OBJECTIVE To investigate the effects of total flavonoids from Carthamus tinctorius L. （TFCTL） on hepatic stellate cell （HSC） activation based on the microRNA （miRNA）-204/NUAK family SNF1-like kinase 1 （NUAK1）/Hippo signaling axis， thereby elucidating the potential mechanism underlying their antifibrotic effects. METHODS The HSC-T6 cells were divided into control group， model group， TFCTL low-concentration group （20 μg/mL）， TFCTL medium-concentration group （40 μg/mL）， and TFCTL high-concentration group （60 μg/mL）. Except for control group， the remaining groups were treated with 5 ng/mL of transforming growth factor-β to induce the activation of hepatic stellate cells， followed by the addition of corresponding drug solutions/culture medium and incubation for 24 hours. Cell apoptosis was assessed， the expression levels of α-smooth muscle actin （α-SMA）， type Ⅰ collagen （Collagen Ⅰ） and proteins associated with the Hippo/Yes-associated protein （YAP） pathway [YAP， large tumor suppressor kinase 1 （LATS1）， and mammalian STE20-like kinase 1 （MST1）] were detected. Additionally， cell transfection was used to investigate the activity of the miRNA-204/NUAK1/Hippo signaling axis at both the genetic and protein levels. RESULTS After intervention with TFCTL， the apoptosis rate of HSC-T6 cells and the protein expressions of MST1 （except for the TFCTL high-concentration group） and LATS1 were significantly increased （P＜0.05）， while the protein expressions of α-SMA， CollagenⅠ， and YAP （except for the TFCTL medium-concentration group） were significantly decreased （P＜0.05）. Further results from cell transfection experiments revealed that after transfection with miRNA-204 mimics， the mRNA it’s protein expressions of α-SMA， CollagenⅠ， NUAK1， and YAP in HSC-T6 cells were significantly decreased （P＜0.05）， while the mRNA and protein expressions of LATS1 and the mRNA expression of MST1 were significantly increased （P＜0.05）. Conversely， the results were opposite following transfection with miRNA-204 inhibitors. CONCLUSIONS TFCTL can exert anti-hepatic fibrosis effects by up-regulating the expression of miRNA-204， thereby down- regulating the expressions of NUAK1， inactivating the Hippo/YAP pathway， which in turn suppresses the activation of HSC and promotes their apoptosis.

Cancer-related cognitive impairment(CRCI)refers to cognitive dysfunction that occurs during or after chemotherapy in patients with cancer.However,the pathogenesis of CRCI remains unclear,and effective treatments are lacking in clinical practice.Based on the"toxin damaging brain collaterals"theory,this study systematically explores the traditional Chinese medicine(TCM)etiology,pathogenesis,and treatment strategies of CRCI.In TCM,CRCI is attributed to a"deficiency of brain collaterals"in patients with cancer.Chemotherapy drugs,as exogenous pathogens,invade the brain when the body is weakened and interact with endogenous phlegm,blood stasis,and turbid toxins.This creates a vicious cycle of"toxin,blood stasis,phlegm,deficiency"ultimately leading to the malnourishment of the sea of marrow and the dysfunction of the spiritual mechanism.Modern biological research aligns with this TCM perspective,as neurotoxicity,oxidative stress,and inflammatory responses associated with CRCI correspond to the TCM concepts of"toxin damaging brain collaterals."Pathological changes such as increased microvascular permeability and neuronal network disruption are similar to the TCM pathogenesis characteristics of"toxin and blood stasis blocking the collaterals"and"emptiness of the sea of marrow."Given the progressive nature of CRCI pathogenesis,TCM therapeutic principles focus on strengthening healthy qi,enhancing cognitive function,eliminating toxins,and unblocking collaterals.Acupuncture,moxibustion,and Daoyin serve as supplementary external treatments,forming a comprehensive treatment approach of"treating the viscera through the collaterals and regulating the body to nourish the spirit."This framework provides novel insights for TCM diagnosis and CRCI treatment.

