The morphological characteristics of hepatocellular carcinoma(HCC)tumor margins are pivotal in influencing patient's prognosis and the selection of therapeutic strategies.This paper re-viewed the classification methods of HCC tumor margins,ranging from traditional macroscopic classifi-cations to refined classification systems based on multi-omics analysis,and analyzed the role of these classification methods in guiding the formulation of personalized treatment plans.Additionally,this paper emphasized the crucial role of three-dimensional imaging techniques in assessing tumor margin morphology and outlined future research directions,including validating the effectiveness of multi-omics classification systems and developing new imaging and molecular biomarkers to achieve more precise treatment plans and prolong patient survival.

AIM To explore the clinical effects of Supplemented Buyang Huanwu Decoction on postoperative patients with lumbar vertebral fracture complicated with spinal cord injury due to Qi Deficiency and Blood Stasis Pattern.METHODS One hundred and twenty patients were randomly assigned into control group(60 cases)for 6-week intervention of conventional treatment,and observation group(60 cases)for 6-week intervention of both Supplemented Buyang Huanwu Decoction and conventional treatment.The changes in clinical effects,TCM syndrome scores,spinal cord conduction signals(SEP amplitude,MEP amplitude),serum neurotrophic factors(NGF,IGF-1,BDNF),coagulation and inflammatory indices(PT,APTT,TNF-α,IL-1 β)and incidence of adverse reactions were detected.RESULTS The observation group demonstrated higher total effective rate than the control group(P＜0.05).After the treatment,the two groups displayed decreased TCM syndrome scores,TNF-α,IL-1β(P＜0.05),increased spinal cord conduction signals,coagulation and inflammatory indices(P＜0.05),and shortened PT,APTT(P＜0.05),especially for the observation group(P＜0.05).No significant difference in incidence of adverse reactions was found between the two groups(P＞0.05).CONCLUSION For the patients with lumbar vertebral fracture complicated with spinal cord injury due to Qi Deficiency and Blood Stasis Pattern,Supplemented Buyang Huanwu Decoction can safely and effectively promote neurological function recovery.

Yttrium-90(90Y)selective internal radiation therapy(SIRT)is an emerging modality for the treatment of hepatocellular carcinoma(HCC),leveraging the nuclide 90Y to deliver targeted radiation therapy.90Y has a long half-life and can be used to selectively ablate tumor cells by high-energy beta rays.It has high biological effectiveness and robust local control capabilities.In recent years,with the continuous advancement of basic and clinical research,the application of 90Y-SIRT in the conversion treatment of unresectable HCC(uHCC)has made significant progress.However,challenges remain in the clinical application of 90Y-SIRT,including how to improve the efficacy of conversion therapy and how to optimize therapy regimens.This review aims to summarize the research progress of90Y-SIRT in the conversion therapy of uHCC.

OBJECTIVES: To investigate the impact of hepatitis B virus (HBV) infection on oral microbiota and metabolites in patients with metabolic dysfunction-associated fatty liver disease (MAFLD) and the underlying mechanisms. METHODS: This prospective study was conducted in 47 MAFLD patients complicated with chronic hepatitis B (CHB) and 48 MAFLD patients without CHB enrolled from November, 2023 to January, 2024. Fasting tongue coating samples were collected from the patients for analyzing microbial community structures and metabolites using high-throughput 16S rDNA sequencing and non-targeted metabolomics techniques, and their associations with clinical indicators and biological pathways were explored using correlation analysis and functional annotation. RESULTS: The levels of fasting blood glucose, total cholesterol (TC), gamma-glutamyl transferase (GGT), and severity of fatty liver were all significantly lower in MAFLD+CHB group than in MAFLD group. Microbiota analysis showed that the abundances of Patescibacteria (at the phylum level), Hydrogenophaga, and Absconditabacteriales (at the genus level) were significantly increased, while the abundance of Megasphaera was decreased in MAFLD+CHB group. The differential microbiota were significantly correlated with TC, GGT and low-density lipoprotein (r=-0.68‒0.75). Metabolomics analysis revealed that 469 metabolites (including lipids and amino acids) were upregulated and 2306 (including organic oxygen-containing compounds and phenylpropanoids) were downregulated in MAFLD+CHB group, for which KEGG enrichment analysis suggested abnormal activation of the linoleic acid metabolism and glycerophospholipid metabolism pathways. Correlation analysis between microbiota and metabolites indicated that Patescibacteria and Megasphaera, which were positively correlated with lipid metabolites and negatively with fatty acid metabolites, respectively, jointly affected glycolipid metabolism and oxidative stress pathways. CONCLUSIONS Compared to patients with MAFLD alone, MAFLD patients with concurrent chronic HBV infection showed lower levels in some lipid metabolism indicators and the degree of hepatic steatosis, accompanied by alterations in oral microbiota structure and metabolic profiles. The precise mechanisms involved require further investigation to be fully elucidated.
Humans ; Lipid Metabolism ; Prospective Studies ; Microbiota ; Hepatitis B, Chronic/microbiology* ; Male ; Female ; Adult ; Fatty Liver/microbiology* ; Middle Aged ; Mouth/microbiology* ; Metabolomics

