Endoscopic transforaminal lumbar interbody fusion (TLIF) offers substantial advantages in the management of degenerative spinal diseases, including accelerated postoperative recovery. However, its technical complexity and steep learning curve pose risks for nerve root injury. Optimizing nerve root protection in full-endoscopic facet-sparing TLIF (FE fs-TLIF) and full-endoscopic facet-resecting TLIF (FE fr-TLIF) is essential for enhancing surgical safety. This study aimed to improve the nerve root protection in FE fs-TLIF and FE fr-TLIF by optimizing cage glider selection and insertion techniques based on the specific cage shape—banana-shaped or bullet-shaped. The goal was to ensure safe cage positioning and mitigate nerve root injury during discectomy, endplate preparation, and cage insertion. These strategies were validated through cadaveric simulations and clinical implementation. In FE fr-TLIF utilizing bullet-shaped (straight) cages, one-tip and two-tip cage gliders effectively protected the traversing nerve root by facilitating medial cage entry, thereby minimizing irritation of the exiting nerve root. Conversely, in FE fr-TLIF with banana-shaped cages, the lateral tilt of the cage holder during implantation required the use of a two-tip cage glider to protect the traversing and exiting nerve roots, thereby mitigating the potential risk of nerve irritation. In FE fs-TLIF, a one-tip cage glider is preferred for safeguarding the exiting nerve root, while the traversing root is inherently protected by the medial wall of the facet joint. The use of a two-tip cage glider in FE fs-TLIF can cause injury to the nerve root during glider insertion. In addition to the selection of cage gliders, improper cage insertion steps can also contribute to postoperative neurapraxia. The appropriate selection of cage gliders with corresponding insertion techniques is critical for nerve root protection in endoscopic TLIF. Tailoring these choices to the specific approach (FE fs-TLIF or FE fr-TLIF) and cage type (banana or bullet) enhances surgical safety and clinical outcomes.

Objective:To construct a tripartite game model involving the government,the public,and the pharmaceutical industry alliance during public health emergencies,revealing the dynamic mechanisms of health-related information quality regulation and exploring effective strategies to optimize the informa-tion dissemination environment through reward-punishment mechanisms.Methods:Based on evolutionary game theory,a tripartite evolutionary game model was established,integrating strategy spaces,payoff functions,and parameter definitions for each stakeholder.The pharmaceutical industry alliance's strate-gies included publishing high-or low-quality information(α),the public's strategies encompassed ration-al analysis or passive response(β),and the government's strategies involved regulatory enforcement or inaction(γ).Key parameters,such as economic benefits(Iyy),regulatory costs(Czf),penalties(Fyy),and incentives(Pyy),were quantified to reflect real-world scenarios.Replicator dynamic equa-tions and Jacobian matrices were derived to analyze the stability of equilibrium points,while MATLAB 2016a simulations were conducted to validate the model under varying initial conditions(e.g.,Iyy=100,150,200;Pyy=0,20,35;Fyy=0,10,20).Sensitivity analyses examined the impact of critical pa-rameters on system evolution,by 50 iterative simulations to observe convergence patterns.Results:The study revealed three key findings:(1)Public rational discernment(β)significantly influenced the phar-maceutical industry's strategy.Simulations demonstrated that increasing Iqz(benefits of information acqui-sition)reduced Cqz(cognitive costs),elevating β from 0.4 to 0.8 and driving α(high-quality information probability)to stabilize at 1.(2)Government regulatory intensity(γ)correlated positively with the so-cial hazards of low-quality information.When Fyy+Pyy＞Iyy,speculative behaviors decreased,achieving equilibrium at α=1.(3)Dual stable equilibria emerged:a high-quality equilibrium(α=1,β=1,γ=0)with lower regulatory costs and a low-quality equilibrium(α=0,β=0,γ=1)associated with higher social risks.Phase diagrams illustrated path dependency,where initial α＜0.5 led to the low-quality equilibrium unless dynamic penalties(Fyy＞20)and incentives(Pyy＞30)were enforced.Conclusion:A"carrot-stick"collaborative governance framework is proposed,emphasizing categorized regulation,AI-enabled auditing,and dynamic penalty systems.Future research should integrate emotional utility func-tions to address irrational decision-making impacts,thereby enhancing the adaptability of health informa-tion regulatory systems.

