OBJECTIVE To systematically evaluate the correlation between dynamic changes in inflammatory markers during treatment with epidermal growth factor receptor-tyrosine kinase inhibitors （EGFR-TKIs） in non-small cell lung cancer （NSCLC） patients and therapeutic efficacy， with the aim of providing evidence-based support for clinical prognosis assessment and treatment strategy adjustment. METHODS Databases including PubMed， Embase， Cochrane Library， CNKI， Wanfang Data， and CBM were searched from the inception to July 20， 2025. Following literature screening， data extraction and quality assessment， descriptive analysis was conducted on the outcomes of included studies. RESULTS A total of eight studies were included to analyze the correlation of 6 inflammatory markers before and after treatment with EGFR-TKIs with therapeutic efficacy. The risk of bias assessment identified six high-quality studies and two moderate-quality studies. Among these studies， seven studies demonstrated that lower levels of neutrophil-to-lymphocyte ratio （NLR）， derived neutrophil-to-lymphocyte ratio （dNLR）， platelet-to-lymphocyte ratio （PLR）， and monocyte-to-lymphocyte ratio （MLR）， higher lymphocyte-to-monocyte ratio （LMR） before treatment， as well as decreased NLR and MLR and increased LMR after treatment were associated with longer median progression-free survival. Five studies indicated that lower levels of NLR， dNLR， PLR， and interleukin-6 （IL-6）， higher LMR before treatment as well as decreased NLR and dNLR and increased LMR were associated with longer median overall survival. Three studies indicated that lower levels of IL-6 were associated with a higher objective response rate， while the association of these markers after treatment remained controversial； another study showed that an early decline in NLR， MLR， and PLR after treatment may be associated with objective response benefit. CONCLUSIONS Lower inflammatory levels during EGFR-TKIs therapy correlate with better therapeutic efficacy in NSCLC patients.

Background and aims As a ferroptosis inducer, sorafenib, a first-line treatment for hepatocellular carcinoma (HCC), has a significant antitumor effect. Nonetheless, HCC patients frequently develop sorafenib resistance. Here, we investigated the impacts of progestagen-associated endometrial protein (PAEP), which controls sorafenib resistance and tumorigenesis in HCC. Furthermore, we investigated the function of PAEP and the underlying molecular mechanisms that cause HCC ferroptosis when sorafenib is applied. Methods Western blot analysis, cell proliferation, colony formation and animal experiments were performed to investigate the function of PAEP in sorafenib resistance and tumorigenesis in HCC. We detected the levels of reactive oxygen species, iron, and malondialdehyde and preformed transmission electron microscopy to investigate the relationship between PAEP and ferroptosis. Co-immunoprecipitation (co-IP) assay was performed to investigate the underlying molecular mechanisms of PAEP that cause HCC ferroptosis. Results PAEP was significantly overexpressed in HCC tissues, and this was associated with a poor clinical prognosis. PAEP silencing dramatically reduced HCC cells’ malignant phenotype. We found that sorafenib-induced ferroptosis was more sensitive to HCC cells with PAEP knockdown. Furthermore, the orthotopic cell line-derived xenograft mouse model results showed that sorafenib sensitivity can be effectively increased in vivo by PAEP knockdown. We determined that transferrin (TF) was a PAEP target using the String database, and we further supported this finding with Co-IP analysis. Additionally, on sorafenib-induced ferroptosis in HCC cells, TF partially reversed the effects of PAEP knockdown. Conclusions Our research indicates that PAEP may be a potential biomarker for predicting sorafenib resistance in HCC and disruption of PAEP expression may be a potential cancer-directed therapeutic option for HCC.

Hyperlipidemia is a common metabolic disorder driven by dysregulated lipid metabolism， whose pathological progression involves multifaceted interactions across various signaling pathways， including disrupted cholesterol homeostasis， insulin resistance， chronic inflammation， and oxidative stress. Although existing clinical medications such as statins can effectively reduce low-density lipoprotein cholesterol through single-target inhibition， significant limitations remain in comprehensively improving reverse cholesterol transport， metabolic inflammation， and coordinated regulation of glucose and lipid metabolism. Curcumin， the primary polyphenolic active compound derived from the traditional medicinal herb turmeric， exhibits multi-dimensional pharmacological effects including modulation of lipid metabolism， improvement of insulin sensitivity， suppression of inflammatory responses， and enhancement of antioxidant defense. This review systematically integrates the multi-target regulatory network of curcumin， elucidating its key mechanisms： Balancing the low density lipoprotein receptor/proprotein convertase subtilisin/kexin type 9 （LDLR/PCSK9） signaling pathway to promote reverse cholesterol transport， activating peroxisome proliferator-activated receptor α/γ （PPARα/γ） signaling pathways to coordinate glucolipid metabolic homeostasis， remodeling the gut microbiota-bile acid axis， inhibiting nuclear factor kappa-B （NF-κB）-mediated inflammatory responses， and activating the nuclear factor erythroid 2-related factor 2/antioxidant response element （Nrf2/ARE） antioxidant signaling pathway. Furthermore， supported by clinical research data， the review validates curcumin's therapeutic potential in reducing total cholesterol （TC） and triglyceride （TG） levels， increasing high-density lipoprotein cholesterol （HDL-C）， as well as improving vascular endothelial function and insulin sensitivity. The study highlights the multi-target regulatory properties of curcumin and discusses future clinical applications based on nano-delivery systems and personalized treatment strategies， providing a theoretical basis and novel insights for the prevention and treatment of hyperlipidemia and related metabolic disorders.

