ObjectiveTo explore the effect of elbow-wrist functional orthosis on plantar pressure distribution and balance function in stroke patients with hemiplegia. MethodsFrom June, 2024 to April, 2025, 60 patients with post-stroke hemiplegia were recruited from Huashan Hospital, Fudan University, and Shanghai Hebin Rehabilitation Hospital. They were randomly divided into control group (n = 30) and intervention group (n = 30). The control group received routine neurological rehabilitation, while the intervention group received additional training with an elbow-wrist functional orthosis on the affected side, for eight weeks. Before and after intervention, the Modified Ashworth Scale (MAS) of the elbow joint, plantar pressure symmetry index (SI), plantar contact area and mean plantar pressure were recorded, and balance and mobility were assessed using the Berg Balance Scale (BBS), Timed Up & Go Test (TUGT) and 10-Meter Walk Test (10MWT). ResultsTwo cases dropped out in the control group. After treatment, MAS grades of the elbow joint, forefoot SI, affected side plantar pressure area, BBS scores, TUGT and 10MWT of both groups improved (|Z| > 3.969, |t| > 3.528, P < 0.01), while the hindfoot SI and average pressure of the affected foot improved in the intervention group (∣t∣ > 4.264, P < 0.001). Except for TUGT and 10MWT, the intervention group was superior to the control group (∣Z∣ > 2.030, ∣t∣ > 2.096, P < 0.05). ConclusionThe elbow-wrist functional orthosis can enhance balance function in stroke patients with hemiplegia by reducing upper-limb spasticity, optimizing center-of-gravity distribution, and improving postural control.

Objective:To explore the short- and medium-term clinical outcomes of covered stent implantation in the treatment of transplant renal artery stenosis (TRAS).Methods:A retrospective analysis was conducted on the clinical data of 12 consecutive patients with TRAS (transplant renal artery stenosis) who underwent covered stent implantation in Henan Provincial People′s Hospital from January 2021 to December 2024. The changes in indicators such as serum creatinine (Cr), blood urea nitrogen (BUN), mean arterial pressure (MAP), peak systolic velocity (PSV), intrarenal resistance index (RI), and the diameter of the stenotic site were analyzed before the operation, one week after the operation, six months after the operation, and 12 months after the operation. Repeated measures analysis of variance was used to investigate the changes of each observation index over time.Results:The surgery was successfully performed on all 12 patients, with a technical success rate of 100%. Among them, 8 cases used self-expanding covered stents, and 4 cases used balloon-expandable covered stents. One week, six months and twelve months after the surgery, the levels of Cr, BUN, PSV and MAP were all lower than those before the surgery. The RI and the diameter of the stenotic site were significantly increased compared with those before the surgery, the difference was statistically significant ( P<0.05). During the perioperative period and the postoperative follow-up period, no surgery-related complications were found. Conclusion:The implantation of the covered stent can effectively relieve the stenosis of the transplant renal artery, significantly improve renal function, and reduce blood pressure levels in TRAS patients, while maintaining excellent short-to medium-term clinical outcomes.

OBJECTIVE To observe the clinical efficacy of Zhenshi Burn Ointment on postoperative wound healing of simple anal fistula and explore its potential mechanism of action.METHODS A total of 60 patients with low-position simple anal fistula of damp-heat pouring downward type admitted to the Department of Anorectum,Nanjing Hospital of Chinese Medicine Affiliated to Nan-jing University of Chinese Medicine from May to December 2023 were selected as the research subjects and randomly divided into an experimental group and a control group,with 30 cases in each group.After surgery,the control group was given sterilized vaseline gauze for external application,and the experimental group was given Zhenshi Burn Ointment for external application.The course of treatment for both groups was 30 d.After treatment,the postoperative wound healing time,wound healing rate,pain score,wound granulation growth and secretion,and changes in TCM syndrome score were compared between the two groups.The pathological sec-tions of wound granulation tissue were compared 14 d after surgery.The transcription levels of COL1A1,type Ⅲ collagen(COL3A1),epidermal growth factor(EGF),and fibroblast growth factor(FGF2)in granulation tissue were detected by qPCR.The expression lev-els of proteins related to MEK/ERK signaling pathway were detected by Western blot.RESULTS Compared with the control group,the wound healing rates of the experimental group were significantly increased at 7,14,21,and 30 d after surgery(P<0.01),and the wound healing time was significantly shortened(P<0.01).At 7 d after surgery,the pain score of the experimental group was signifi-cantly lower than that of the control group(P<0.05).At 7 and 14 d after surgery,the granulation growth score of the wound in the ex-perimental group was significantly lower than that of the control group(P<0.01).At 14 d after surgery,the secretion score of the ex-perimental group was significantly lower than that of the control group(P<0.01).At 14 and 30 d after surgery,the total score of TCM syndrome in the experimental group was significantly better than that in the control group(P<0.05).At 14 d after surgery,the patho-logical improvement of granulation tissue in the wound in the experimental group was better than that in the control group,and the con-tent of collagen fiber and type I collagen(Collagen I)was significantly higher than that in the control group(P<0.01).The mRNA contents of COL1A1,COL3A1,EGF,and FGF2 were significantly higher than those in the control group(P<0.05,P<0.01);the levels of p-MEK1/2 and p-ERK1/2 proteins were higher than those in the control group(P<0.05).CONCLUSION Zhenshi Burn Ointment has a good effect on promoting postoperative anal fistula wound healing,which may be related to upregulating growth factor expression,promoting collagen regeneration,and activating MEK/ERK pathway.

