ObjectiveTo investigate the correlation between neutrophil-to-lymphocyte ratio （NLR）， platelet-to-lymphocyte ratio （PLR）， systemic immune-inflammation index （SII） and the severity of intrauterine adhesions （IUA）. MethodsThe retrospective study included 380 patients who underwent transcervical resection of adhesions （TCRA） from December 2019 to March 2025. Based on the American Fertility Society （AFS） classification， patients were divided into mild （n=61）， moderate （n=225）， and severe （n=94） groups. NLR， PLR， and SII were calculated from preoperative blood tests. Statistical analyses included Kruskal-Wallis test and ordinal Logistic regression. ResultsNLR， PLR， and SII were significantly higher in the severe IUA group compared to the mild group （P<0.05）， with SII showing the strongest predictive ability （OR=1.004， P=0.001）. The number of intrauterine procedures was an independent risk factor （OR=1.27/level， P=0.016）. The predictive model ［Logit（P）=-0.676+0.241×operation times+0.004×SII］ effectively identified severe IUA cases. ConclusionInflammatory markers （particularly SII） are correlated with IUA severity and may serve as non-invasive tools for clinical assessment.

Objective:To explore the efficacy and safety of brain radiotherapy combined with pyrotinib and capecitabine in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer with brain metastases.Methods:Clinical data of 30 HER2-positive breast cancer patients with brain metastases treated at the Fourth Hospital of Hebei Medical University between January 2018 and January 2024 were retrospectively analyzed. According to the timing of drug administration, patients were divided into the concurrent radiotherapy and medication group ( n=20) and the sequential group receiving pyrotinib plus capecitabine within 1 month before or after radiotherapy ( n=10). Intracranial progression-free survival (iPFS), intracranial and extracranial objective response rates (ORR), overall survival (OS), and treatment safety were analyzed. Survival curves were plotted using the Kaplan-Meier method, and survival differences were compared by log-rank test. Results:The median follow-up time was 23.5 months (range, 5.2-37.8), with a median iPFS of 13.0 months (range, 1.7-27.3) and a median OS of 28.2 months (range, 7.3-46.2). The 1-year iPFS and OS in the concurrent radiotherapy with pyrotinib and capecitabine group were numerically higher than those in the sequential group treated within 1 month before or after radiotherapy, but the differences were not statistically significant ( P=0.825, 0.724, respectively). The intracranial and extracranial ORRs were 83.3% and 64.3%, respectively. The most common grade ≥3 treatment-related adverse reactions were diarrhea (27%) and neutropenia (23%). Conclusions:Radiotherapy combined with pyrotinib and capecitabine provides prolonged survival benefits with acceptable safety in patients with HER2-positive breast cancer brain metastases. Compared to concurrent administration, pyrotinib plus capecitabine given within 1 month before or after radiotherapy does not appear to affect prognosis.

Objective To examine the time window effect of high-load exerciseon skeletal muscle in-flammation genes,and identify the key genes and signaling pathways involved in this process.Methods Forty-eight Sprague-Dawley rats were randomly assigned to a control group(group C,n=8)and an ex-ercise group(group E,n=40).Gastrocnemius muscles were collected immediately(group E0),12h(group E12),24h(group E24),48h(group E48),and 72 h(group E72)after exercise for transcrip-tome sequencing.Differentially expressed genes(DEGs)were identified,and enrichment analysis was carried out using the Gene Ontology(GO)and the Kyoto Encyclopedia of Genes and Genomes(KEGG)annotations.Meanwhile,inflammation-related genes were obtained from databases,and differ-entially expressed inflammation-related genes(DEIRGs)were done through identifying their intersec-tion with DEGs.Moreover,the Mfuzz algorithm was used for time series clustering to obtain subsets with similar characteristics.GO and KEGG analyses,along with protein interaction network analysis,were performed to obtain key DEIRGs,followed by secondary functional enrichment to analyze changes in expression of key genes over time and identify key signaling pathways.Results Seven DEIRG clus-ters were obtained through Mfuzz time series clustering of skeletal muscle inflammation genes after high-load exercise.Overall,the expression of DEGs in cluster 5 was downregulated,while that in cluster 7 was upregulated.The expression of DEGs in clusters 3 and 4 was upregulated at E0 and rap-idly downregulated at E12.In contrast,the expression of DEGs in cluster 2 and 6 were downregulated at E0 and rapidly upregulated at E12.The expression of DEGs in cluster 1 was upregulated at E0,rapidly downregulated at E12,and remained upregulated at E24.Screening identified TP53,STAT3,CD44,AKT1,KDR,GJA1,CYCS,HIF1A,IQGAP3,FASN,and TFRC as key DEIRGswhich were enriched in apoptosis,HIF-1,apoptosis,ferroptosis,MAPK,VEGF,PI3K-Akt,insulin resistance,FoxO,AMPK and the JAK-STAT signaling pathway.Conclusion Inflammation-related genes exhibit temporal dynamic changes in exercise-induced muscle damage and show significant time window effects at 12 h after exercise.The key targets STAT3,AKT1 and HIF-1A react to exercise-induced muscle damage through the JAK-STAT,PI3K-Akt,HIF-1 and VEGF signaling pathways,and promote tissue repair.

