Nuclear factor-erythroid 2-related factor 2 （Nrf2）/glutathione peroxidase 4 （GPX4） signaling pathway plays a key role in the occurrence and development of tumors， and is involved in tumor cell proliferation， apoptosis， ferroptosis， invasion， migration， and drug resistance. Based on the Nrf2/GPX4 signaling pathway， this paper summarizes the research progress of the anti- tumor effects of traditional Chinese medicine. It is found that flavonoids （ginkgetin， luteolin， etc.）， terpenoids （atractylenolide， cucurbitacin B， etc.）， saponins （polyphyllin Ⅰ， polyphyllin Ⅶ）， ester （brusatol） and other effective components， and traditional Chinese medicine extracts （total coumarins in Pileostegia tomentella and total flavonoids of Pterocarya hupehensis Skan）， traditional Chinese medicine compounds （Fushao diqin fang， Xiaoai jiedu fang， etc.） can promote ferroptosis in tumor cells by inhibiting Nrf2/GPX4 signaling pathway and the expressions of its upstream and downstream factor proteins， as well as by increasing Fe2+ levels and lipid peroxidation， thereby exerting an antitumor effect.

Sleep deprivation (SD) has emerged as a significant modifiable risk factor for Alzheimer’s disease (AD), with mounting evidence demonstrating its multifaceted role in accelerating AD pathogenesis through diverse molecular, cellular, and systemic mechanisms. SD is refined within the broader spectrum of sleep-wake and circadian disruption, emphasizing that both acute total sleep loss and chronic sleep restriction destabilize the homeostatic and circadian processes governing glymphatic clearance of neurotoxic proteins. During normal sleep, concentrations of interstitial Aβ and tau fall as cerebrospinal fluid oscillations flush extracellular waste; SD abolishes this rhythm, causing overnight rises in soluble Aβ and tau species in rodent hippocampus and human CSF. Orexinergic neurons sustain arousal, and become hyperactive under SD, further delaying sleep onset and amplifying Aβ production. At the molecular level, SD disrupts Aβ homeostasis through multiple converging pathways, including enhanced production via beta-site APP cleaving enzyme 1 (BACE1) upregulation, coupled with impaired clearance mechanisms involving the glymphatic system dysfunction and reduced Aβ-degrading enzymes (neprilysin and insulin-degrading enzyme). Cellular and histological analyses revealed that these proteinopathies are significantly exacerbated by SD-induced neuroinflammatory cascades characterized by microglial overactivation, astrocyte reactivity, and sustained elevation of pro-inflammatory cytokines (IL-1β, TNF-α, IL-6) through NF‑κB signaling and NLRP3 inflammasome activation, creating a self-perpetuating cycle of neurotoxicity. The synaptic and neuronal consequences of chronic SD are particularly profound and potentially irreversible, featuring reduced expression of critical synaptic markers (PSD95, synaptophysin), impaired long-term potentiation (LTP), dendritic spine loss, and diminished neurotrophic support, especially brain-derived neurotrophic factor (BDNF) depletion, which collectively contribute to progressive cognitive decline and memory deficits. Mechanistic investigations identify three core pathways through which SD exerts its neurodegenerative effects: circadian rhythm disruption via BMAL1 suppression, orexin system hyperactivity leading to sustained wakefulness and metabolic stress, and oxidative stress accumulation through mitochondrial dysfunction and reactive oxygen species overproduction. The review critically evaluates promising therapeutic interventions including pharmacological approaches (melatonin, dual orexin receptor antagonists), metabolic strategies (ketogenic diets, and Mediterranean diets rich in omega-3 fatty acids), lifestyle modifications (targeted exercise regimens, cognitive behavioral therapy for insomnia), and emerging technologies (non-invasive photobiomodulation, transcranial magnetic stimulation). Current research limitations include insufficient understanding of dose-response relationships between SD duration/intensity and AD pathology progression, lack of long-term longitudinal clinical data in genetically vulnerable populations (particularly APOE ε4 carriers and those with familial AD mutations), the absence of standardized SD protocols across experimental models that accurately mimic human chronic sleep restriction patterns, and limited investigation of sex differences in SD-induced AD risk. The accumulated evidence underscores the importance of addressing sleep disturbances as part of multimodal AD prevention strategies and highlights the urgent need for clinical trials evaluating sleep-focused interventions in at-risk populations. The review proposes future directions focused on translating mechanistic insights into precision medicine approaches, emphasizing the need for biomarkers to identify SD-vulnerable individuals, chronotherapeutic strategies aligned with circadian biology, and multi-omics integration across sleep, proteostasis and immune profiles may delineate precision-medicine strategies for at-risk populations. By systematically examining these critical connections, this analysis positions sleep quality optimization as a viable strategy for AD prevention and early intervention while providing a comprehensive roadmap for future mechanistic and interventional research in this rapidly evolving field.