In recent years,the prevalence of overweight/obesity in solid organ transplant recipients has been rising rapidly.Clinical research evidence on obesity in solid organ transplant recipients has been increasing,but there is a lack of standardized diagnostic and treatment guidelines and comprehensive management pathways to guide clinical practice.Based on this,the Expert Consensus on Weight Management in Overweight or Obese Adult Solid Organ Transplant Recipients(2025 Edition)was organized and written by experts from the Diabetes Professional Committee of the Chinese Research Hospital Association.This consensus mainly provides recommendations on the epidemiological data,diagnostic criteria,screening and assessment methods,management pathways,and intervention strategies for overweight/obesity in solid organ transplant recipients.It aims to further improve the management level of medical workers engaged in the whole process of organ transplantation for the population with overweight/obesity combined with solid organ transplantation,standardize clinical diagnosis and treatment,improve patient prognosis,and enhance quality of life.

AIM To study the effects of total flavonoids of Dracocephalum Moldavica L.(TFDM)on reducing the inflammatory response of RAW264.7 macrophages induced by ox-LDL via the nuclear factor κB(NF-κB)/NOD-like receptor 3(NLRP3)signaling pathway.METHODS The RAW264.7 macrophages cultured in vitro were divided into the normal group,the model group(50 μg/mL ox-LDL),the TFDM group(100 μg/mL TFDM+50 μg/mL ox-LDL),the NF-κB inhibitor group(10 μmol/L Bay11-7821+50 μg/mL ox-LDL)and the TFDM+NF-κB inhibitor group(100 μg/mL TFDM+10 μmol/L Bay11-7821+50 μg/mL ox-LDL).The cells had their viability assessed by CCK-8 method;their ROS expression detected by the ROS kit;their mRNA expressions of NF-κB p65,NLRP3,Caspase-1,IL-18 and IL-1β detected by RT-qPCR;their protein expressions of NF-κB p65,IκBα,NLRP3,pro-Caspase-1,Caspase-1,IL-18 and IL-1β by Western blot;their protein expressions of NF-κB p65 and NLRP3 detected using immunofluorescence method.RESULTS Compared with the normal group,the model group showed increased ROS expression(P＜0.01);increased mRNA expressions of NF-κB p65,NLRP3,Caspase-1,IL-18 and IL-1β(P＜0.05,P＜0.01);decreased protein expressions of IκBα and cytoplasmic NF-κB p65(P＜0.01);increased protein expressions of nuclear NF-κB p65,NLRP3,Caspase-1,IL-1 β and IL-18(P＜0.01);and increased fluorescence intensity of NF-κB p65 and NLRP3(P＜0.01).Compared with the model group,the groups intervened with either TFDM or TFDM+inhibitor displayed decreased ROS expression(P＜0.01);the groups administrated with TFDM or NF-κB inhibitor,or TFDM+inhibitor showed decreased mRNA expressions of NF-κB p65,NLRP3,Caspase-1,IL-18 and IL-1β(P＜0.05,P＜0.01),increased protein expressions of IκBα and cytoplasmic NF-κB p65(P＜0.05,P＜0.01),decreased protein expressions of nuclear NF-κB p65,NLRP3,Caspase-1,IL-1β and IL-18(P＜0.05,P＜0.01),and decreased fluorescence intensity of NF-κB p65 and NLRP3(P＜0.01).There existed no significant group difference between the TFDM group and the NF-κB inhibitor group(P＞0.05).The TFDM+inhibitor group demonstrated decreased mRNA expressions of IL-1βand IL-18(P＜0.05),increased IκBα protein expression(P＜0.05),decreased protein expressions of nuclear NF-κB p65,NLRP3,Caspase-1,IL-1 β and IL-18(P＜0.05),and decreased fluorescence intensity of NLRP3 protein(P＜0.05).CONCLUSION TFDM can inhibit the ox-LDL-induced inflammatory response of RAW264.7 macrophages,and the mechansism may be associated with the reduced ROS expression and inflammatory factors due to the inhibited activation of the NF-κB/NLRP3 signaling pathway.

Objective:To observe the effects of ear acupressure combined with acupoint application on serum inflammatory factors,pain and psychological status of children with limb fractures.Methods:By using random number table method,60 children with limb fracture who were admitted to Qiantang Campus of Zhejiang Provincial Traditional Chinese Medicine Hospital from February 2022 to August 2024 were divided into control group(received conventional treatment combined with acupoint application)and experimental group(combined with ear acupressure based on the control group),with 30 cases in each group.Pain and swelling degree of the affected limb,anxiety and depression[Screening Checklist for Childhood Anxiety Disorders(SCARED),Depression self-rating scale for children(DSRSC)],inflammatory factors[High sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1(IL-1)]and family satisfaction rate were compared between the two groups.Results:The scores of visual analogue scale(VAS),SCARED and DSRSC in the experimental group were lower than those in the control group at 1 week and 4 weeks after treatment(P＜0.05).Swelling degree of the affected limb in the experimental group was better than that in the control group at 4 weeks after treatment(P＜0.05).hs-CRP,IL-1,IL-6 and TNF-α in the experimental group were lower than those in the control group at 4 weeks after treatment(P＜0.05).The family satisfaction rate in the experimental group was higher than that in the control group(P＜0.05).Conclusion:Ear acupressure combined with acupoint application therapy for children with limb fractures can significantly alleviate postoperative pain,promote swelling reduction,effectively reduce inflammation,and improve anxiety and depression,with high treatment satisfaction.