Chronic heart failure (CHF) is a pathological state in which the cardiac ejection fraction is insufficient to meet an individual's metabolic needs owing to changes in the cardiac structure or function. Various etiologies such as myocardial infarction and inflammation are implicated, and the main symptoms are dyspnea, lower limb edema, fatigue, and discomfort during rest or exercise. CHF is the primary outcome of cardiovascular disease, and the increasing morbidity and mortality rates highlight the significant risks of this condition. According to traditional Chinese medicine, the pathogenesis of CHF is deficiency of heart qi and heart yang, which predominantly affects the heart, but may also impede the function of other zang-organs such as the spleen and kidney, and aggravate the symptoms of heart failure. With technological advancements and enhanced awareness of health conditions and disease prevention, China has promoted traditional medicine practices such as medicine and food homology (MFH), which has received increasing attention in recent years. This concept stipulates that certain medicines and foods have the same origin; ergo, these foods have medicinal properties, with many being used in the prevention and treatment of CHF. However, the efficacy and safety of MHF substances have yet to be determined, and there is no consensus regarding the development of disease prevention and treatment strategies. This article therefore reviews the current evidence for MFH in the prevention and treatment of CHF by summarizing the therapeutic potential of this practice and discussing treatment strategies and aims to improve the understanding of Chinese medicine and food homologous substances in the treatment of this condition, as well as highlight the current literature and avenues for future research.

OBJECTIVE To explore the effects of Lishukang capsules on hypoxic pulmonary artery hypertension （HPAH） rats by regulating the HIF-1α/NF-κB signaling pathway. METHODS Sixty rats were randomly divided into control group， model group， positive control group （sildenafil， 30 mg/kg）， Lishukang low-， medium- and high-dose groups （Lishukang capsules 6， 12， 18 g/kg）， with 10 rats in each group. Except for control group， the HPAH model was induced by intermittent hypoxia method （simulating an altitude of 5 000 m） in other groups； at the same time， they were given relevant medicine or normal saline intragastrically， for consecutive 28 days. Within 24 hours of the last administration， the mean pulmonary artery pressure （MPAP） and right ventricule hypertrophy index （RVHI） of rats were detected； pathological morphology of lung tissue was observed， and the expression of α-smooth muscle actin （α-SMA）， mRNA expressions of HIF-1α and NF-κB as well as protein expressions of HIF-1α and NF-κB p65 in lung tissue were determined. RESULTS Compared with model group， MPAP and RVHI in Lishukang medium- and high-dose groups and positive control group were all decreased significantly （P＜0.05）； the expression of α-SMA， mRNA expressions of HIF-1α and NF-κB， and protein expressions of HIF-1α and NF-κB p65 in lung tissue were all decreased significantly （P＜0.05）； additionally， pulmonary vascular remodeling was improved to varying degrees. CONCLUSIONS Lishukang capsules may protect HPAH rats， the mechanism of which may be associated with inhibiting the HIF-1α/NF- κB signaling pathway.