Lung cancer has the highest morbidity and mortality rate among all cancers. Because of the complex pathogenesis， there are limitations in the common Western medicine treatment methods. Clinical and experimental studies have proved that traditional Chinese medicine （TCM） can not only effectively treat lung cancer and alleviate the clinical symptoms of cancer patients but also reduce the adverse reactions and complications caused by surgery， chemotherapy， and radiotherapy to improve the quality of life of the patients. The biological behaviors of lung cancer cells， such as proliferation， invasion， and metastasis， are closely related to their metabolic reprogramming. Metabolic reprogramming in lung cancer involves a series of metabolic changes such as increased glucose uptake and consumption， enhanced glycolysis， increased amino acid uptake and catabolism， and enhanced lipid and protein synthesis. Studies have reported that TCM active components， extracts， and compound prescriptions can effectively inhibit the biological behaviors of lung cancer by regulating metabolic reprogramming. Therefore， this paper reviews the pharmacological mechanisms of TCM active components， extracts， and compound prescriptions in regulating metabolic reprogramming of lung cancer， with the aim of providing a new way of thinking for the treatment of lung cancer by TCM regulation of metabolic reprogramming of lung cancer cells. The available studies suggest that TCM mainly inhibits the extracellular signal-regulated protein kinase （ERK）/c-Myc， phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）/mammalian target of rapamycin （mTOR）， and hypoxia-inducible factor-α （HIF-1α） pathways. Furthermore， the expression of monocarboxylate transporter 4 （MCT4）， glucose transporter 1 （GLUT1）， pyruvate dehydrogenase （PDH）， phosphofructokinase 1 （PFK1）， pyruvate dehydrogenase kinase 1 （PDK1）， pyruvate kinase M2 （PKM2）， hexokinase （HK）， lactate dehydrogenase （LDH）， and lactate dehydrogenase A （LDHA） are inhibited. In this way， TCM inhibits the glucose uptake by lung cancer cells and glycolysis in lung cancer cells to reduce the energy metabolism of tumor cells， ultimately achieving the therapeutic effect on lung cancer.

The effect of porcine SIRT5 on replication of foot and mouth disease virus type O(FMDV-O)and the underlying regulatory mechanism were investigated.Western blot and RT-qPCR analyses were employed to monitor expression of endoge-nous SIRT5 in PK-15 cells infected with FMDV-O.Three pairs of SIRT5-specific siRNAs were synthesized.Changes to SIRT5 and FMDV-O protein and transcript levels,in addition to virus copy numbers,were measured by western blot and RT-qPCR analyses.PK-15 cells were transfected with a eukaryotic SIRT5 expression plasmid.Western blot and RT-qPCR analyses were used to explore the impact of SIRT5 overexpression on FMDV-O replication.Meanwhile,RT-qPCR analysis was used to detect the effect of SIRT5 overexpression on the mRNA expression levels of type I interferon-stimulated genes induced by SeV and FMDV-O.The results showed that expression of SIRT5 was up-regulated in PK-15 cells infected with FMDV-O and siRNA interfered with SIRT5 to inhibit FMDV-O replication.SIRT5 overexpression promoted FMDV-O replication.SIRT5 over-expression decreased mRNA expression levels of interferon-stimulated genes induced by SeV and FMDV-O.These results suggest that FMDV-O infection stimulated expression of SIRT5 in PK-15 cells,while SIRT5 promoted FMDV-O rep-lication by inhibiting production of type I interferon-stimula-ted genes.These findings provide a reference to further ex-plore the mechanism underlying the ability of porcine SIRT5 to promote FMDV-O replication.

Cases of human infection with H7 subtype avian influenza virus(AIV)combined with five NA subtypes(N2,N3,N4,N7,and N9)have been reported.This study was aimed at establishing a method for simultaneous detection and dif-ferential diagnosis of H7 and five NA subtypes of AIV.Seven pairs of specific primers were designed according to the conserved sequences of the HA gene of H7 subtype AIV,the NA gene of five NA AIV subtypes,and the M gene of all AIV subtypes.A high-throughput GeXP typing method was established for simultaneous detection of the H7 subtype and the five NA subtypes of AIV by using GeXP multiple gene expression and capillary electrophoresis analysis technology.The specificity and sensitivity of the method were determined,and clinical samples were tested.The specificity results indicated that this method was able to simultaneously detect seven target genes in a single tube;each pair of specific primers was able to detect the corresponding AIV subtype,and the universal detection primers were able to detect all subtypes of AIV,with no cross-reaction with other common avian disease pathogens.Sensitivity results demonstrated that this method was able to simultaneously detect seven target genes with a threshold detection limit was 100 copies/μL.The detection results for 150 clinical samples were consistent with those of viral isolation and identification.The high-throughput GeXP method for simultaneous differential diagnosis of the H7 subtype and five subtypes of AIV established in this study has advantages of high specificity,high sensitivity,rapidity,and simplicity,thus providing a new detection method for the effective prevention and control of AIV.

