With the aging population and the widespread implementation of lung cancer screening programs, an increasing number of elderly patients are undergoing curative lung resection. Due to diminished physiological reserve and complex comorbidities, this demographic exhibits a significantly higher incidence of severe perioperative complications (defined as Clavien-Dindo grade≥Ⅲ), which adversely affects both perioperative safety and long-term prognosis. In recent years, the research paradigm has shifted from univariate analysis toward multidimensional risk integration and the development of predictive models. This article systematically reviews the key risk factors for severe perioperative complications in elderly lung cancer patients, encompassing biological aging processes, frailty and sarcopenia, cardiopulmonary and renal functional reserves, inflammatory-immune and coagulation status, and perioperative interventions. Furthermore, it traces the evolution of risk assessment tools from traditional regression models to machine learning models that integrate multimodal data. The review also discusses common challenges in this field, including the standardization of outcome definitions, external validation, calibration assessment, and clinical translation. Future efforts should prioritize the deep integration of predictive tools with clinical decision support systems to establish a closed-loop care pathway from risk identification to stratified intervention, thereby effectively reducing complication rates and enhancing surgical outcomes for elderly lung cancer patients.

Objective To explore the predictive efficiency of serum Dickkopf-1 protein(DKK-1)and C1q tumor necrosis factor-related protein 3(CTRP3)levels for thoracolumbar fractures in patients with osteoporosis(OP).Methods Between January 2020 and August 2024,124 OP patients treated at the hospital were recruited into the OP group.Based on the occurrence of thoracolumbar fractures,these OP patients were divided into a non-fracture group(n=70)and a fracture group(n=54).Additionally,124 healthy individuals who underwent physical examinations served as the control group.The enzyme-linked immunosorbent assay(ELISA)was employed to measure the levels of serum DKK-1 and CTRP3.Multivariate logistic regression analysis was utilized to analyze the influencing factors of thoracolumbar fractures in OP patients.Receiver operating characteristic(ROC)curves were used to evaluate the predictive value of serum DKK-1 and CTRP3 for thoracolumbar fractures in OP patients.Results In comparison with the control group,the serum level of DKK-1 was significantly higher,while the serum level of CTRP3 was significantly lower in the OP group(P<0.05).When compared with the non-fracture group,the fracture group exhibited prominently higher serum DKK-1 levels,age,duration of OP,and proportion of OP grade Ⅲ,whereas the serum CTRP3 level was significantly lower(P<0.05).High expression of DKK-1 was iden-tified as an independent risk factor for thoracolumbar fractures in patients with osteoporosis,while high expression of CTRP3 was found to be an independent protective factor for thoracolumbar fractures in such patients(P<0.05).The area under the curve(AUC)values of serum DKK-1 and CTRP3 levels for predicting thoracolumbar fractures in OP patients were 0.790 and 0.753,respectively.The AUC of the combined prediction of the two was 0.888,which was superior to the individual predictions of either one(ZDKK-1-combined=3.351,ZCTRP3-combined=3.172,both P<0.05).Conclusions In the serum of OP patients,the expression of DKK-1 is upregulated,while the expression of CTRP3 is downregulated.Both are factors influencing the occurrence of thoracolumbar fractures in OP patients.The combination of the two has a high predictive value for the occurrence of thoracolumbar fractures in OP patients.

Objective·To explore the effects and potential mechanisms of emodin on Alzheimer's disease(AD).Methods·Wild-type C57BL/6J mice and 3×Tg-AD mice were divided into 6 groups:Control group(C57BL/6J mice),AD group(3×Tg-AD mice),Emodin 25 mg/kg group(3×Tg-AD mice+Emodin 25 mg/kg),Emodin 50 mg/kg group(3×Tg-AD mice+Emodin 50 mg/kg),Emodin 100 mg/kg group(3×Tg-AD mice+Emodin 100 mg/kg)and Donepezil group(3×Tg-AD mice+Donepezil 3 mg/kg).The Morris water maze test was used to evaluate the learning and memory abilities of mice.The expression of glial fibrillary acidic protein(GFAP),glucose-regulated protein 78kDa(GRP78),and inositol-requiring enzyme 1α(IRE1α)was detected by immunohistochemistry.The levels of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),and IL-6 in brain tissue were measured by enzyme-linked immunosorbent assay(ELISA).Western blotting was used to detect the expression of NF-κB p65,p-NF-κB p65,p38,and p-p38 proteins.Results·Compared with the control group,mice in the AD group showed impaired cognition,increased GFAP expression,elevated levels of TNF-α,IL-1β and IL-6,and increased expression of GRP78 and IRE1α,along with enhanced phosphorylation of NF-κB p65 and p38.Compared with the AD group,emodin improved cognitive impairment of AD mice,inhibited astrocyte overactivation and neuroinflammation,and decreased the expression of GRP78,IRE1α,phosphorylated NF-κB p65,and phosphorylated p38 in brain tissue.Conclusion·Emodin can effectively improve cognitive impairment in AD mice,which may be related to the inhibition of endoplasmic reticulum stress-mediated neuroinflammation in astrocytes.