The incidence of anaphylaxis has been on the rise in recent years. Drugs and foods are main triggers, and individuals in different regions and age groups have different characteristics. Its pathogenesis includes immune (IgE-mediated and non-IgE-mediated) factors, non-immune factors and idiopathic ones. The clinical manifestations are symptoms and signs of the skin and mucosa, and respiratory, circulatory, digestive, and nervous systems. There is still a lack of laboratory test indices with high sensitivity and specificity to diagnose anaphylaxis. Adrenaline intramuscular injection is the first-line treatment for anaphylaxis, but its usage during emergencies is unsatisfactory. Glucocorticoids are most frequently used in anaphylaxis, but there is controversy over whether they are beneficial. Currently, high-quality clinical cohort studies are needed to provide solid evidence for the epidemiology, diagnosis and treatment of anaphylaxis. This article reviews the research progress on anaphylaxis, aiming to enhance the understanding of anaphylaxis among medical staff.

Objective To investigate the epidemiological characteristics of knee osteoarthritis(KOA)among military personnel in plateau regions and to explore its risk factors.Methods From July 2023 to July 2024,a multi-stage stratified cluster random sampling method was employed to survey the prevalence of KOA and related risk factors among military personnel in the northwest plateau regions of China,covering different altitudes(1500-4500 m)and geographical areas(Gansu,Qinghai,Tibet,and Xinjiang).All study subjects were divided into KOA and non-KOA groups based on the presence or absence of KOA.Variables including age,gender,body mass index(BMI),education level,smoking status,military rank,military branch,service duration,regional altitude,annual average temperature,training duration,perceived training intensity,and history of knee injury were selected for univariate analyses between groups.Variables with P<0.05 in the univariate analyses were included in the binary multifactor logistic regression to identify risk factors for KOA.Results A total of 3000 questionnaires were distributed,and 2854 valid questionnaires were collected,with a response rate of 95.13%.The sample included 2584 males and 270 females,with 510 cases of KOA,resulting in a prevalence rate of 17.9%.Univariate analysis showed that there were statistically significant differences between KOA and non-KOA groups in terms of age,BMI,smoking status,military rank,military branch,service duration,regional altitude,annual average temperature,training duration,perceived training intensity,and history of knee injury(P<0.05).However,no significant differences were found in gender and education level(P>0.05).Binary multivariate logistic regression analysis revealed that older age(OR=1.382,P=0.017),higher BMI(P<0.01),smoking(OR=1.929,P<0.01),higher military rank(OR=1.485,P=0.007),being a member of the Armed Police(P<0.01),longer service duration(P<0.01),higher regional altitude(OR=1.459,P<0.01),lower annual average temperature(OR=1.188,P=0.001),longer training duration(P<0.01),higher perceived training intensity(OR=2.450,P<0.01),and history of knee injury(OR=2.768,P=0.002)were independent risk factors for KOA.Conclusions Older age,overweight/obesity,smoking,higher military rank,being a member of the Armed Police,longer service duration,higher altitude,cold climate,longer training duration,higher training intensity,and history of knee injury are independent risk factors for KOA among military personnel in the northwest plateau regions of China.

Objective To investigate the potential mechanism of action of polygonatum odoratum in treating Alzheimer's disease through the utilization of network pharmacology and molecular docking techniques.Methods The methods employed include target screening,Gene Ontology(GO)function and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis,and molecular docking simulations to assess the binding interactions between the active compounds in polygonatum odoratum(POD)and the key target proteins associated with Alzheimer's disease.Subsequently,lipopolysaccharide(LPS)was used to induce an inflammatory cell model in BV2 microglial cells.After treating the cell model with POD extract for 24 hours,the cells were collected,and the expression of the target genes were detected by Real-time PCR.Results Eight active ingredients and 172 targets of POD were screened.The biological processes such as protein phosphorylation and signal transduction,protein binding and ATP binding were obtained by GO functional analysis.KEGG enrichment yielded PI3K/Akt,cAMP and other signaling pathways.The molecular docking result showed that the active ingredient of POD had well binding activity with epidermal growth factor receptor(EGFR),proto-oncogene tyrosine-protein kinase Src(SRC),tumor necrosis factor(TNF),STAT3.Through Real-time PCR experiments,the gene expressions of inducible nitric oxide synthase(iNOS),prostaglandin G/H synthase 2(PTGS2),interleukin(IL)-6,and IL-1β in the LPS-induced inflammatory cell model were significantly upregulated.After treating the inflammatory model with POD extract for 24 hours,the expression of TNF-α was significantly reduced,the expression of STAT3 was upregulated,there were no significant changes in the expressions of SRC and EGFR.Conclusion Network pharmacology suggests polygonatum odoratum's potential anti-Alzheimer's effects may be mediated through its interaction with targets such as EGFR,TNF,SRC,and STAT3.The experimental results suggest that polygonatum odoratum exerts an anti-inflammatory effect by acting on TNF-α,which may further alleviate the symptoms of Alzheimer's disease.