Intraoperative neural monitoring (IONM) combines electrophysiology with anatomy to monitor nerve function during thyroid surgery,and has become an important auxiliary technology for neuroprotection. After more than ten years of development,the technology has been widely applied and popularized in China,promoting the development of a number of new technologies in the industry. Combined with the questionnaire survey data of the Chinese Neural Monitoring Study Group,this paper aims to summarize the clinical effect of IONM technology, the application status and existing problems at home and abroad, and propose the possible future development direction.

In the traditional theoretical system of traditional Chinese medicine， latent pathogenic factors deeply hiding in the liver and gallbladder of the Jueyin meridian are the core pathogenesis of chronic hepatitis B. Interferon can regulate immunity and eliminate viruses， and clinical cure can be achieved by penetrating and removing pathogenic factors and toxins. However， it often causes dizziness and confusion reactions in the initial stage of treatment， and long-term use can damage Qi-blood； furthermore， its therapeutic effect depends on the patient’s own vital Qi. When traditional Chinese medicine is used in combination with interferon， drug compatibility should be adjusted according to the dynamic changes of pathogenesis， which can reduce adverse reactions， enhance the therapeutic outcome， expand the applicable population of interferon， and improve the clinical symptoms of patients.

Objective:To screen out the differentially expressed genes(DEGs)in multiple primary lung cancers(MPLCs)using bioinformatics methods,and to analyze their biological functions and their influence in the prognosis of lung adenocarcinoma.Methods:Single-cell transcriptome sequencing data(GSE200972)was downloaded from the Gene Expression Omnibus(GEO)database.After preliminary data processing with R software,the Seurat R package was used for data processing,cell clustering,and annotation.The clusterProfiler R package was used for Gene Set Enrichment Analysis(GSEA).The STRING database and Cytoscape software were employed to construct the protein-protein interaction(PPI)network and to screen out the key genes(Hub genes).The gene expression levels in the lung adenocarcinoma database were analyzed using Gene Expression Profiling Interactive Analysis(GEPIA)database.Real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the gene expression in tumor tissue of A549 xenograft mice and lung tissue of normal mice.Kaplan-Meier Plotter was used for prognosis analysis.Results:Seven cell types were identified from cell clustering analysis,which were epithelial cells,endothelial cells,fibroblasts,T cells and natural killer(NK)cells,B cells,myeloid cells,and mast cells.A total of 14 605 DEGs were screened out between tumor epithelial cells and normal epithelial cells.The GSEA results revealed four activated pathways in tumor samples[myelocytomatosis oncogene(MYC)pathway,P53 pathway,oxidative phosphorylation pathway and glycolysis pathway]and one inhibited pathway[tumor necrosis factor-α(TNF-α)and nuclear factor kappa B(NF-κB)pathway].The Hub genes identified from PPI network included CXC motif chemokine ligand 8(CXCL8),glyceraldehyde-3-phosphate dehydrogenase(GAPDH),CXC motif chemokine receptor 4(CXCR4),kirsten rat sarcoma viral proto-oncogene(KRAS),CXC motif chemokine ligand 1(CXCL1),C-C motif chemokine ligand 2(CCL2),mucin 1(MUC1),and secreted phosphoprotein 1(SPP1).The GEPIA database analysis and animal experiments showed that the expression levels of SPP1 mRNA in non-small cell lung cancer tissue were increased compared with normal lung tissue(P＜0.01).The Kaplan-Meier survival analysis indicated that the patients with high expression level of SPP1 had shorter overall survival(OS)than those with low expression level(P＜0.01).Conclusion:There are activation of oncogene-related pathways and activation of tumor suppressor pathway antagonizing tumor progression in MPLCs.Moreover,elevated expression of SPP1 in non-small cell lung cancer may indicate a relatively poor prognosis.