In the context of globalization,zoonosis prevention and control requires an integrated approach across human,animal,and environmental systems,including interdisciplinary and cross sectional collaboration,which impose heightened requirements for the core competencies among relevant professionals.By a systematic analysis of literature and policy documents,this study explored progress in the application of the One Health concept to the global prevention and control of zoonoses,with a focus on dissecting practi-cal achievements and empirical insights regarding policies promoting the development of core competencies among professionals in this field.By summarizing the existing core competency frameworks and their construction methods,this article also disscussed the guiding roles of existing frameworks,such as the"competencies for one health field epidemiology framework"and the"Ecohealth and One Health network competency framework"on the cultivation of professional talent.This work aimed at providing theoretical support for establishing a One Health-oriented competency framework in China,promoting multidisciplinary collaboration,offering scientific foundations for policy-making and talent cultivation,and contributing to achieving the strategic objectives of"Healthy China 2030"and the Sustainable Development Goals.

Objective:To investigate the efficacy of nafamostat mesylate in traumatic extracorporeal membrane oxygenation (ECMO) therapy.Methods:Patients admitted to the intensive care units of Children's Hospital Affiliated to Xi'an Jiaotong University and Gansu Provincial Maternal and Child Health Hospital for ECMO-assisted cardiopulmonary support due to trauma from January 2021 to December 2024 were selected as the study subjects. Based on different anticoagulation strategies, patients were divided into the nafamostat mesylate group( n=11) and the common heparin group( n=10). The general conditions of the two groups were compared. In addition, differences in various clinical indicators during the ECMO-assisted process were compared, including white blood cell count (WBC), platelet count (PLT), hemoglobin level (Hb), hematocrit (HCT), prothrombin time(PT), activated partial thromboplastin time (APTT), thrombin time(TT), fibrinogen(FIB) and D-dimer. Furthermore，the differences in the total volume of component blood transfusions, coagulation substances, complications and prognosis between the two groups were compared. Results:No statistically significant differences were observed between the two groups regarding age, gender, weight, type of ECMO support, type of trauma, presence of active bleeding, or rate of surgical intervention. There were no statistically significant differences in WBC, PLT, Hb, HCT, PT, APTT, TT, FIB, and D-dimer between the two groups of patients prior to the initiation of ECMO support (all P>0.05). Compared with the common heparin group, children in the nafamostat mesylate group had lower PT[(21±6)s vs. (27±3)s; (20±4) vs. (28±5)], APTT[(68±8)s vs. (89±12)s; (64±15)s vs. (85±21)s], TT [(25±11)s vs. (31±13)s; (24±8)s vs. (35±6)s], and D-dimer[(5.8±1.1) μg/mL vs. (11.5±5.6) μg/mL; (4.2±1.8) μg/mL vs. (14.6±2.5) μg/mL],and higher FIB[(2.1±0.5) g/L vs. (1.6 ± 0.3) g/L; (2.4 ± 0.4) g/L vs. (1.3 ± 0.6) g/L] when ECMO assisted for 24 h and 72 h,the differences were all statistically significant(all P<0.05). Compared to the nafamostat mesylate group, the common heparin group exhibited significantly higher total cumulative infusion amounts of red blood cell suspension, plasma, platelet, FIB, hemocoagulase, and thromboplastin complex during the ECMO-assisted process, and the differences were statistically significant (all P<0.05). There was no statistically significant difference between the two groups of children in terms of time to ECMO assistance, membrane lung failure, loop thrombosis, embolism, and successful withdrawal rate (all P>0.05). Conclusion:Nafamostat mesylate can effectively reduce the risk of bleeding and minimize the requirement for blood product and coagulation substance infusions during traumatic ECMO assistance.