Objective To observe the clinical effect of Zuogui Pill combined with western medi-cine in treatment of gestational diabetes mellitus(GDM)with qi and yin deficiency syndrome.Meth-ods A total of 92 GDM patients with qi and yin deficiency syndrome from the Second Affiliated Hos-pital of Guizhou University of Traditional Chinese Medicine between January 2022 and October 2023 were enrolled and randomly divided into study group and control group,with 46 patients in each group.The control group received western medicine treatment,while the study group received Zuogui Pill combined with western medicine treatment.Both groups were treated for 4 weeks.The treatment effects,as well as the levels of glycolipid indicators[total cholesterol(TC),triglyceride(TG),fast-ing plasma glucose(FPG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),and glycated hemoglobin(HbA1c)],insulin resistance indicators[fasting in-sulin(FINS),homeostasis model assessment of β-cell function(HOMA-β),and homeostasis model assessment of insulin resistance(HOMA-IR)],inflammatory and stress factors[serum amyloid A(SAA),interleukin-6(IL-6),malondialdehyde(MDA),and reactive oxygen species(ROS)],serum microRNA(miR)-21 and miR-149 levels,and occurrence of adverse pregnancy outcomes were compared be-tween the two groups before and after treatment.Results After 4 weeks of treatment,the total ef-fective rate was higher in the study group than that in the control group(P＜0.05).After treat-ment,the levels of FPG,HbA1c,TC,LDL-C,and TG were lower,and the levels of HDL-C were higher in both groups than before treatment,and the levels of FPG,HbA1c,TC,LDL-C in the study group were lower than those in the control group,and the level of HDL-C was higher in the study group than that in the control group(P＜0.05).After treatment,the levels of FINS and HOMA-IR were lower in both groups than before treatment,and their levels in the study group were lower than those in the control group;the levels of HOMA-β were higher in both groups than before treatment,and its level in the study group was higher than that in the control group(P＜0.05).After treat-ment,the levels of SAA,IL-6,MDA,and ROS were lower in both groups than before treatment,and their levels in the study group were lower than those in the control group(P＜0.05).Before treatment,there were no statistically significant differences in the levels of serum miR-21 and miR-149 between the two groups(P＞0.05);after treatment,the levels of serum miR-21 and miR-149 were lower in both groups than before treatment,and their levels in the study group were lower than those in the control group(P＜0.05).Before treatment,the traditional Chinese medicine syndrome score was(8.12±1.31)in the study group and(7.86±1.28)in the control group,with no statisti-cally significant difference between the two groups(P＞0.05);after treatment,the traditional Chi-nese medicine syndrome score was(3.31±0.46)in the study group,which was lower than(4.57±0.59)in the control group(t=11.423,P＜0.05).Compared with the control group,the incidence of adverse pregnancy outcomes was lower in the study group(P＜0.05).Conclusion Zuogui Pill combined with western medicine can effectively improve glycolipid metabolism and insulin resistance in GDM patients and reduce the incidence of adverse pregnancy outcomes.

Objective To construct and validate the application effect of a standardized nursing protocol for transoral endoscopic thyroidectomy via vestibular approach(TOETVA)led by nurses in operating room under guidance of enhanced recovery after surgery(ERAS).Methods Based on Del-phi method,a TOETVA protocol led by operating room nurses under ERAS guidance was constructed.Eighty patients were randomly divided into control group and experimental group using random number table method,with 40 cases in each group.The control group received routine nursing interventions,while the experimental group received the standardized TOETVA nursing protocol led by operating room nurses under ERAS guidance.The number of days of drainage tube indwelling,length of hospital stay,incidence of complications,anxiety levels,and nursing satisfaction were compared between the two groups.Results Compared with the control group,the experimental group had a shorter number of days of drainage tube indwelling and length of hospital stay,as well as higher nursing satisfaction(P＜0.05).There was no statistically significant difference in anxiety levels between the two groups before intervention(P＞0.05).After intervention,the score of the Self-Rating Anxiety Scale(SAS)in the experimental group decreased and was lower than that in the control group(P＜0.05).However,there was no statistically significant difference in the incidence of complications between the two groups(P＞0.05).Conclusion The construction of a standardized TOETVA nursing protocol led by nurses in operating room under ERAS guidance is scientific and effective.It has positive significance in shortening the drainage tube indwelling time and hospital stay,improving patients' anxiety,and en-hancing patients' nursing satisfaction.