Aim To systematically investigate the ac-tive components,targets,and regulatory pathways of Po-lygonum capitatum in intervening atherosclerosis(AS)through network pharmacology,molecular docking and animal experiments.Methods Active components of Polygonum capitatum and AS-related targets were screened and identified through database searches.Protein-protein interaction(PPI)network analysis was performed using the STRING database,followed by GO and KEGG enrichment analyses via the David plat-form.Molecular docking validation was conducted with AutoDock.An AS model was established in Syrian golden hamsters fed a high-fat diet.Predicted pathways and targets were validated using qPCR,ELISA,and histopathological assessment of aortic and hepatic tis-sues via HE staining.Results Network pharmacology identified 27 potential active components of Polygonum capitatum(primarily flavonoids such as quercetin and luteolin)and 110 drug-disease intersection targets,in-cluding core targets MMP-9,ALB,and AKT1.GO and KEGG analyses enriched 593 and 125 pathways,re-spectively,with the NF-κB inflammatory pathway,TNF signaling pathway and lipid metabolism/atherosclerosis pathways highlighted as key mechanisms.Animal ex-periments demonstrated that Polygonum capitatum im-proved serum lipid profiles(reduced TC,TG,LDL-C)in AS hamsters,suppressed the MMP-9/NF-κB signa-ling pathway(downregulated MMP-9,p65 phosphoryla-tion,TNF-α,and IL-6),and inhibited VSMC synthetic phenotypic transformation(upregulated α-SMA and myocardin)by downregulating MCPIP1.Additionally,Polygonum capitatum ameliorated aortic lesions and he-patic lipid deposition in AS hamsters.Conclusions Polygonum capitatum alleviates AS by synergistically regulating the MMP-9/NF-κB/MCPIP1 axis through flavonoid components,suppressing vascular inflammato-ry cascades and maintaining VSMC contractile pheno-types.This reflects Polygonum capitatum's multi-com-ponent,multi-pathway,and multi-target characteristics in combating AS.

Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.

Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.

Alpha-enolase 1(ENO1)is a multifunctional protein that serves as a glycolysis enzyme,a plasminogen receptor,and a DNA-binding protein,playing a critical role in tumorigenesis and progres-sion.Long non-coding RNAs(lncRNAs)are crucial regulators of chromatin structure and gene expres-sion.Accumulated data have unveiled that lncRNAs regulate ENO1 through multiple pathways.In the nucleus,lncRNAs act on the ENO1 promoter to regulate its transcription.In the cytoplasm,lncRNAs af-fect ENO1 translation by acting directly or indirectly with ENO1 mRNA and by adsorbing small ribonucle-ic acids as sponges.Additionally,in the cytoplasm,lncRNAs influence the stability,enzyme activity,and other functions of ENO1 by directly binding to the ENO1 protein and acting as scaffold molecules to form a polymer with ENO1.In tumors,the abnormal expression of lncRNA regulates the overexpression and function of ENO1,promoting the proliferation and metastasis of tumor cells.There is currently some knowledge on the interaction between lncRNA and ENO1,and further investigation is needed to reveal the specific molecular mechanisms and biological functions,as well as the potential applications of ln-cRNA in clinical treatment.Here,we review the regulatory role of lncRNAs on ENO1,focusing on 16 i-dentified lncRNAs that regulate ENO1.Understanding the regulatory effects of lncRNAs on ENO1 will enhance our knowledge of the regulatory network involving ENO1 in tumor cells and may reveal new tar-gets for cancer treatment.

In recent years,the prevalence of overweight/obesity in solid organ transplant recipients has been rising rapidly.Clinical research evidence on obesity in solid organ transplant recipients has been increasing,but there is a lack of standardized diagnostic and treatment guidelines and comprehensive management pathways to guide clinical practice.Based on this,the Expert Consensus on Weight Management in Overweight or Obese Adult Solid Organ Transplant Recipients(2025 Edition)was organized and written by experts from the Diabetes Professional Committee of the Chinese Research Hospital Association.This consensus mainly provides recommendations on the epidemiological data,diagnostic criteria,screening and assessment methods,management pathways,and intervention strategies for overweight/obesity in solid organ transplant recipients.It aims to further improve the management level of medical workers engaged in the whole process of organ transplantation for the population with overweight/obesity combined with solid organ transplantation,standardize clinical diagnosis and treatment,improve patient prognosis,and enhance quality of life.