OBJECTIVES: Non-small cell lung cancer (NSCLC) is associated with poor prognosis, with 30% of patients diagnosed at an advanced stage. Mutations in the EGFR and KRAS genes are important prognostic factors for NSCLC, and targeted therapies can significantly improve survival in these patients. Although tissue biopsy remains the gold standard for detecting gene mutations, it has limitations, including invasiveness, sampling errors due to tumor heterogeneity, and poor reproducibility. This study aims to develop machine learning models based on radiomic features to predict EGFR and KRAS gene mutation status in NSCLC patients, thereby providing a reference for precision oncology. METHODS: Imaging and mutation data from eligible NSCLC patients were obtained from the publicly available Lung-PET-CT-Dx dataset in The Cancer Imaging Archive (TCIA). A three-dimensional-convolutional neural network (3D-CNN) was used to extract imaging features from the regions of interest (ROI). The LightGBM algorithm was employed to build classification models for predicting EGFR and KRAS gene mutation status. Model performance was evaluated using 5-fold cross-validation, with receiver operator characteristic (ROC) curves, area under the curve (AUC), accuracy, sensitivity, and specificity used for validation. RESULTS: The models effectively predicted EGFR and KRAS mutations in NSCLC patients, achieving an AUC of 0.95 for EGFR mutations and 0.90 for KRAS. The models also demonstrated high accuracy (EGFR 89.66%; KRAS 87.10%), sensitivity (EGFR 93.33%; KRAS 87.50%), and specificity (EGFR 85.71%; KRAS 86.67%). CONCLUSIONS A radiogenomics-machine learning predictive model can serve as a non-invasive tool for anticipating EGFR and KRAS gene mutation status in NSCLC patients.
Humans ; Carcinoma, Non-Small-Cell Lung/diagnostic imaging* ; Lung Neoplasms/diagnostic imaging* ; Mutation ; Proto-Oncogene Proteins p21(ras)/genetics* ; ErbB Receptors/genetics* ; Machine Learning ; Positron Emission Tomography Computed Tomography ; Female ; Male ; Neural Networks, Computer ; Middle Aged ; Aged

OBJECTIVE: To evaluate the clinical efficacy of ultrasound-guided needle knife release with different pathways for carpal tunnel syndrome (CTS). METHODS: Sixty CTS patients were randomly divided into a transverse group and a longitudinal group, with 30 patients in each group. The transverse group received the needle knife release under ultrasound above and below the median nerve along the short axis, while the longitudinal group received the needle knife release under ultrasound above the median nerve along the long axis. The patients' visual analogue scale (VAS) scores, Levine scores, and median nerve cross-section area (CSA) were assessed before treatment, on the 7th, 14th, and 30th days after treatment. The median nerve conduction indexes (motor conduction: latency [Lat], amplitude[Amp], motor conduction velocity [MCV]; sensory conduction: Lat, Amp, sensory conduction velocity [SCV]) were evaluated before treatment and on the 30th day after treatment. RESULTS: Compared before treatment, the VAS scores, Levine scores, and median nerve CSA were reduced in both groups on the 7th, 14th, and 30th days after treatment (P<0.05); the transverse group showed lower VAS and Levine scores and smaller CSA than those in the longitudinal group (P<0.05). On the 30th day after treatment, motor and sensory Lat was reduced (P<0.05), motor and sensory Amp was increased (P<0.05), and MCV and SCV were faster (P<0.05) in both groups. The transverse group had shorter Lat, higher Amp, and faster MCV and SCV than those in the longitudinal group (P<0.05). CONCLUSION The ultrasound-guided needle knife release with transverse and longitudinal pathways could both effectively alleviate pain and improve median nerve conduction in CTS patients, with the transverse pathway showing superior efficacy to longitudinal pathway.
Humans ; Carpal Tunnel Syndrome/therapy* ; Female ; Middle Aged ; Male ; Adult ; Median Nerve/physiopathology* ; Acupuncture Therapy/instrumentation* ; Treatment Outcome ; Neural Conduction ; Aged ; Ultrasonography

Objective To identify the cuproptosis genes associated with prognosis and immune microenvironment in lung cancer with the use of bioinformatics.Methods The lung cancer dataset used in this study was obtained from the TCGA database.The cuproptosis-related genes(CRGs)were obtained from the previously reported literature.The R software Deseq2 package was used to identify the differentially expressed genes(DEGs)in lung cancer.The intersection of DEGs and CRGs was taken to obtain the differentially expressed CRGs(DE-CRGs).COX analysis and R software rms package were used to identify DE-CRGs associated with the prognosis of lung cancer.Estimate and Cibersort algorithms were applied to identify the correlation of DE-CRGs with the immune microenvironment.Results Compared to the normal tissues,a total of 5,269 DEGs were present in lung cancer tissues in the TCGA database,and there were 11 shared genes between DEGs and CRGs.The 11 DE-CRGs mainly regulated the energy metabolism,carbon metabolism and amino acid metabolism.In the DE-CRGs,LIPT1 was an independent risk factor for lung cancer,and the column chart constructed with the clinical features(age,TNM staging,and residual tumor)predicted the survival of lung cancer patients in a manner similar to their actual outcomes.LIPT1 showed a positive correlation with the infiltration of M1 and M2 type macrophages,activated natural killer cells cells and CD8+T cells,and showed a significant negative correlation with M0 type macrophages,activated mast cells,neutrophils and Treg cells(P<0.05).Conclusion LIPT1 may serve as a prognostic and immune microenvironment-associated cuproptosis gene,which is a novel biomarker for lung cancer therapy.