Objective:To explore the therapeutic efficacy and prognostic factors of induction therapy for secondary central nervous system lymphoma(SCNSL).Methods:Clinical data of patients diagnosed with SCNSL from 2010 to 2021 at Guangdong Provincial People's Hospital were retrospectively collected.A retrospective cohort study was performed on all and grouped patients to analyze the efficacy and survival.Multivariate logistic regression analysis was used to explore the adverse prognostic factors.Results:Thirty-seven diffuse large B-cell lymphoma patients with secondary central involvement were included in the research.Their 2-year overall survival(OS)rate was 46.01％and median survival time was 18.1 months.The 2-year OS rates of HD-MTX group and TMZ group were 34.3％and 61％,median survival time were 8.7 and 38.3 months,and median progression-free survival time were 8.1 and 47 months,respectively.Multivariate logistic regression analysis showed that age,sex,IPI,Ann Arbor stage were correlated with patient survival time.The median survival time of patients with CD79B,KMT2D,CXCR4.ERBB2,TBL1XR1,BTG2,MYC,MYD88,and PIM1 mutations was 8.2 months,which was lower than the overall level.Conclusion:HD-MTX combined with TMZ as the first-line strategy may improve patient prognosis,and early application of gene sequencing is beneficial for evaluating prognosis.

Objective:To analyze the prognostic value and threshold effect of serum C3,C4 in patients with multiple myeloma (MM). Methods:The clinical data of 146 patients with MM who visited Suqian First People's Hospital from October 2016 to October 2019 were collected. The patients were divided into deceased group (42 cases) and survival group (104 cases) according to their prognosis and survival. The risk factors affecting the prognosis of the patients were analyzed. The correlation of serum C3 and C4 with prognosis was analyzed by threshold effect. The predictive value of serum C3/C4 on the prognosis of MM patients was evaluated by the receiver operating characteristic (ROC) curve. Nomogram model was constructed,and the discrimination and accuracy of the model were evaluated. The nomogram model was internally validated by bootstrap resampling. Results:Durie-Salmon (DS) stage Ⅲ,decreased low density lipoprotein cholesterol (LDL-C) and apolipoprotein B (Apo B),elevated homocysteine (Hcy),uric acid (UA),and serum C3 and C4 were independent risk factors affecting the prognosis of MM patients (P<0.05). Curve fitting showed that the mortality probability of MM patients increased with the increase of serum C3 and C4 levels. The threshold effect analysis showed that when serum C3 was higher than 1.2 g/L or serum C4 was higher than 0.37 g/L,the mortality rate of MM patients increased with the increase of the index levels;When serum C3 was lower than 1.2 g/L or serum C4 was lower than 0.37 g/L,the mortality rate of MM patients had no significant correlation with the indexes. Serum C3 and C4 had a good predictive value for the prognosis of MM patients,and the combination of C3 and C4 had a higher predictive value. The validation results showed that the nomogram model constructed in our study had good discrimination and high accuracy. Conclusion:Elevated levels of serum C3 and C4 are independent risk factors for mortality in patients with MM. The combination of serum C3 and C4 is more valuable in predicting mortality in MM patients than C3 or C4 alone,which can be used as a sensitive index to evaluate the prognosis of MM patients.

Objective To compare the clinical efficacy and prognosis of endoscopic submucosal dissection(ESD)and surgical methods in the treatment of early esophagogastric junction adenocarcinoma(AEG),and to analyze factors influencing prognosis.Methods Hospitalized patients with early AEG who underwent ESD or surgical treatment at Anhui Provincial Hospital from January 2010 to December 2022 were collected.Among them,186 patients underwent ESD and 364 patients underwent surgical treatment.Propensity score matching was used with a ratio of 1∶1,with 164 patients in each group.Clinical outcomes,survival outcomes,and postoperative complications were compared before and after matching.Factors influencing mortality and recurrence in EGJ patients were analyzed.Results 1.Before and after matching,the ESD group had lower surgical time,hospital stay,hospital costs,intraoperative bleeding volume,and adverse events compared to the surgical group(P＜0.001).2.The matched ESD group had 1-,3-,and 5-year overall survival rates of 99.5％,94.5％,and 90.2％,respectively,while the surgical group had rates of 100％,99.4％,and 97.5％for the same periods.The 1-,3-,and 5-year recurrence-free survival rates in the matched ESD group were 99.5％,96.3％,and 93.4％,respectively,compared to 100％,98.6％,and 92.5％in the surgical group.Kaplan-Meier survival analysis before and after matching showed no significant difference in overall survival and recurrence-free survival between the two groups(P＞0.05).3.Age,poor differentiation,and vascular invasion were independent risk factors for OS;age and tumor size were independent risk factors for RFS.Conclusion Patients with early AEG undergoing ESD or surgical treatment have consistent clinical outcomes.ESD can be considered an effective and safe treatment for early AEG.