Objective To investigate the expression levels of serum tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activation protein β(14-3-3β)and clara's cell secretory protein 16(CC16)in patients with chronic obstructive pulmonary disease(COPD)complicated by respiratory failure,and their relationship with prognosis.Methods A total of 232 patients with COPD complicated with respiratory failure admitted to Yantian Hospital of Southern University of Science and Technology from April 2020 to October 2023 were enrolled in the COPD complicated with respiratory failure group.According to the severity of the disease,they were divided into mild group(n=67),moderate group(n=73)and severe group(n=92).According to the 28-day prognosis,they were divided into death group(n=73)and survival group(n=159).In addition,80 patients with simple COPD(COPD group)and 80 healthy subjects(control group)were selected at the same time.Enzyme-linked immunosorbent assay(ELISA)was used to detect the expression of serum 14-3-3β and CC16.Multivariate Logistic regression analysis was used to analyze the factors of death in patients with COPD complicated with respiratory failure.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum 14-3-3β and CC16 expression on the death of patients with COPD complicated with respiratory failure.Results The expression of serum 14-3-3β in COPD complicated with respiratory failure group was higher than that in COPD group and control group(U=3.894,11.417),the expression of CC16 was lower than that in COPD group and control group(t=5.845,14.306),and the differences were statistically significant(all P<0.05),respectively.The expression of serum 14-3-3β in severe group was higher than that in moderate group and mild group(U=5.179,8.234),the expression of CC16 was lower than that of moderate group and mild group(t=4.090,9.281),and the differences were statistically significant(all P<0.05),respectively.The 28-day mortality rate of 232 COPD patients with respiratory failure was 31.47%(73/232).The expression of serum 14-3-3β in the death group was higher than that in the survival group,and the expression of CC16 was lower than that in the survival group,the differences were statistically significant(U/t=6.790,8.265,all P<0.05).The age of the death group was older than that of the survival group,the degree of airflow limitation and the number of acute exacerbations within 1 year were higher than those of the survival group,and the differences were statistically significant(t/χ2/U=3.895,7.202,3.360,all P<0.05).Age,severe airflow limitation,extremely severe airflow limitation,and the number of acute exacerbations within 1 year,elevated 14-3-3β were independent risk factors for death in patients with COPD complicated with respiratory failure(Wald χ2=3.914～22.668,all P<0.05),and elevated CC16 was an independent protective factor(Wald χ2=23.675,P<0.05).The area under the curve(AUC)of serum 14-3-3β combined and CC16 expression in predicting the death of patients with COPD complicated with respiratory failure which was greater than that of serum 14-3-3β and CC16 expression alone,the differences were statistically significant(Z=3.995,3.813,all P<0.01).Conclusion The increase of serum 14-3-3β expression and the decrease of CC16 expression in patients with COPD complicated by respiratory failure are closely related to the aggravation of the disease and poor prognosis.The combination of serum 14-3-3β and CC16 expression is of high value in predicting the death of patients with COPD complicated with respiratory failure.

Objective:To investigate the feasibility of areal bone mineral density (aBMD) quantification and the diagnostic performance for abnormal bone mass using the coronal spectral localizer radiography (SLR) from photon-counting detector CT (PCD-CT).Methods:This cross-sectional study prospectively enrolled 67 participants who underwent both dual-energy X-ray absorptiometry (DXA) and dual-source PCD-CT examinations within 7 days at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine between April 2024 and September 2025. The aBMD values of L1-L4 derived from DXA and calculated based on PCD-CT SLR were obtained (aBMD DXA and aBMD SLR, respectively). Participants were categorized into four groups based on body mass index (BMI): underweight (BMI<18.5 kg/m2, n=3), normal weight (18.5 kg/m2≤BMI<24 kg/m2, n=33), overweight (24 kg/m2≤BMI<28 kg/m2, n=22), and obese (BMI≥28 kg/m2, n=9) groups. Using aBMD DXA as the golden reference, T-scores were calculated, and participants were classified into normal bone mass (T-score≥-1.0, n=42), osteopenia (-2.50.05). Across the normal bone mass, osteopenia, and osteoporosis groups, significant differences were found in aBMD DXA, aBMD SLR, and AE ( P<0.001), but not in RAE ( P=0.426). Using aBMD SLR-based T-score classification, 38, 16, and 13 participants were classifying as having normal bone mass, osteopenia, and osteoporosis. For diagnosing osteoporosis, aBMD SLR achieved an accuracy of 94.0% (63/67), sensitivity of 90.9% (10/11), and specificity of 94.6% (53/56). For detecting abnormal bone mass, the accuracy, sensitivity, and specificity were 94.0% (63/67), 100% (25/25), and 90.5% (38/42), respectively. Conclusions:Quantitative bone density assessment based on PCD-CT SLR is feasible and accurate, unaffected by body habitus or bone mass status, and demonstrates high diagnostic performance for osteoporosis and abnormal bone mass.

