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.

With the rapid advancement of artificial intelligence technology, chatbots have shown great potential in the healthcare sector. From personalized health advice to chronic disease management and psychological support, chatbots have demonstrated significant advantages in improving the efficiency and quality of healthcare services. As the scope of their applications expands, the relationship between technological complexity and practical application scenarios has become increasingly intertwined, necessitating a more comprehensive evaluation of both aspects. This paper, from the perspective of he althcare applications, systematically reviews the technological pathways and development of chatbots in the medical field, providing an in-depth analysis of their performance across various medical scenarios. It thoroughly examines the advantages and limitations of chatbots, aiming to offer theoretical support for future research and propose feasible recommendations for the broader adoption of chatbot technologies in healthcare.

Objective: To investigate the status of drug resistance before anti-retroviral therapy among newly dignosed HIV/AIDS patients aged ≥50 years in Yangzhou City, Jiangsu Province, so as to provide the evidence for improving the anti-retroviral therapy effect of AIDS. Methods: HIV/AIDS patients aged ≥50 years who were newly dignosed in Yangzhou City from 2021 to 2024 and did not receive anti-retroviral therapy were selected. Basic information were collected through the Chinese Disease Prevention and Control Information System. Blood samples were collected to determine CD4+T lymphocyte (CD4 cell) counts and HIV-1 viral load. Following nucleic acid extraction, the pol gene region was amplified using reverse transcription and nested PCR, and subsequently subjected to Sanger sequencing. The resulting sequences were uploaded to the Stanford University HIV Drug Resistance Database to analyze drug resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), and nucleoside reverse transcriptase inhibitors (NRTIs). Results: Totally 404 blood samples from HIV/AIDS patients were collected, with successful sequencing of the pol gene region in 341 cases. Among them, 253 (74.19%) were males and 88 (25.81%) were females, with a mean age of (62.48±7.60) years. A total of 152 cases (44.57%) had CD4 cell counts below 200 cells/μL, and 296 cases (86.80%) had HIV-1 viral loads exceeding 5 000 copies/mL. A total of 87 cases exhibited drug resistance-associated mutations, corresponding to a mutation rate of 25.51%. The predominant mutation site was V179, with a mutation rate of 17.01%. A total of 29 cases exhibited resistance to at least one drug, resulting in a resistance rate of 8.50%. The resistance rates to NNRTIs, PIs, and NRTIs were 5.57%, 2.93%, and 1.17%, respectively. The HIV/AIDS patients exhibited varying degrees of resistance to 13 anti-retroviral drugs, with low- or intermediate-level drug resistance being predominant. High-level drug resistance cases were observed against NNRTIs such as nevirapine and efavirenz. Conclusions The drug resistance rate before anti-retroviral therapy among newly dignosed HIV/AIDS patients aged ≥50 years in Yangzhou City was at a moderate level. The predominant resistance mutation was observed at V179 site, with NNRTIs resistance being most prevalent, primarily demonstrating low- or intermediate-level drug resistance.

Salmonella enterica serovar Goldcoast isolates from Yangzhou were analyzed for assessment of their pathogenic and ge-nomic characteristics.From 2017 to 2023,eight strains were detected through foodborne disease surveillance and health check-ups.These strains exhibited resistance to two to seven antibiotic classes,and all strains bore a T57S mutation in the parC gene.Notably,50％(4/8)of the strains carried sulfonamide resistance genes(sul1 or sul3),and 37.5％(3/8)were positive for extended-spectrum beta-lactamase(ESBL)genes,including blaCTX-M-55 and blaTEM-1.Multilocus sequence typing(MLST)revealed that ST358(five strains)and ST2529(three strains)were the predominant sequence types,corresponding to CRISPR Ⅰ and Ⅱ groups,respectively.Single nucleotide polymorphism(SNP)phylogenetic analysis indicated a close genetic relationship between the case isolate Sal-2214 and strains from multiple regions,with a SNP difference≤20,thus suggesting potential inter-regional transmission.For example,one isolate from the stool of a 4-year-old child with diarrhea(Sal-2214)carried the beta-lactam resistance gene(blaCTX-M-55)and exhib-ited high resistance to cefotaxime(CTX)and ceftazidime(CAZ).These findings indicated that S.enterica Goldcoast emerged in Yang-zhou from 2022,and was characterized by multidrug resistance and a genetic relationship with strains from coastal regions.These find-ings highlight the need for enhanced resistance monitoring and trace-back studies to better understand the epidemiology and control the potential spread of this pathogen.