Frailty and depressive disorders exhibit a high prevalence and comorbidity rate in the elderly population.Their coexistence significantly reduces patients'quality of life,increases the risk of disability and mortality,and substantially exacerbates the socioeconomic burden.Emerging evidence indicates a significant bidirectional causal relationship between frailty and depressive disorders.The underlying comorbid mechanisms may be related to elevated levels of pro-inflammatory cytokines such as C-reactive protein,neutrophils,and white blood cells.Grey matter volume reduces in specific brain regions including the bilateral thalamus and right precentral gyrus.And abnormal hormone secretion,such as cortisol,resulting from the overactivation of the hypothalamic-pituitary-adrenal axis.Exercise interventions demonstrate positive effects in preventing and managing both frailty and depressive disorders,indicating broad application prospects.However,the underlying mechanisms require further validation.In summary,the comorbidity of frailty and depressive disorders in the elderly requires greater attention.Current evidence supports exercise intervention as an effective therapeutic strategy for improving health outcomes in this population.

Objective:To explore the clinical characteristics of neonatal necrotizing enterocolitis（NEC）and analyze the risk factors for early-onset NEC.Methods:A total of 220 children with NEC admitted to the Department of Pediatrics，Tianjin Medical University General Hospital from January 1st，2018 to February 29th，2024 were retrospectively selected as the research objects. According to the time of onset，the early-onset group（ n=120）and the late-onset group（ n=100）were established，and the clinical characteristics of the two groups were compared. Another 150 cases of normal healthy newborns born in this hospital in the same period were selected as the control group，and the clinical data of the control group were collected. The clinical characteristics of the early-onset group and the control group were compared，and the risk factors of early-onset NEC were analyzed by multivariate Logistic regression. Results:Compared with the late-onset group，the early-onset group had fever［50.0%（60/120）vs. 40%（40/100）， χ2=7.333， P=0.007］，apnea［39.17%（47/120）vs. 28%（28/100）， χ2=7.568， P=0.006］，no rise in body temperature［56.67%（68/120）vs. 39%（39/100）， χ2=6.815， P=0.009］，abdominal distension［25%（30/120）vs. 40%（40/100）， χ2=13.200， P<0.001］，vomiting［30.83%（37/120）vs. 45%（45/100）， χ2=12.797， P<0.001］was significantly different（all P<0.05）；Multivariate Logistic regression analysis：weight<1 500 g（ OR=5.871，95% CI：3.153～9.673， P<0.001），gestational age<30 weeks（ OR=4.256，95% CI：2.641～7.896， P=0.007），hemodynamically significant patent ductus arteriosus（hs-PDA）（ OR=3.113，95% CI：1.865～5.133， P=0.033），severe anemia（ OR=3.057，95% CI：2.165～4.802， P=0.001），feeding intolerance（ OR=4.215，95% CI：1.579～10.802， P=0.005），amniotic fluid pollution（ OR=2.452，95% CI：1.579～3.111， P<0.001）were the independent risk factors for early-onset NEC（all P<0.05）. Conclusion:Weight<1 500 g，gestational age<30 weeks，hs-PDA，severe anemia，feeding intolerance，and amniotic fluid contamination are independent risk factors for early-onset NEC. In clinical practice，more attention should be paid to these factors for disease prevention，early identification，and timely intervention in newborns to reduce the occurrence of NEC.

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 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.