Objective·To explore the effects and potential mechanisms of emodin on Alzheimer's disease(AD).Methods·Wild-type C57BL/6J mice and 3×Tg-AD mice were divided into 6 groups:Control group(C57BL/6J mice),AD group(3×Tg-AD mice),Emodin 25 mg/kg group(3×Tg-AD mice+Emodin 25 mg/kg),Emodin 50 mg/kg group(3×Tg-AD mice+Emodin 50 mg/kg),Emodin 100 mg/kg group(3×Tg-AD mice+Emodin 100 mg/kg)and Donepezil group(3×Tg-AD mice+Donepezil 3 mg/kg).The Morris water maze test was used to evaluate the learning and memory abilities of mice.The expression of glial fibrillary acidic protein(GFAP),glucose-regulated protein 78kDa(GRP78),and inositol-requiring enzyme 1α(IRE1α)was detected by immunohistochemistry.The levels of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),and IL-6 in brain tissue were measured by enzyme-linked immunosorbent assay(ELISA).Western blotting was used to detect the expression of NF-κB p65,p-NF-κB p65,p38,and p-p38 proteins.Results·Compared with the control group,mice in the AD group showed impaired cognition,increased GFAP expression,elevated levels of TNF-α,IL-1β and IL-6,and increased expression of GRP78 and IRE1α,along with enhanced phosphorylation of NF-κB p65 and p38.Compared with the AD group,emodin improved cognitive impairment of AD mice,inhibited astrocyte overactivation and neuroinflammation,and decreased the expression of GRP78,IRE1α,phosphorylated NF-κB p65,and phosphorylated p38 in brain tissue.Conclusion·Emodin can effectively improve cognitive impairment in AD mice,which may be related to the inhibition of endoplasmic reticulum stress-mediated neuroinflammation in astrocytes.

In the context of globalization,zoonosis prevention and control requires an integrated approach across human,animal,and environmental systems,including interdisciplinary and cross sectional collaboration,which impose heightened requirements for the core competencies among relevant professionals.By a systematic analysis of literature and policy documents,this study explored progress in the application of the One Health concept to the global prevention and control of zoonoses,with a focus on dissecting practi-cal achievements and empirical insights regarding policies promoting the development of core competencies among professionals in this field.By summarizing the existing core competency frameworks and their construction methods,this article also disscussed the guiding roles of existing frameworks,such as the"competencies for one health field epidemiology framework"and the"Ecohealth and One Health network competency framework"on the cultivation of professional talent.This work aimed at providing theoretical support for establishing a One Health-oriented competency framework in China,promoting multidisciplinary collaboration,offering scientific foundations for policy-making and talent cultivation,and contributing to achieving the strategic objectives of"Healthy China 2030"and the Sustainable Development Goals.

Objective To propose a Weka-based method for classifying acute lymphoblastic leukemia(ALL)images,aiming to improve ALL cell classification accuracy and stability.Methods Firstly,totally 180 images were randomly selected from ALL-IDB2 subset of Acute Lymphoblastic Leukemia Image Database(ALL-IDB),including 90 images of patients and 90 images of healthy people;secondly,the image preprocessing was carried out using ImageJ software and image features were extracted such as texture,edge and shape;thirdly,image classification was implemented with four classifiers of Weka,including random forest(RF),Bayesian network(BN),J48 decision tree and sequential minimal optimization(SMO),and the key parameters of each classifier were optimized;finally,the performance of the classifiers was verified using 80 independent test images.Results Before parameter optimization,the accuracy of RF,J48 decision tree,BN and SMO classifiers was 94.3％,86.2％,83.6％and 83.0％,respectively.After optimization,the accuracy increased to 95.2％,86.3％,86.3％and 89.7％,respectively.After optimization,RF behaved the best on the independent test set with a classification accuracy of 90.0％,followed by SMO(81.3％),BN(81.3％)and J48 decision tree(75.0％).Conclusion The Weka-based ALL image classification method with a high accuracy is efficient and reliable for automated classification of ALL cell.[Chinese Medical Equipment Journal,2025,46(2):10-15]