OBJECTIVE: To assess the safety and topical efficacy of prim-O-glucosylcimifugin (POG) and investigate the molecular mechanisms of its therapeutic effects in atopic dermatitis (AD). METHODS: The effects of POG on human keratinocyte cell viability and its anti-inflammatory properties were evaluated using cell counting kit-8 assay and reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Subsequently, the impact of POG on the differentiation of cluster of differentiation (CD) 4⁺ T cell subsets, including T-helper type (Th) 1, Th2, Th17, and regulatory T (Treg), was examined through in vitro experiments. Network pharmacology analysis was used to elucidate POG's therapeutic mechanisms. Furthermore, the therapeutic potential of topically applied POG was further evaluated in a calcipotriol-induced mouse model of AD. The protein and transcript levels of inflammatory markers, including cytokines, lymphocyte-specific protein tyrosine kinase (Lck) mRNA, and LCK phosphorylation (p-LCK), were quantified using immunohistochemistry, RT-qPCR, and Western blot analysis. RESULTS: POG was able to suppress cell proliferation and downregulate the transcription of interleukin 4 (Il4) and Il13 mRNA. In vitro experiments indicated that POG significantly inhibited the differentiation of Th2 cells, whereas it exerted negligible influence on the differentiation of Th1, Th17 and Treg cells. Network pharmacology identified LCK as a key therapeutic target of POG. Moreover, the topical application of POG effectively alleviated skin lesions in the calcipotriol-induced AD mouse models without causing pathological changes in the liver, kidney or spleen tissues. POG significantly reduced the levels of Il4, Il5, Il13, and thymic stromal lymphopoietin (Tslp) mRNA in the AD mice. Concurrently, POG enhanced the expression of p-LCK protein and Lck mRNA. CONCLUSION Our research revealed that POG inhibits Th2 cell differentiation by promoting p-LCK protein expression and hence effectively alleviates AD-related skin inflammation. Please cite this article as: Zhao H, Ma X, Wang H, Ding XJ, Kuai L, Song JK, Zhang Z, Yang D, Gao CJ, Li B, Zhou M. Prim-O-glucosylcimifugin mitigates atopic dermatitis by inhibiting Th2 differentiation through LCK phosphorylation modulation. J Integr Med. 2025; 23(3): 309-319.
Dermatitis, Atopic/drug therapy* ; Animals ; Humans ; Cell Differentiation/drug effects* ; Phosphorylation/drug effects* ; Mice ; Th2 Cells/drug effects* ; Keratinocytes/drug effects* ; Disease Models, Animal ; Mice, Inbred BALB C ; Calcitriol/analogs & derivatives*

Objective To evaluate the value of a nomogram model based on ultrasonographic features and inflammatory indicators in the preoperative noninvasive prediction of pathological grading of urothelial carcinoma of bladder(UCB).Methods A retrospective analysis was conducted on 471 patients with pathologically confirmed UCB,and the patients were assigned to high-grade group(401 cases)or low-grade group(70 cases).Basic clinical data(gender,age,macroscopic hematuria),ultrasonographic features(lesion location,blood flow signal,etc.),and blood inflammatory indicators(e.g.neutrophil-to-lymphocyte ratio[NLR])were collected.Independent predictors were screened using univariate and multivariate logistic regression,and a nomogram model was constructed.Model performance was evaluated using the receiver operating characteristic(ROC)curve,calibration curve,and decision curve analysis(DCA).Results Multivariate logistic analysis identified gender(odds ratio[OR]=2.68),age(OR=1.08),macroscopic hematuria(OR=3.19),lesion located in the trigone(OR=4.59),positive blood flow signal(OR=2.87),and NLR(OR=1.03)were independent predictors of high-grade UCB(all P＜0.05).The combined model(clinical features+ultrasonographic characteristics+inflammatory indicators)achieved an area under curve(AUC)of 0.892,which was significantly higher than the clinical feature-only model(AUC=0.799)and the clinical+ultrasonographic model(AUC=0.856).The calibration curve demonstrated good consistency between predicted and actual outcomes,and DCA confirmed its optimal clinical net benefit.Conclusion The nomogram model integrating clinical features,ultrasonographic characteristics,and inflammatory indicators can effectively discriminate UCB pathological grading,providing a reliable preoperative noninvasive assessment tool for personalized treatment decisions.

