells.Methods The tube double-centrifu-gation method was employed to optimize platelet enrichment,and the platelet count in the enriched PRP was measured.ELISA was used to detect the concentration changes of vascular endothelial growth factor(VEGF),endostatin(ES),and P-selectin(CD62P)in PRP before and after activation.The PRP was activated by using liquid nitrogen freeze-thaw method,and the effect of its activated products on the proliferation of rat endothelial progenitor cells was evaluated by using the methyl thiazolyl tetrazolium(MTT)assay.Results The optimal enrichment coefficient of platelets achieved by the double-centrifugation method was 4.63.After low-speed,long-duration double centrifugation,the platelet count was highest in the upper layer of the buffy coat.For PRP with a platelet count of 500× 109/L obtained by machine collection,the VEGF con-centrations before and after activation were(3 418.12±488.80)pg/mL and(4 530.04±308.30)pg/mL,re-spectively,the ES concentrations were(6 168.98±253.22)pg/mL and(6 594.65±82.47)pg/mL,respec-tively,the CD62P concentrations were(6 678.23±324.15)pg/mL and(17 630.53±746.24)pg/mL,respec-tively,statistically significant differences were observed in the above indicators before and after activation(P＜0.01).The activated PRP was diluted in a gradient manner by using a specialized culture medium for en-dothelial progenitor cells.MTT assay results indicated that,in the basal medium,the optimal volume fraction for promoting endothelial progenitor cell proliferation was 0.25％after 48 hours of culture;in the complete medium,the optimal volume fractions for promoting endothelial progenitor cell proliferation were 0.062 5％after 24 hours and 0.125％after 48 hours.Conclusion The concentrations of VEGF,ES,and CD62P in the optimized,enriched PRP exhibited significant changes before and after activation.The optimal volume fraction for promoting endothelial progenitor cell proliferation in the basal medium was 0.25％.

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

Aim To investigate the intestinal protection and possible mechanism of magnolol(MG)in newborn rats with necrotizing enterocolitis(NEC).Methods The rats were randomly divided into control group(Ctrl group),model group(NEC group)and treatment group(MG group).The NEC model was induced by hypoxia,cold stimulation,deep formula milk and LPS intragastric administration in 7-day-old rats for four days.They were killed after five days of treatment with MG(20 mg·kg-1).HE staining was used to observe the intestinal pathological injury.Western blot was used to detect the expressions of IL-1 β,TNF-α,NL-RP3,ASC,caspase-1 and tight junction protein in the distal ileum of rats.Colon contents were collected for 16S rDNA sequencing to understand the gut microbio-ta.Results MG improved the body mass and intesti-nal injury of NEC neonatal rats.The expressions of in-testinal IL-1β,TNF-α,NLRP3,ASC and caspase-1 proteins were down-regulated,and the expressions of Claudin,Occludin and ZO-1 proteins were up-regula-ted.16S rDNA showed that MG increased the diversity of intestinal flora,and at the phylum level,MG in-creased the abundance of firmicutes and bacteroides in NEC model,and decreased the abundance of pro-teobacteria.At the genus level,MG treatment in-creased the abundance of Lactobacillus,unclassified_Muribaculaceae,Racteroides,but decreased the abun-dance of Escherichia_Shigella,Rodentibacter and Fuso-bacterium.Conclusion MG intervention can protect the intestinal tract of NEC rats by potentially improving barrier function,and regulating the intestinal microbiota through the NLRP3/ASC/caspase-1 signaling pathway.

Aim To investigate the effect of Zhenwu decoction on inflammation,oxidative stress and apopto-sis of human glomerular epithelial cells(HGEC)in-duced by lipopolysaccharide(LPS)based on Nrf2/HO-1 signaling pathway,and to explore the underlying mechanism.Methods HGEC were treated with LPS(1.0 mg·L-1)for 24 h to construct an oxidative damage model.On this basis,2.5％,5％and 10％Zhenwu decoction-containing serum were added to the low,medium and high dose groups of Zhenwu decoc-tion,and a normal group was set up.The changes of cell activity were assessed by MTT method and LDH method.The contents of TNF-α,IL-6,IL-10,SOD,CAT,GSH-Px,ROS and MDA in each group were de-tected by ELISA.The apoptosis of each group was de-tected by flow cytometry.The mRNA and protein ex-pressions of Bax,Bcl-2,caspase-3,caspase-9 and Nrf2/HO-1 pathway were detected by RT-qPCR and Western blot,respectively.Results Compared to the normal group,the model group of HGEC exhibited increased levels of inflammatory cytokines,enhanced oxidative stress response and aggravated apoptosis;after inter-vention with various doses of Zhenwu decoction,the in-flammatory levels in HGEC were reduced,oxidative damage and apoptosis were effectively ameliorated,and the mRNA and protein expression levels of the Nrf2/HO-1 signaling pathway were upregulated.Conclu-sions Zhenwu decoction can protect HGEC from LPS-induced inflammation and oxidative damage and im-prove apoptosis.The mechanism may be related to the activation of Nrf2/HO-1 signaling pathway.

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:This study aims to analyze historical trends and predict future trends of disability-adjusted life years (DALYs) attributable to high BMI for osteoarthritis (OA) in China. OA is a common chronic degenerative joint disease, with high body mass index (BMI) being a significant risk factor. in China.Methods:Based on the Global Burden of Disease (GBD) 2021 database, we analyzed trends in high-BMI-attributable OA. The ASR of hogh-BMI-attributable OA DALYs increased from DALYs in China from 1990 to 2021. A Bayesian age-period-cohort (BAPC) model was used to predict trends from 2022 to 2046. Age-standardized rates (ASR) and estimated annual percentage changes (EAPC) were calculated to assess trend changes of trends. A Bayesian age-period-cohort (BAPC) model was used to predict trends from 2022 to 2046. Chi-square tests were used to compare differences in high BMI attribution proportions between regions and years.Results:From 1990 to 2021, China′s OA DALYs increased from 1.829 to 5.327 million, with the proportion attributable to high BMI rising from 13.47% to 21.86% ( χ2=60 527.25, P<0.001). The ASR of high-BMI-attributable to OA increased from 27.4 (-2.2, 81.5) per 100,000 to 53.0 (-4.7, 150.7) per 100 000, with an EAPC of 2.48% [95% (uncertainty interval, UI): 2.35, 2.62]. In 2021, females showed significantly higher ASR (69.2 per 100 000) than males (36.1 per 100 000). Knee OA (ASR: 50.5/100 000) demonstrated substantially higher burden than hip OA (ASR: 2.5/100 000). Age effect analysis showed DALYs peaked at ages 80~90; period effect indicated accelerated growth after 2005; cohort effect showed a U-shaped trend with the 1990 birth cohort having the highest relative risk (approximately 3.0). Projections indicated that up to 2046, total OA DALYs will reach approximately 2.39 million with an ASR of about 71, showing more significant growth among females (ASR reaching 100). Conclusion:High-BMI-attributable to OA DALYs in China shows a significant upward trend, and is expected to continue. This trend is more pronounced among females and elderly populations than males, highlighting the urgency of implementing preventive measures for high-risk groups, particularly in weight management.

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.