Urolithiasis represents a prevalent clinical challenge marked by high recurrence rates and morbidity，with existing preventive strategies struggling to effectively curb its epidemic trajectory，thereby posing a significant threat to public health. The etiology of this condition is intricate，involving a complex network of interactions spanning classical supersaturation-crystallization theory，Randall’s plaque theory，and multifactorial elements such as cellular injury，inflammatory responses，metabolic derangements，the gut-kidney axis，immune dysregulation，and genetic predisposition. However，the critical mechanisms initiating stone formation and the early pathophysiological processes remain incompletely elucidated，constituting the core impasse in current preventive strategies. This review systematically synthesizes classical theories and cutting-edge advancements in urolithiasis etiology research，emphasizing the urgent need to integrate emerging technologies，including high-dimensional omics，advanced imaging modalities，and artificial intelligence，to dissect pivotal pathological nodes in early stone formation. Such interdisciplinary efforts are essential to overcome cognitive bottlenecks and ultimately achieve personalized，precision-based prevention strategies.

Objective:To investigate the clinical efficacy of 3D-printed metal augment or integrated acetabular prostheses for reconstruction of bone defects in hip revision.Methods:A total of 11 patients who underwent total hip revision in Zhengzhou Orthopaedic Hospital from June 2021 to July 2023 were retrospectively analysed. There were 5 males and 6 females, age 64.8±10.7 years (range, 58-75 years), and body mass index 23.3±4.8 kg/m 2 (range, 21-27 kg/m 2). Paprosky classification of acetabular bone defects: 3 cases of type IIA, 4 cases of type IIB, 3 cases of type IIIA, 1 case of type IIIB. Reasons for revision: 8 cases of aseptic loosening, 3 cases after infection exclusion procedure. A 3D-printed metal augment was used in 9 cases (8 cases of aseptic loosening and 1 case of infected exclusion procedure) and a 3D-printed integrated acetabulum was used in 2 cases (infected exclusion procedure). The time from primary total hip arthroplasty to revision was 11.8±5.6 years (range, 5-17 years). Harris hip score and visual analogue scale (VAS) were used to evaluate the improvement of hip function and pain recovery. The leg length discrepancy, vertical height and horizontal position of the hip rotation center were measured on pelvic anteroposterior X-ray films. Results:All patients successfully completed the operation. The operation time was 145.9±35.5 min (range, 110-159 min), and the intraoperative blood loss was 950.5±310.8 ml (range, 680-1,450 ml). The postoperative Harris hip function score was significantly higher than that before operation ( F=554.085, P<0.001). One year after operation, the Harris hip function score was 74.36±5.16, which was higher than that before operation 32.18±4.07, and the difference was statistically significant ( P<0.05). The VAS scores of all patients decreased after operation, and the difference was statistically significant compared with that before operation ( F=177.717, P<0.001). The VAS score at 1 year after operation was 1.27±0.65, which was lower than that before operation 6.18±1.17, and the difference was statistically significant ( P<0.05). The preoperative leg length discrepancy was 1.97±0.71 cm, which was greater than 0.69±0.52 cm at the last follow-up, and the difference was statistically significant ( t=4.824, P<0.001). The vertical height of the hip rotation center was 1.88±0.46 cm on the affected side and 1.67±0.35 cm on the healthy side, showing no significant difference ( t=1.205, P=0.242). The postoperative horizontal position of the hip rotation center was 3.48±0.55 cm on the affected side and 3.54±0.32 cm on the healthy side, and the difference was no statistically significant ( t=-0.313, P=0.758). One case had an intraoperative greater trochanteric fracture that healed 3 months after reduction and internal fixation. All patients were followed up for 21.3±9.5 months (range, 15-31 months). All incisions healed in one stage, and all patients were fully weight-bearing at 3 months after operation. At the last follow-up, there was no case of loosening, dislocation or infection of the prosthesis; 4 cases had mild claudication, 1 case had heterotopic ossification, and the patients had good hip flexion and extension functions, which did not affect daily life without further treatment. Conclusion:The clinical efficacy of 3D-printed metal augment or integrated acetabular prosthesis for reconstruction of acetabular bone defects is satisfactory, which can restore the normal center of rotation of the hip joint and has a low incidence of postoperative complications.