Objective To investigate the expression and prognostic value of uncoupling protein 2(UCP2)and ubiquitin associated protein 2-like(UBAP2L)in non-small cell lung cancer(NSCLC).Methods A total of 94 patients with NSCLC who received surgical treatment in a hospital from March 2019 to March 2021 were selected as the study objects.The expressions of UCP2 protein,UBAP2L protein,UCP2 mRNA and UBAP2L mRNA in cancer tissues and adjacent tissues of NSCLC patients were detected by real-time fluorescence quan-titative polymerase chain reaction and immunohistochemistry.The correlation between UCP2 mRNA and UBAP2L mRNA in NSCLC was analyzed by Pearson correlation.Kaplan-Meier curve was used to analyze the differences in survival rates of NSCLC patients with different UCP2 mRNA and UBAP2L mRNA expres-sions,and multivariate Cox regression was used to analyze the prognostic factors of NSCLC patients.Results The positive rate of UCP2 protein and UBAP2L protein in cancer tissues of NSCLC patients was higher than that in adjacent tissues,and the difference was statistically significant(P＜0.05).The expressions of UCP2 mRNA and UBAP2L mRNA in cancer tissues of NSCLC patients were significantly higher than those in adjacent tissues,and the differences were statistically significant(P＜0.05).There was a positive cor-relation between UCP2 mRNA and UBAP2L mRNA expression in NSCLC patients(r=0.721,P＜0.001).The expression of UCP2 mRNA and UBAP2L mRNA in cancer tissues of NSCLC patients was related to TNM stage and lymph node metastasis.There was significant difference in 3-year survival rate between UCP2 mRNA high expression group and UCP2 mRNA low expression group(P＜0.05).There was significant difference in 3-year survival rate between UBAP2L mRNA high expression group and UBAP2L mRNA low expression group(P＜0.05).TNM stage Ⅲ A,lymph node metastasis,UCP2 mRNA high expression and UBAP2L mRNA high expression were risk factors for prognosis of NSCLC patients(P＜0.05).Conclusion UCP2 protein,UBAP2L protein,UCP2 mRNA and UBAP2L mRNA are up-regulated in NSCLC patients,and UCP2 mRNA and UBAP2L mRNA are helpful to evaluate the survival prognosis of NSCLC patients.

Objective:To understand the research hotspots and research trends of Chinese literature about acupuncture and moxibustion treatment for post-stroke depression (PSD).Methods:Research literature on the treatment of post-stroke depression with acupuncture and moxibustion was retrieved from CNKI, Wanfang Data, and Chongqing VIP from January 1,2002 to August 31,2023. CiteSpace 6.1.R6 software was used to visually analyze the authors, research institutions and key words.Results:A total of 734 articles were included. Wang Zhen, Xiao Wei and Zhang Xianbao (the Second Affiliated Hospital of Anhui University of Chinese Medicine) published the most articles (12 articles each). The Second Affiliated Hospital of Anhui University of Chinese Medicine had the largest number of articles (32 articles), and the inter-agency cooperation was mainly based on TCM colleges and their affiliated hospitals. In addition to the search terms, the keywords with higher frequency were efficacy observation, acupuncture and medicine, nerve function, etc., and 10 representative keyword clusters were obtained. The acupoints with high frequency were Baihui, Neiguan, Taichong, etc., and 13 common acupuncture methods and acupoint combinations used in different acupuncture methods were obtained, as well as 8 representative acupoint clusters. The main treatment methods were acupuncture, acupuncture and moxibustion, fluoxetine and so on.Conclusions:The research hotspots of acupuncture and moxibustion in the treatment of PSD mainly lie in the observation of the efficacy of acupuncture and moxibustion, the study of the mechanism, and the summary of the experience of famous experts. The research trend is to explore how to use acupuncture and moxibustion, medicine, music and other combined treatment to improve clinical symptoms and improve the overall quality of life of patients.

Background and Objectives: Heart failure is a potentially fatal event caused by diverse cardiovascular diseases, leading to high morbidity and mortality. Histone deacetylase (HDAC) inhibitors positively influence cardiac hypertrophy, fibrosis, hypertension, myocardial infarction, and heart failure, causing some side effects. We aimed to investigate the effect of the novel HDAC inhibitor YAK577 on the heart failure mouse model and its underlying mechanism. Methods: New hydroxamic acid YAK577 was prepared via methyl-2,3-diphenylpropanoate synthesis using carboxylic acids. We used a micro-osmotic pump, including isoproterenol (ISO; 80 mg/kg/day), to induce a heart failure with reduced ejection fraction. Cardiac hypertrophy was assessed by heart weight to body weight ratio and cross-sectional area.The left ventricular (LV) function was assessed by echocardiography. Fibrosis was evaluated using picrosirius red staining. Overexpression and knockdown experiments were performed to investigate the association between HDAC8 and matrix metalloproteinase 12 (MMP12). Results: YAK577 treatment restored ISO-induced reduction in LV fractional shortening and ejection fraction (n=9–11). YAK577 significantly downregulated cardiac hypertrophy marker genes (natriuretic peptide B, NPPB, and myosin heavy chain 7, MYH7) and cardiomyocyte size in vitro but not in vivo. YAK577 ameliorated cardiac fibrosis and fibrosis-related genes in vivo and in vitro. Additionally, YAK577 reduced elevated HDAC8 and MMP12 mRNA and protein expressions in ISO-infused mice, H9c2 cells, and rat neonatal cardiomyocytes.HDAC8 overexpression stimulated MMP12 and NPPB mRNA levels, while HDAC8 knockdown downregulated these genes. Conclusions YAK577 acts as a novel heart failure drug through the HDAC8/MMP12 pathway.