Objective To synthesize qualitative studies on the experiences of postoperative lung cancer patients participating in pulmonary rehabilitation,aiming to comprehensively understand the barriers and facilitators influencing their engagement and to provide evidence-based insights for improving rehabilitation adherence.Methods Qualitative studies were retrieved from databases including Web of Science,PubMed,Cochrane Library,Embase,CNKI,Wanfang Data,VIPand Sinomed,with a search period spanning from database inception to January,2025.The methodological quality of eligible studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research.Extracted findings were mapped and synthesized using the Theoretical Domains Framework(TDF)and the Capability-Opportunity-Motivation-Behavior mode(COM-B).Results Ultimately,a total of 11 studies were included,yielding 48 findings.Using the Theoretical Domains Framework(TDF)and COM-B model,facilitators and barriers to pulmonary rehabilitation in postoperative lung cancer patients were mapped and consolidated into 14 categories,culminating in 2 synthesized findings.Conclusion Participation in pulmonary rehabilitation among postoperative lung cancer patients is influenced by multiple factors.Clinicians should develop patient-centered pulmonary rehabilitation plans by considering these factors and incorporating patients' attitudes and perspectives.

Allergic rhinitis(AR)affects 10%-40%of the population in the world.Because CLOCK genes regulate the circadian rhythms of AR,the symptoms in parts of the patients are aggravated in the morning and evening and relieved at moon.Although lots of studies showed that traditional Chinese medicine is effective for AR,further explores are still needed to analyze the circadian rhythm of AR based on Chinese Chronological Medicine for controlling the circadian outbreak point of symptoms of AR in daily cycle.We supposed that Weiyang might play an important role for controlling the circadian rhythm of AR with closed similarities with the tidal variation of the expressions of CLOCK genes.Thus based on Weiyang theory,we tried to clarify the mechanism of circadian rhythm of AR and explore the relationship between Weiyang and the CLOCK genes so as to further expand the treatment methods of adjusting the circadian cycle of AR with TCM and improve the corresponding therapeutic efficacy.

Allergic rhinitis(AR)affects 10%-40%of the population in the world.Because CLOCK genes regulate the circadian rhythms of AR,the symptoms in parts of the patients are aggravated in the morning and evening and relieved at moon.Although lots of studies showed that traditional Chinese medicine is effective for AR,further explores are still needed to analyze the circadian rhythm of AR based on Chinese Chronological Medicine for controlling the circadian outbreak point of symptoms of AR in daily cycle.We supposed that Weiyang might play an important role for controlling the circadian rhythm of AR with closed similarities with the tidal variation of the expressions of CLOCK genes.Thus based on Weiyang theory,we tried to clarify the mechanism of circadian rhythm of AR and explore the relationship between Weiyang and the CLOCK genes so as to further expand the treatment methods of adjusting the circadian cycle of AR with TCM and improve the corresponding therapeutic efficacy.