Objective To establish an electrical field(EF)stimulation model for Schwann cells(SCs),and to provide a basis for exploring the mechanisms of EF stimulation in promoting proliferation,migration and epithelial-to-mesenchymal transition of SCs.Methods A YC-3 bipolar programmable electrical stimulator and an electrotaxis chamber were used to construct an EF stimulation system to stimulate SCs.In the study,SCs were divided into control group(Ctrl)receiving no EF stimulation and EF group stimulated by continuous constant-voltage EF(100 mV/mm,3 h).The effects of EF stimulation on the proliferation and migration of SCs were analyzed using CCK-8 assay,and wound healing assay+Transwell assay,separately;and its effect on SCs adhesion was observed by analyzing the expressions of E-cadherin and N-cadherin using Western Blot.Results The CCK-8 assay results suggested that the absorbance at 450 nm was significantly higher in EF group than in Ctrl group(P<0.05).The results of wound healing assay+Transwell assay revealed that EF group had higher cell migration efficiency than Ctrl group(P<0.05).Western Blot results showed decreased E-cadherin expression and increased N-cadherin expression in EF group as compared with Ctrl group(P<0.05).Conclusion The improved EF stimulation system for SCs is operable.EF stimulation can promote the proliferation and migration of SCs.The decreased E-cadherin expression and increased N-cadherin expression may be related to the occurrence of epithelial-to-mesenchymal transition in SCs after EF stimulation.

AIM:To investigate the mechanism through which aerobic exercise improves inflammatory senes-cence in SAMP8 mice via Janus kinase 3(JAK3)-signal transducer and activator of transcription 5α(STAT5α)signaling pathway and to provide novel insights for anti-inflammatory aging interventions.METHODS:Sixteen 28-week-old SAMP8 mice were randomly divided into model(Mod)group and exercise(Exe)group,with 8 mice in each group.Addi-tionally,8 senile SAMR1 mice served as control(Con)group.The mice in Exe group underwent an 8-week aerobic training regimen on a treadmill.We monitored the changes in hair quality and body weight,immune organ indexes,histomorpho-logical alterations in immune organs,the expression levels of spleen aging marker P16,and the serum and spleen levels of inflammatory factors[tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)]and aging indicator IL-2.Moreover,we examined the alterations in the mRNA and protein expression of IL-2,JAK3 and STAT5α in the spleen.RESULTS:(1)Compared with Con group,the mice in Mod group exhibited decreased hair luster and volume,with some instances of alopecia areata,increased body weight,markedly reduced spleen and thymus indexes,evident atrophy and senescence of immune organs,and markedly decreased concentration of IL-2 in the serum and spleen.The expression of P16 in the spleen,and the serum and spleen levels of inflammatory factors TNF-α and IL-1β were significantly increased.The mRNA expression of IL-2 and IL-2 receptor subunit gamma(IL-2RG)in the spleen was markedly decreased,whereas that of JAK3 and STAT5α was markedly increased.Furthermore,the protein expression of IL-2 in the spleen was markedly de-creased,whereas that of STAT5α and JAK3 was markedly increased.(2)Compared with Mod group,the mice in Exe group showed relatively vigorous hair growth and better hair luster,lower body weight,markedly increased spleen and thy-mus indexes,and delayed immune organ aging.The concentration of IL-2 in the serum and spleen was markedly in-creased,while the expression of P16 in the spleen was markedly decreased.The levels of TNF-α and IL-1β in the serum and spleen were markedly decreased.The mRNA expression of IL-2 and IL-2RG in the spleen was markedly increased,whereas that of JAK3 and STAT5α was markedly decreased.The protein levels of IL-2 were markedly increased,whereas those of STAT5α and JAK3 were markedly decreased.CONCLUSION:Aerobic exercise can delay inflammatory aging in mice possibly through the JAK3-STAT5α signaling pathway.