Objective:To compare and analyze the differences in positioning errors and placement outside the target area between two different image-guided systems(Halcyon and Synergy)in radiotherapy for cervical cancer.Methods:The data of 40 patients with cervical cancer who received treatment in Dezhou People's Hospital from March 2023 to June 2023 were retrospectively selected.Each patient was treated respectively with Halcyon linear accelerator and Synergy linear accelerator,with 20 cases for each treatment method.All patients underwent cone beam computed tomography(CBCT)at kV level to conduct image scanning before radiotherapy,and the obtained CBCT images were matched with the positioned CT images by online.The registration results of left and right(x),head and foot(y)and front and back(z)of three translation direction,and pitch(Rx),rotation(Ry)and deflection(Rz)directions of rotation direction were respectively obtained.The margin of planning target volume(MPTV)was calculated according to positioning expansion formula.The differences of positioning errors and target area expansion between Halcyon and Synergy image-guided systems were compared and analyzed.Results:Halcyon and Synergy image-guided systems obtained respectively 479 and 447 sets of CBCT images.The translational errors of Halcyon image-guided system on x,y,and z directions were respectively(-0.03±0.21),(0.12±0.63)and(0.02±0.15)cm,and the rotational errors of that on Rx,Ry and Rz directions were respectively(0.38±1.26)°,(-0.40±1.02)°,and(0.07±1.07)°.The translational errors of Synergy image-guided system were respectively(-0.07±0.18),(0.08±0.49)and(0.11±0.22)cm on the three directions,and the rotational errors of that were respectively(0.28±1.29)°,(-0.29±1.29)° and(-0.16±1.20)°.The translational error values on the y direction of both image-guided system were larger than that on x and z directions,and the absolute values of the range of translational errors of them were basically within 5 mm.There were no statistically significant difference in the positioning errors of rotation on Rx and Ry directions between Halcyon and Synergy image-guided systems(P＞0.05),while there was a statistically significant difference in the positioning error of rotation on Rz direction between them(t=-3.06,P＜0.05).The MPTV values of Halcyon image-guided system on x,y and z directions were respectively 0.4,1.4 and 0.3 cm,and those of Synergy image-guided system were respectively 0.4,0.9 and 0.5 cm.The expansion boundary of target area of Halcyon image-guided system on the y direction was larger than that of Synergy image-guided system,and that on other directions were all less or equal to 0.5 cm.Conclusion:The MPTV values of Halcyon and Synergy image-guided systems can meet clinical requirements in radiotherapy.The positioning errors and the tube current of the scan of Halcyon image-guided system were larger than those of Synergy image-guided system,but the scanning time and treatment time of that were significantly lower than those of Synergy image-guided system.Different treatment systems can be selected individually for patients according to their different conditions.

Objective To investigate the effects of polyphyllin Ⅲ on proliferation,cycle and apoptosis of colon cancer cells HCT116;To explore its mechanism in treating colon cancer.Methods Colon cancer cells HCT116 were cultured in vitro,the cells were dived into control group and polyphyllin Ⅲ low-,medium-and high-dosage group,drug-free media and low-,medium-and high-concentration of polyphyllin Ⅲ were applied to the cells.Cell proliferation was detected by CCK-8 method,and cell cycle and apoptosis were detected by flow cytometry,the expressions of cyclinD1,CDK4,CDK6,RB,p-RB,Bax,Bcl-2,Bcl-xl mRNAs and proteins were detected by RT-PCR and Western blot.Results Compared with the control group,the HCT116 cell viability decreased in the polyphyllin Ⅲ groups with different dosages(P<0.01),the proportion of G0-G1 phase cells increased(P<0.01),the proportion of S,G2-M phase cells decreased(P<0.01),the cell apoptosis rate increased(P<0.01),and the expressions of cyclinD1,CDK4,CDK6,Bcl-2,Bcl-xl mRNA and cyclinD1,CDK4,CDK6,p-RB,Bcl-2,Bcl-xl proteins decreased,while the expression of Bax mRNA and protein increased,with a dosage-dependent manner(P<0.05,P<0.01).Conclusion Polyphyllin Ⅲ can inhibit the proliferation of colon cancer cells cultured in vitro and promote cell apoptosis,blocking cells in the G0-G1 phase.The mechanism may be related to the inhibition of cell cycle related proteins and apoptosis related protein expression.