Objective:To compare the effect of immediate and delayed post-space preparation on apical sealing ability between 2 root canal obturation techniques.Methods:60 freshly extracted single-rooted human premolars were collected and instrumented by M3-Pro instruments.The specimens were randomly divided into 6 groups and respectively treated by AH-Plus sealer with warm vertical compac-tion(WVC)followed by delayed post-space preparation(PSP)(A1);AH-Plus sealer with WVC followed by immediate PSP(A2);AH-Plus sealer with WVC,control group(A3);iRoot SP sealer with single cone(SC)followed by delayed PSP(B1);iRoot SP sealer with SC followed by immediate PSP(B2);iRoot SP sealer with SC,control group(B3).In group A1,A2,B1 and B2,gutta percha was removed by 1# starter drill and post-space was prepared by 2# finishing drill leaving 5 mm of apical filling.In control groups(A3 and B3),only apical 5 mm of the specimens was obturated.Dye leakage was measured as the linear penetration(LP)of the stain.The SPSS one-way analysis of variance test was used for statistical analysis.Results:The LP(mm)of group A1,A2,A3,B1,B2 and B3 was 3.986±0.500,3.382±0.806,2.178±0.554,3.844±0.877,3.416±0.579 and 1.897±0.217 respectively.Among A1,A2 and A3 groups,P＜0.05.The LP of group A1 was higher than that of group A2(P＜0.05).Among group B1,B2 and B3,P＜0.05,but be-tween group B1 and B2,P＞0.05.Between group A1 and B1,P＞0.05.Between A2 and B2,P＞0.05.Conclusion:Apical sealing is affected by PSP with the 2 root obturation techniques.Delayed PSP may have negative effect on apical sealing compared with immediate PSP,especially in the specimens compacted by AH-Plus sealer with WVC.

Objective To investigate the effect of chaperone-mediated autophagy(CMA)on the damage of mouse microglial BV2 cells induce by unconjugated bilirubin(UCB).Methods The BV2 cell experiments were divided into two parts.(1)For the CMA activation experiment:control group(treated with an equal volume of dimethyl sulfoxide),QX77 group(treated with 20 μmol/L QX77 for 24 hours),UCB group(treated with 40 μmol/L UCB for 24 hours),and UCB+QX77 group(treated with both 20 μmol/L QX77 and 40 μmol/L UCB for 24 hours).(2)For the cell transfection experiment:LAMP2A silencing control group(treated with an equal volume of dimethyl sulfoxide),LAMP2A silencing control+UCB group(treated with 40 μmol/L UCB for 24 hours),LAMP2A silencing group(treated with an equal volume of dimethyl sulfoxide),and LAMP2A silencing+UCB group(treated with 40 μmol/L UCB for 24 hours).The cell viability was assessed using the modified MTT method.The expression levels of p65,nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3),and cysteinyl aspartate specific proteinase-1(caspase-1)were detected by Western blot.The relative mRNA expression levels of the inflammatory cytokines interleukin(IL)-l β,IL-6,and tumor necrosis factor-α(TNF-α)were determined by real-time quantitative polymerase chain reaction.Levels of IL-6 and TNF-α in the cell culture supernatant were measured using ELISA.The co-localization of heat shock cognate protein 70 with p65 and NLRP3 was detected by immunofluorescence.Results Compared to the UCB group,the cell viability in the UCB+QX77 group increased,and the expression levels of inflammation-related proteins p65,NLRP3,and caspase-1,as well as the mRNA relative expression levels of IL-1β,IL-6,and TNF-α and levels of IL-6 and TNF-αdecreased(P＜0.05).Compared to the control group,there was co-localization of heat shock cognate protein 70 with p65 and NLRP3 in both the UCB and UCB+QX77 groups.After silencing the LAMP2A gene,compared to the LAMP2A silencing control+UCB group,the LAMP2A silencing+UCB group showed increased expression levels of inflammation-related proteins p65,NLRP3,and caspase-1,as well as increased mRNA relative expression levels of IL-1 β,IL-6,and TNF-α and levels of IL-6 and TNF-α(P＜0.05).Conclusions CMA is inhibited in UCB-induced BV2 cell damage,and activating CMA may reduce p65 and NLRP3 protein levels,suppress inflammatory responses,and counteract bilirubin neurotoxicity.[Chinese Journal of Contemporary Pediatrics,2024,26(4):385-393]