Objective:To evaluate the clinical efficacy of Tianma Xionglin Zhixuan Tablets in treating hypertension patients with liver yang hyperactivity or comorbid phlegm-stasis syndrome and explore its therapeutic mechanisms through plasma metabolomics.Methods:Thirty-six hypertension patients(4 dropouts)diagnosed with liver yang hyperactivity or phlegm-stasis syndrome were enrolled as the treatment group from June 2022 to September 2023 at the First Affiliated Hospital of Hunan University of Chinese Medicine,while 30 healthy volunteers with balanced constitutions were recruited as the blank group.Plasma samples were collected from patients pre-and post-treatment and from healthy volunteers.Clinical outcomes,including syndrome scores,office blood pressure(BP),and 24-hour ambulatory BP,were recorded.Plasma metabolomic profiling was performed using liquid chromatography-mass spectrometry(LC-MS).Results:Compared with baseline,Tianma Xionglin Zhixuan Tablets significantly reduced traditional Chinese medicine syndrome scores(P＜0.01),office systolic/diastolic BP(P＜0.01),and 24-hour ambulatory BP parameters(24-hour mean BP,daytime/nighttime mean BP;all P＜0.01).Metabolomic analysis identified 45 differential metabolites between the blank group and pretreatment patients,and 64 metabolites altered post-treatment(VIP＞1,P＜0.05).Enrichment analysis of 16 overlapping endogenous metabolites revealed that Tianma Xionglin Zhixuan Tablets primarily modulated arachidonic acid metabolism and sphingolipid metabolism pathways.Conclusion:Tianma Xionglin Zhixuan Tablets demonstrates significant clinical efficacy in hypertension patients with liver yang hyperactivity or phlegm-stasis syndrome,potentially mediated through regulation of arachidonic acid and sphingolipid metabolism.

Objective To synthesize qualitative studies on the experiences of postoperative lung cancer patients participating in pulmonary rehabilitation,aiming to comprehensively understand the barriers and facilitators influencing their engagement and to provide evidence-based insights for improving rehabilitation adherence.Methods Qualitative studies were retrieved from databases including Web of Science,PubMed,Cochrane Library,Embase,CNKI,Wanfang Data,VIPand Sinomed,with a search period spanning from database inception to January,2025.The methodological quality of eligible studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research.Extracted findings were mapped and synthesized using the Theoretical Domains Framework(TDF)and the Capability-Opportunity-Motivation-Behavior mode(COM-B).Results Ultimately,a total of 11 studies were included,yielding 48 findings.Using the Theoretical Domains Framework(TDF)and COM-B model,facilitators and barriers to pulmonary rehabilitation in postoperative lung cancer patients were mapped and consolidated into 14 categories,culminating in 2 synthesized findings.Conclusion Participation in pulmonary rehabilitation among postoperative lung cancer patients is influenced by multiple factors.Clinicians should develop patient-centered pulmonary rehabilitation plans by considering these factors and incorporating patients' attitudes and perspectives.

Objective To investigate levels of soluble T cell immunoglobulin mucin domain 3(sTim-3)and soluble growth stimulating gene expression protein 2(sST2)in peripheral blood of patients with alcoholic liver disease(ALD),and their correlation with disease severity.Methods A total of 112 ALD patients in our hospital from June 2021 to June 2023 were selected as the ALD group,including 47 patients with alcoholic fatty liver(AFL group),37 patients with alcoholic steatohepatitis(ASH group)and 28 patients with alcoholic liver cirrhosis(ALC group).Another 112 healthy subjects were used as the control group.Enzyme linked immunosorbent assay was applied to detect serum levels of sTim-3 and sST2.ROC curve was used to analyze the diagnostic value of sTim-3 and sST2 in different clinical types of ALD.The correlation between serum sTim-3,sST2 levels and clinical indicators in ALD patients was analyzed by Pearson correlation analysis.The factors influencing disease severity in ALD patients was analyzed by Logistic regression model.Results The serum levels of sTim-3 and sST2 were higher in the ALD group than those in the control group(P＜0.05).The serum levels of sTim-3 and sST2 were increased successively in the AFL group,the ASH group and the ALC group(P＜0.05).The area under the curve(AUC)of the combined diagnosis of ALC and ASH by sTim-3 and sST2 was significantly larger than that of AUC of the single diagnosis of sTim-3 and sST2(P＜0.05).Levels of glutamic-pyruvic transaminase(ALT),glutamic oxalacetic transaminase(AST),total bilirubin(TBIL),alkaline phosphatase(ALP)and glutamyl transpeptidase(GGT)were increased successively in the AFL group,the ASH group and the ALC group(P＜0.05).The serum levels of sTim-3 and sST2 were positively correlated with levels of ALT,AST,TBIL,ALP and GGT,respectively(P＜0.05).Logistic regression analysis showed that high levels of sTim-3 and sST2 were independent risk factors for severe disease in ALD patients(P＜0.05).Conclusion The serum levels of sTim-3 and sST2 increase in ALD patients,which are related to disease severity in ALD patients.