Cancer-related cognitive impairment(CRCI)refers to cognitive dysfunction that occurs during or after chemotherapy in patients with cancer.However,the pathogenesis of CRCI remains unclear,and effective treatments are lacking in clinical practice.Based on the"toxin damaging brain collaterals"theory,this study systematically explores the traditional Chinese medicine(TCM)etiology,pathogenesis,and treatment strategies of CRCI.In TCM,CRCI is attributed to a"deficiency of brain collaterals"in patients with cancer.Chemotherapy drugs,as exogenous pathogens,invade the brain when the body is weakened and interact with endogenous phlegm,blood stasis,and turbid toxins.This creates a vicious cycle of"toxin,blood stasis,phlegm,deficiency"ultimately leading to the malnourishment of the sea of marrow and the dysfunction of the spiritual mechanism.Modern biological research aligns with this TCM perspective,as neurotoxicity,oxidative stress,and inflammatory responses associated with CRCI correspond to the TCM concepts of"toxin damaging brain collaterals."Pathological changes such as increased microvascular permeability and neuronal network disruption are similar to the TCM pathogenesis characteristics of"toxin and blood stasis blocking the collaterals"and"emptiness of the sea of marrow."Given the progressive nature of CRCI pathogenesis,TCM therapeutic principles focus on strengthening healthy qi,enhancing cognitive function,eliminating toxins,and unblocking collaterals.Acupuncture,moxibustion,and Daoyin serve as supplementary external treatments,forming a comprehensive treatment approach of"treating the viscera through the collaterals and regulating the body to nourish the spirit."This framework provides novel insights for TCM diagnosis and CRCI treatment.

Frailty and depressive disorders exhibit a high prevalence and comorbidity rate in the elderly population.Their coexistence significantly reduces patients'quality of life,increases the risk of disability and mortality,and substantially exacerbates the socioeconomic burden.Emerging evidence indicates a significant bidirectional causal relationship between frailty and depressive disorders.The underlying comorbid mechanisms may be related to elevated levels of pro-inflammatory cytokines such as C-reactive protein,neutrophils,and white blood cells.Grey matter volume reduces in specific brain regions including the bilateral thalamus and right precentral gyrus.And abnormal hormone secretion,such as cortisol,resulting from the overactivation of the hypothalamic-pituitary-adrenal axis.Exercise interventions demonstrate positive effects in preventing and managing both frailty and depressive disorders,indicating broad application prospects.However,the underlying mechanisms require further validation.In summary,the comorbidity of frailty and depressive disorders in the elderly requires greater attention.Current evidence supports exercise intervention as an effective therapeutic strategy for improving health outcomes in this population.

Objective:To explore the impact of transcatheter edge-to-edge repair (TEER) devices on mitral valve regurgitant flow convergence post-procedure using computational fluid dynamics(CFD), and to seek solutions for accurately measuring effective regurgitant orifice area(EROA) after TEER.Methods:Multimodal fusion was conducted based on preoperative cardiac CT images and intraoperative three-dimensional transesophageal echocardiography(3DTEE) of 33 patients with mitral valve regurgitation undergoing TEER at Renmin Hospital of Wuhan University from January 2020 to August 2023. Using this data, CFD models of mitral valve regurgitation post-TEER, including with and without the TEER device, were constructed. The distance (D) from the midpoint of the mitral regurgitation orifice to the TEER device was measured. The proximal isovelocity surfice area(PISA) radius with and without the TEER device was measured, and the corresponding EROA1 and EROA2 based on this was calculated. The EROA correction factor CC=EROA2/EROA1 was calculated.Results:A total of 42 sets of CFD models with mild or greater residual mitral regurgitation, both with and without the TEER device, and 50 sets of PISA were obtained. Based on the relative position of PISA to the TEER device, four types of PISA were observed: Type 1: PISA away from the TEER device (D>R, 14 cases), with a CC of 0.93±0.07; Type 2: PISA adjacent to the TEER device (D

Replacement of the temporomandibular joint (RTJ) has undergone decades of technological improvements and is now an important treatment for end-stage temporomandibular joint (TMJ) disease. The main complications of RTJ include aseptic loosening, heterotopic ossification, postsurgical infection, hypersensitivity reaction, prosthesis loosening or malposition, nerve injury and severe bleeding. Improvement in clinical technique is now the key to resolving complications. In the future, improvements in prosthetic materials may be an important development for newer iterations. With the development and popularity of TMJ surgical techniques, prosthesis-related complications will increasingly come into clinical view. This article provides a systematic review of the complications of RTJ prosthesis replacement and the measures to deal with them, and looks forward to the direction of the development of this field from the perspective of reducing complications, so as to provide a reference for clinical work.