Loss of protein homeostasis is a hallmark of cellular senescence, and ribosome pausing plays a crucial role in the collapse of proteostasis. However, our understanding of ribosome pausing in senescent cells remains limited. In this study, we utilized ribosome profiling and G-quadruplex RNA immunoprecipitation sequencing techniques to explore the impact of RNA G-quadruplex (rG4) on the translation efficiency in senescent cells. Our results revealed a reduction in the translation efficiency of rG4-rich genes in senescent cells and demonstrated that rG4 structures within coding sequence can impede translation both in vivo and in vitro. Moreover, we observed a significant increase in the abundance of rG4 structures in senescent cells, and the stabilization of the rG4 structures further exacerbated cellular senescence. Mechanistically, the RNA helicase DHX9 functions as a key regulator of rG4 abundance, and its reduced expression in senescent cells contributing to increased ribosome pausing. Additionally, we also observed an increased abundance of rG4, an imbalance in protein homeostasis, and reduced DHX9 expression in aged mice. In summary, our findings reveal a novel biological role for rG4 and DHX9 in the regulation of translation and proteostasis, which may have implications for delaying cellular senescence and the aging process.
G-Quadruplexes ; Cellular Senescence ; Ribosomes/genetics* ; Humans ; Animals ; Mice ; DEAD-box RNA Helicases/genetics* ; Protein Biosynthesis ; RNA/chemistry* ; Neoplasm Proteins

Chronic, unresolved inflammation correlates with persistent hepatic injury and fibrosis, ultimately progressing to hepatocellular carcinoma (HCC). Bisdemethoxycurcumin (BDMC) demonstrates therapeutic potential against HCC, yet its mechanism in preventing hepatic "inflammation-carcinoma transformation" remains incompletely understood. In the current research, clinical HCC specimens underwent analysis using hematoxylin-eosin (H&E) staining and immunohistochemistry (IHC) to evaluate the expression of fibrosis markers, M2 macrophage markers, and CXCL12. In vitro, transforming growth factor-β1 (TGF-β1)-induced LX-2 cells and a co-culture system of LX-2, THP-1, and HCC cells were established. Cell functions underwent assessment through 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), flow cytometry, and Transwell assays. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR), Western blotting and immunofluorescence evaluated the differential expression of molecules. The interaction between β-catenin/TCF4 and CXCL12 was examined using co-immunoprecipitation (Co-IP), dual luciferase, and chromatin immunoprecipitation (ChIP) assays. A DEN-induced rat model was developed to investigate BDMC's role in liver fibrosis-associated HCC (LFAHCC) development in vivo. Our results showed that clinical HCC tissues exhibited elevated fibrosis and enriched M2 macrophages. BDMC delayed liver fibrosis progression to HCC in vivo. BDMC inhibited the inflammatory microenvironment induced by activated hepatic stellate cells (HSCs). Furthermore, BDMC suppressed M2 macrophage-induced fibrosis and HCC cell proliferation and metastasis. Mechanistically, BDMC repressed TCF4/β-catenin complex formation, thereby reducing CXCL12 transcription in LX-2 cells. Moreover, CXCL12 overexpression reversed BDMC's inhibitory effect on macrophage M2 polarization and its mediation of fibrosis, as well as HCC proliferation and metastasis. BDMC significantly suppressed LFAHCC development through CXCL12 in rats. In conclusion, BDMC inhibited LFAHCC progression by reducing M2 macrophage polarization through suppressing β-catenin/TCF4-mediated CXCL12 transcription.
Animals ; Liver Neoplasms/etiology* ; Humans ; Carcinoma, Hepatocellular/immunology* ; Liver Cirrhosis/complications* ; Macrophages/drug effects* ; Male ; Rats ; Chemokine CXCL12/genetics* ; Diarylheptanoids/pharmacology* ; Rats, Sprague-Dawley ; beta Catenin/genetics*